Canada's Report on HIV/AIDS - 1999

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Tireless Efforts Meet The Challenge Of HIV

• prevention
• surveillance and epidemiological monitoring
• research

Prevention

One of the greatest challenges to preventing the spread of HIV has been dispelling the early myths and misconceptions that circulated following identification of the epidemic in the early 1980s. Fear and prejudice often dominated public concern. Since then, a research-driven approach to prevention has been adopted. Many initiatives of the Strategy now work to support accurate and useful evidence-based decision making, both in strategic policy direction and on the front lines.

HIV prevention initiatives are being positioned more clearly within the context of sexual health and social environments. For example, increased risk of HIV can exist for some women who have experienced sexual violence. Using a guide for counsellors working with women who are survivors of sexual violence, an urban and rural project training counsellors on HIV and sexual violence is under way. Brochures are being developed as a resource for women and are being produced in French and English and adapted for the Haitian, Asian, Inuit, First Nations and Métis populations. Counsellors are using the guide and brochures to support survivors of sexual violence in their effort to make life changes and build self-esteem.

Women are among those experiencing the fastest growing rates of HIV infection. Successful HIV prevention programs must take into account factors that determine health. Queen's University School of Nursing is sponsoring a collaborative project designed in part to help women with children who use injection drugs to improve their health and their quality of life, to reduce the harms of drug use and to reduce the risk of HIV infection. Among adult females, injection drug use accounts for almost 40% of diagnosed AIDS cases, according to 1998 reports. More broadly, the Canadian AIDS Society has initiated the planning for the first National Canadian Conference on Women and HIV/AIDS, to be held in the spring of 2000.

Prevention programs must continue to be based on current knowledge. Applied HIV prevention research is needed to ensure that programs are effective. Health Canada is working with the Council of Ministers of Education of Canada and a consortium of researchers to undertake a study on youth sexual health and HIV prevention. The study will focus on the impact of factors such as income, social environment and support, health services and practices in relation to Canadian youth and their sexual health. Results of the study will help develop educational and social programs designed to prevent the spread of HIV among youth.

A recently revised resource of the Canadian AIDS Society (CAS) on safe sex guidelines for educators and counsellors entitled "HIV Transmission: Risk Reduction Guidelines" will be complemented by an information pamphlet for students. CAS will also prepare a workshop model to be used as a follow-up to this project.

Keeping youth concerned and involved is crucial to prevention efforts. As part of the National AIDS Awareness and National Youth Awareness campaigns this year, public service announcements, posters, rave cards, brochures and other resource guides were developed and distributed to the public. An appearance by the Minister of Health on MuchMusic for World AIDS Day 1999 reinforced the focus on HIV prevention and youth. Various conferences and workshops for youth have also provided a forum for information exchange and idea generation.

With the identification of policy gaps and barriers, systemic changes to advance HIV prevention efforts among gay men are under way. For example, one cannot reduce the reality of gay men's lives to a series of defined practices, behaviours or risk-taking activities. Some behaviour-based prevention models, developed within the "HIV/AIDS crisis mentality" found in many gay communities, focused narrowly on the need to use condoms to stay safe. Today, community-based programming is being shaped by policy directions and models developed by gay men that encompass the totality of gay men's lives. These initiatives will better reflect the complex, fluid relationship between gay lives, identities and environments. HIV prevention efforts will become more fully integrated into gay men's health strategies.

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