HIV/AIDS

It's Your Health

This article was produced in collaboration with the Public Health Agency of Canada.

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On this page:

• Issue
• Background
• HIV Infection
• Minimizing Your Risk
• Treating HIV/AIDS and Living with HIV/AIDS
• HIV in Canada
• The Government of Canada's Role
• Need More Info

Issue

 Acquired Immune Deficiency Syndrome (AIDS) was first detected in Canada more than 25 years ago. Since then, thousands of Canadians continue to become infected with the Human Immunodeficiency Virus (HIV) every year.

HIV is a virus that attacks the immune system, resulting in a chronic, progressive illness that leaves people vulnerable to infections. When the body can no longer fight infection, the disease has progressed to become AIDS.

AIDS is a deadly disease and continues to be a global health issue. According to the  Joint United Nations Programme on HIV/AIDS, in 2008, there were an estimated 2 million deaths worldwide due to AIDS. There is no cure for AIDS and currently no vaccine to prevent the HIV infection.

Background

Over a period of years, HIV can weaken the body's immune system to the point where it no longer can fight usually harmless bacterial and viral infections, parasites, fungi, and  cancers. These diseases are called "opportunistic infections", and their appearance for a person living with HIV may lead to the onset of AIDS, which is the last stage of the HIV infection. Advanced opportunistic infections can lead to death.

HIV Infection

 HIV is not transmitted through air, food, or water or through everyday social contact, such as shaking hands, sneezing, touching, and swimming. For a person to become infected with HIV, the virus must enter the bloodstream. As such, there are a limited number of ways that a person can transmit or become infected by HIV.

The following activities can place a person at high-risk for HIV infection:

• engaging in unprotected sexual intercourse (anal or vaginal);
• sharing sex toys;
• sharing needles or equipment for injecting drugs or steroids; and
• mother-to-child transmission during pregnancy, delivery, and breast-feeding.

HIV cannot be transmitted in the following ways:

• shaking hands, hugging;
• coughing, sneezing;
• giving blood;
• using swimming pools, toilet seats;
• sharing eating utensils, water fountains;
• mosquito and other insect bites;
• animal bites.

The following activities pose a low risk for contracting the HIV infection, but they still carry a risk. They pose a high risk when one of the partners has a pre-existing infection that resulted from a previous sexual experience or contact with infected blood.

• Unprotected oral sex poses a lower risk for HIV transmission, but a higher risk for causing other sexually transmitted infections, such as chlamydia, gonorrhea, herpes, genital warts (HPV, and syphilis.
• Kissing, in almost all circumstances, has no risk of HIV transmission. However, kissing with the exchange of blood (when there are bleeding cuts, open sores, or ulcers present in the mouth) can still carry a low risk for HIV transmission.
• Reusing or sharing needles for tattooing, skin piercing, electrolysis, or acupuncture carry a low risk for HIV transmission and a high risk for the transmission of other blood-borne infections, such as INK hepatitis B and hepatitis C.
• Exposure to blood and bodily fluids in an occupational setting (for example, in an emergency response or a medical environment) carries a low risk if infection-control precautions are followed. However, the transmission risk is higher in an occupational setting if precautions are not followed, or if the skin is punctured while being exposed to bodily fluids.

Even without treatment, it can take many years for a person infected with HIV to develop noticeable symptoms. That is why people can be unaware that they are infected with HIV. The Agency estimates that, at the end of 2008, 26% of the people in Canada who were living with HIV did not know they were infected. If people have HIV and do not know it, they may unknowingly infect others by not taking proper precautions during sex, or while injecting drugs or steroids. The only way to confirm if you are infected is through a blood test.

Minimizing Your Risk

 HIV is not an easy virus to transmit. It can only be passed from body to body through blood, semen, pre-ejaculate (pre-semen), vaginal fluids, and breast milk.

There are several steps a person can take to reduce the risk of HIV infection.

1. If you decide to have sex, discuss HIV and other  sexually transmitted infections with your sexual partner, and only have sex with a partner who agrees to have safe sex.

To practise safer sex:

• Use a latex or polyurethane condom or a female condom consistently and correctly whenever you have anal or vaginal sex;
• Use a latex or polyurethane condom or a dental dam consistently and correctly every time you have oral sex;
• Use only water-based lubricants with latex condoms, as oil-based lubricants like Vaseline, can weaken a latex condom and cause it to break;
• Don't share sex toys without properly cleaning them first; and
• Refrain from kissing when there is the possibility of blood exchange via bleeding cuts, open sores, or ulcers in the mouth.

2. If you are injecting drugs or steroids, practise safer injection:

• Never share needles or injection equipment; and
• Always use a new needle and new injection equipment (cookers, spoons, water, etc.) every time you inject.

3. If you are pregnant and concerned about HIV, talk to your doctor about being tested. Early treatment with medication can prevent the transmission of HIV from a mother to her baby.

4. If you are getting a  tattoo, body piercing, electrolysis, or acupuncture, ensure these activities are only carried out by professionals who follow universal infection-control precautions similar to those used in hospitals (see Need More Info below for information on  universal infection-control precautions). The law requires that all needles used in these procedures are used only once and are disposed of after use.

5. If you are exposed to bodily fluids in an occupational setting, follow applicable health and safety guidelines and universal infection-control precautions (see Need More Info below for information on  universal infection-control precautions). If accidental exposure to these fluids occurs through a needle-stick or a sharp-object injury or through a skin puncture, follow organizational guidelines or, in the absence of guidelines, let the wound bleed freely and go to a hospital emergency room as soon as possible.

Remember, if you have engaged in risky behaviour, get an HIV test.

Treating HIV/AIDS and Living with HIV/AIDS

Receiving a positive diagnosis for HIV infection changes your life forever. If you have recently been diagnosed with HIV, the  the Canadian AIDS Treatment Information Exchange website (listed in the Need More Info section below) this site offers helpful advice, information, and recommendations for people living with HIV/AIDS.

There is no cure for the HIV infection. Treatments, known as antiretrovirals, only suppress the virus replication in the body and disrupt the action of the virus. Advances in treatment have helped prolong the lives and improve the quality of life of people living with HIV/AIDS. However, antiretrovirals are not a cure. If treatment is discontinued, the virus becomes active again. Therefore, a person on antiretrovirals must take them for life.

Like all medications, HIV drugs can cause side effects. In most cases, the side effects are mild, like a headache or an upset stomach. In some cases, more serious side effects can happen, such as   liver damage, heart disease or a severe skin rash. There may also be long-term side effects we don't know about yet. Many of the HIV drugs have not been on the market long enough for all the possible long-term effects to have been discovered. Some drug treatments for HIV also fail because some new strains of the virus have developed drug resistance.

The bottom line is that HIV/AIDS is still a deadly disease. Prevention is the only answer.

HIV in Canada

 The Public Health Agency of Canada (PHAC) estimates that approximately 65,000 people were living with HIV infection in Canada at the end of 2008--a 14% increase from 2005. PHAC also estimates that in Canada, in 2008, there were from2,300 to 4,300 new HIV infections.

According to  Summary: Estimates of HIV Prevalence and Incidence in Canada, 2008, men who have sex with men continue to be the group most affected by HIV/AIDS in Canada. Estimates were classified according to the following exposure categories for new infections:

• 44% were men who have sex with men;
• 17% were people who use injection drugs;
• 3% were men who have sex with men and use injection drugs;
• 36% were heterosexuals.

At the end of 2008, women living with HIV accounted for approximately 22% of the national total. Aboriginal peoples account for a disproportionately high percentage of the individuals living with HIV infection in Canada. Although Aboriginal peoples represented only 3.8% of the Canadian population in the 2006 census, they accounted for approximately 7.4% of individuals living with HIV and for 12.5% of those who were newly infected.

Similarly, people from countries where  HIV is endemic (mainly countries of sub-Saharan Africa and the Caribbean) also represent a disproportionate percentage of the total number of HIV infections in Canada. In 2008, individuals who originated from a country where HIV is endemic accounted for 16% of estimated new infections in Canada, an infection rate of almost 8.5 times higher than among other Canadians.

The Government of Canada's Role

 The Federal Initiative to Address HIV/AIDS in Canada is a key element of the Government of Canada's long-term, comprehensive approach to HIV/AIDS. The Federal Initiative provides funding for prevention and support programs reaching key populations, as well as research, surveillance, public awareness, and evaluation. Working in partnership with Health Canada, the  Canadian Institutes of Health Research, and  Correctional Service of Canada, the  Public Health Agency of Canada serves as the focal point for federal expertise in HIV/AIDS.

The goals of the Federal Initiative are as follows:

• to prevent the acquisition and transmission of new infections;
• to slow the progression of the disease and improve quality of life;
• to reduce the social and economic impact of HIV/AIDS; and
• to contribute to the global effort to reduce the spread of HIV and mitigate the impact of the disease.

Canada also recognizes the importance of investing in the development of new HIV-prevention technologies. In February 2007, Prime Minister Harper announced a commitment to the  Canadian HIV Vaccine Initiative (CHVI), an effort funded by the  Government of Canada and the  Bill & Melinda Gates Foundation. The CHVI will contribute to international efforts to develop a safe, effective, affordable, and globally accessible HIV vaccine.

Need More Info?

For more information on preventing HIV or taking an HIV test, you can contact:

• your local public health unit
• in Quebec, a CLSC (Local Community Service Centre)
• your local sexual health or family planning clinic
• a testing clinic
• your local AIDS service organization
• your doctor or primary health care provider
• your  Canadian Aids Society - HIV hotline and Support

For information on issues relating to the disclosure of HIV-positive status when engaging in risk activities, view:

•  The Canadian HIV/AIDS Legal Network website
•  The Canadian AIDS Treatment Information Exchange website
• You may also choose to seek formal legal advice by consulting a lawyer.
• For information on universal infection-control precautions, consult the Public Health Agency of Canada document  Preventing the Transmission of Bloodborne Pathogens in Health Care and Public Service Settings
• If you are travelling and concerned about HIV/AIDS, consult  Well On Your Way: A Canadian's Guide to Healthy Travel Abroad

For general information on HIV/AIDS, consult:

• The Public Health Agency's (PHAC)  HIV/AIDs web section
• Health Canada's HIV/AIDs web section
•  The Canadian AIDS Treatment Information Exchange's website
• For information on the  Government of Canada's domestic response to HIV/AIDS, visit PHAC's website
• For information on the  Government of Canada's international response to HIV/AIDS, consult the Canadian International Development Agency's website

The following organizations are involved in the global response to HIV/AIDS:

•  Joint United Nations Programme on HIV/AIDS (UNAIDS)
•  International Council of AIDS Service Organizations (ICASO)
•  World Health Organization (WHO) - HIV/AIDS Programme
• For additional articles on health and safety issues go to the It's Your Health web section

You can also call toll-free at 1-866-225-0709 or TTY at 1-800-267-1245*

Updated: November 2010
Original: December 2003
©Her Majesty the Queen in Right of Canada, represented by the Minister of Health, 2010