HIV/AIDS

Acquired Immune Deficiency Syndrome (AIDS) was first detected in Canada more than 30 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 continues to be a global health issue. According to the Joint United Nations Programme on HIV/AIDS, 34 million people were living with HIV worldwide in 2011.

While there is no cure for HIV/AIDS, the disease can be prevented.

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 body through blood, spinal fluid, semen, pre-ejaculate (pre-semen), vaginal fluids, or breast milk. As such, there are a limited number of ways that a person can transmit HIV.

The following activities are considered  high-risk for HIV infection transmission to occur:

• engaging in unprotected sexual intercourse (anal or vaginal)
• sharing sex toys that are used internally
• sharing needles or equipment for injecting drugs or steroids
• mother-to-child transmission during pregnancy, delivery, and breastfeeding.

HIV cannot be transmitted in the following ways:

• shaking hands or hugging
• coughing or sneezing
• using swimming pools or toilet seats
• sharing eating utensils or using water fountains
• mosquito and other insect bites
• animal bites

The following activities are considered low risk for HIV transmission to occur:

• Unprotected oral sex poses a lower risk for HIV transmission, but the  risk increases if the person performing oral sex has open sores or cuts in their mouth or throat, or has another sexually transmitted infection, such as chlamydia, gonorrhea, herpes, HPV, or syphilis.
• Kissing has no risk of HIV transmission unless blood is exchanged (when there are bleeding cuts, open sores, or ulcers present in the mouth).
• Reusing or sharing needles for tattooing, skin piercing, electrolysis, or acupuncture carries a low risk for HIV transmission but a high risk for the transmission of other blood-borne infections, such as  hepatitis B and hepatitis C.
• Exposure to blood and bodily fluids in an occupational setting (for example, in an emergency response or  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. It is estimated that, at the end of 2011, 25% of Canadians who were living with HIV did not know they were infected. If people aren't aware they have HIV, they may unknowingly infect others. 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, spinal fluid, semen, pre-ejaculate (pre-semen), vaginal fluids, and breast milk.

While there is no vaccine to protect against HIV, there are several steps a person can take to reduce the risk of contracting and transmitting the disease:

1. If you decide to have sex, discuss HIV and other sexually transmitted infections with your sexual partner, and always practice safer sex.

   To practice safer sex:

   • Use a condom or a female condom consistently and correctly every time you have anal or vaginal sex
   • Use a 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. Oil-based lubricants are only safe to use with polyurethane condoms.
   • Don't share sex toys without properly cleaning them first
   • 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, practice safer injection:
   • Never share needles or injection equipment
   • Always use a new needle and new injection equipment (cookers, spoons, water, etc.) every time you inject.
3. If you are pregnant you should include HIV and STI testing as part of your prenatal screening. 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. 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. 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.

Treating and managing HIV/AIDS

If you have been diagnosed with HIV, the Canadian AIDS Treatment Information Exchange offers helpful advice and information 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.

HIV in Canada

It is estimated that approximately 71,300 people were living with HIV infection in Canada at the end of 2011. That's an 11.4 percent increase from 2008. Approximately 2,250 to 4,100 people were newly infected with HIV in 2011 in Canada.

Men who have sex with men (MSM) continue to be the group most affected by HIV/AIDS in Canada.

New HIV infections in Canada in 2011 are classified as follows:

• 46.6 percent were MSM
• 37.2 percent were heterosexuals
• 13.7 percent were injection drug users

At the end of 2011, women living with HIV accounted for approximately 23.3 percent of the national total.

Aboriginal peoples account for approximately 8.9 percent of all individuals living with HIV, and for 12.2 percent of those who were newly infected in 2011.