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Canada: New trends in HIV/AIDS prevalence

Toronto has more HIV and AIDS cases than ever before, with an estimated one in 120 adults in the city now HIV-positive.

According to a latest report released this Monday, Toronto has more HIV and AIDS cases than ever before, with an estimated one in 120 adults in the city now HIV-positive. In all of Ontario, the number of people living with HIV-AIDS grew by 31 per cent between 2003 and 2008 and that number continues to expand.

The report called, “Facing the Future Together” was released by Casey House to mark World AIDS Week. It says that the face of HIV and AIDS is changing dramatically, which could bring many challenges for the province's health care system. The report was written by Dr. Kevin Gough of St. Michael's Hospital in Toronto, and Stephanie Karapita, CEO of Casey House, a specialty HIV-AIDS hospital that offers home care and outreach programs.

The figures show that gay men continue to make up the largest group of people living with the infection. Additionally women, aboriginal people and newcomers to Canada are also being diagnosed, the report said.

There is also a phenomenon known as the “Greying of AIDS” which refers to the aging population and the impact it will have on health care. Half of the HIV-positive population in Ontario is expected to be older than 50 by 2015, the report said. As a result of advances in treatment, people living with HIV-AIDS are living longer, the report said. But there can be multiple health issues to deal with, as well as other challenges such as poverty, employment issues, isolation, homelessness and addictions.

“The good news is that HIV-AIDS is no longer a death sentence,” said Gough, who is director of infectious diseases at St. Michael's. “But we're seeing that as people age with HIV-AIDS, their health care needs frequently escalate and can become very disabling.”

In Toronto, two people are newly infected every day. And, on the flipside of the greying trend, the report also warns of increasing rates of infection for youths in Toronto. “More than 1,000 people are diagnosed with HIV each year in Ontario,” the report states. “Alarmingly, in Toronto, more than a quarter of these individuals are under the age of 30.”

The Greater Toronto Area remains the hot spot in Ontario, the report suggests. “Two-thirds of the HIV cases in Ontario are in the GTA so as you get more outside the GTA, fewer and fewer people have exposure to HIV,” said Karapita, explaining why some people may not be well-informed about HIV, or know an infected person.

Casey House, founded in Toronto in 1988, is introducing a new Day Health Program that will more than double its capacity to provide care for people living with HIV-AIDS.

According to the U.S. Centers for Disease Control estimates approximately 50,000 more people are infected with HIV each year, and African Americans are seven times more likely than white people to be among those newly infected. African Americans make up about 13 percent of the US population and account for nearly half of all new HIV infections. The epidemic afflicts everyone, young and old alike in black communities throughout the country.

“One in 16 black men and one in 13 black women will be infected with the virus,” says Sharon Arline Bradley, the health director of the N-double A-CP, a civil rights organization that traditionally focuses on racial equality and legal issues. Now it has an office on AIDS.

The causes of AIDS in black communities are the same as anywhere else, having unprotected sex and multiple sex partners, sharing IV drug needles and not getting medical help once infected.

At the National Institutes of Health, Dr. John Ruffin, oversees minority health issues. “There are people, for example, who do not have access to [health] care,” Ruffin says. “They don't have insurance. They don't have many of those things that are needed once they have contacted the disease.”

By Dr Ananya Mandal, MD