There have been an alarming increase in the number of cases of HIV-infected patients in Canada, especially in places like Manitoba, Ottawa and Saskatchewan. Located in the Western province of Canada, Saskatchewan continues to lead the country in new cases HIV, with rates twice the national average.
SHARE, the Saskatchewan HIV/AIDS Research Endeavour, is working to establish a research agenda and learn from successes in other provinces.
AdvertisementThe number of AIDS cases in British Columbia between 1994 and 2013 had an 88% decrease. AIDS-related deaths decreased by 83%. Mother-to-child transmission of HIV has been virtually eliminated in B.C. and there was a two-third reduction in overall HIV transmission.
'Treatment as Prevention' strategy was the reason for the drastic reduction in the number of HIV cases. The four-year HIV strategy provided widespread access to HIV testing, care, support and treatment; it was the reason for the decline in HIV cases. Free antiretroviral (ART) therapy, political commitment, programmatic focus, ongoing innovation coupled with monitoring and evaluation, and appropriate resourcing were the keys to the strategy's success.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has formally proposed a new and ambitious 90-90-90 target for 2020. The new target calls for diagnosis of 90% of people living with HIV worldwide, 90% of them to be on ART, and 90% receiving ART to have sustained viral suppression by 2020. Meeting the 90-90-90 target would maximize the effectiveness of existing tools in order to virtually eliminate progression to AIDS, premature death and HIV transmission by 2020, and thereby transform the HIV/AIDS pandemic into a low-level sporadic endemic by 2030.
China, parts of the US, Brazil, South Africa, Argentina, Panama, France and Switzerland among a growing number of countries have formally endorsed the 90-90-90 target. Canada, unfortunately, has yet to embrace the target.
HIV prevention and care, which address the social determinants of health such as housing, employment, poverty, and access to health care, should be considered. National Chief Perry Bellegarde of the Assembly of First Nations has specifically called for addressing poverty and other upstream factors among indigenous people in Saskatchewan. Targeting vulnerable population of injection drug users led to the virtual elimination of the spread of HIV in B.C. and the same would be replicated in Saskatchewan.