Fewer people worldwide are getting HIV — so why are rates going up in Canada?

The fight against HIV/AIDS has seen significant progress globally, with fewer people being diagnosed and dying from the virus. However, a new study published in The Lancet HIV medical journal reveals that the progress is uneven, and only a few countries are on track to meet the United Nations’ goal of ending HIV as a public health threat by 2030.

Between 2010 and 2021, new HIV infections decreased by almost 22% worldwide, with much of the decline driven by advancements in sub-Saharan Africa. Despite this positive trend, Canada is experiencing a concerning rise in new HIV diagnoses. In 2023, there were 2,434 new cases reported, marking a 35% increase from the previous year. This is a stark contrast to the declining trend observed between 2016 and 2020. However, despite the increase in infections, fewer people are dying from HIV in Canada.

Globally, HIV-related deaths have also seen a significant decline of nearly 40% between 2010 and 2021, largely attributed to the widespread availability of antiretroviral treatment. This medication, which stops the virus from replicating, has proven to be effective in reducing mortality rates. According to the authors of the Lancet report, sustained focus is required to maintain and further improve these positive outcomes.

Sub-Saharan Africa has witnessed the most dramatic improvements in both diagnoses and deaths related to HIV/AIDS. However, the region still faces challenges, with high mortality rates and limited access to HIV testing. Dr. Gertrude Komoyo from Doctors Without Borders highlighted the issue of late testing and the lack of free HIV testing services in the Central African Republic.

In high-income countries like Canada, the rise in new HIV infections is attributed to an increase in high-risk populations, including men who have sex with men and individuals who inject drugs. Dr. Rejean Thomas, who has been treating HIV patients since the 1980s, emphasized the importance of prevention and education in combating the spread of the virus.

Prevention methods such as self-testing and pre-exposure prophylaxis (PrEP) have proven effective in lowering the risk of contracting HIV. Injectable HIV prevention drugs are also being introduced in some regions, offering a promising alternative to daily oral medications. However, concerns about access and affordability remain key challenges in achieving global HIV elimination goals.

In Canada, provinces like Saskatchewan and Manitoba are facing higher rates of new HIV diagnoses, emphasizing the need for targeted interventions and harm reduction programs. Community workers like Vidya Reddy are advocating for increased access to sterile injection equipment and culturally sensitive solutions to address barriers to HIV testing and care.

Margaret Kisikaw Piyesis, CEO of the Canadian Aboriginal AIDS Network, stressed the importance of culturally sensitive approaches tailored to Indigenous communities. She called for increased government funding for programs that reflect Indigenous knowledge and values, highlighting the need for long-term sustainable solutions to combat HIV/AIDS.

As the fight against HIV/AIDS continues, it is crucial for governments and healthcare providers to prioritize prevention, education, and access to care. With sustained efforts and investments in innovative solutions, the goal of ending HIV as a public health threat by 2030 can become a reality.