Vancouver HIV/AIDS
Care Co-ordinating Committee
Public Sections
Documents: Environment Report 1999-2002
This is a companion document to the Strategic Plan and a work in progress; this version March 31, 2000
CURRENT EPIDEMIOLOGY
The World Health Organization estimated that the number of adults and children living with HIV worldwide was 33.4 million at the end of 1998. In North America, 890,000 adults and children, or 2.6% of the global total, were living with HIV/AIDS as of December 31,1998.
It was estimated that there were 6 million new infections and 2.5 million AIDS deaths in 1998 worldwide. More than 95% of the new infections were estimated to have occurred in developing countries. These countries have experienced 95% of all deaths to date from AIDS, largely among young adults who would normally be in their peak productive and reproductive years. Since the start of the epidemic nearly 20 years ago, HIV has infected more than 47 million people and caused the death of nearly 14 million adults and children.
Estimates of new AIDS diagnoses in Canada and British Columbia look like this:
| CANADA | BC | |
| 1994 | 1698 | 291 |
| 1995 | 1551 | 257 |
| 1996 | 1000 | 155 |
| 1997 | 498 | 113 |
| 1998 | 279 | 101 |
The British Columbia Centre for Disease Control (BCCDC) estimated that as of the end of 1998 the number of people ever infected with HIV in British Columbia, including those who have died, was between 9,500 and 10,000.
The British Columbia Centre for Excellence in HIV/AIDS reports
that while the number of AIDS cases has declined dramatically due
to availability of effective antiretroviral therapy, the number
of people with symptomatic HIV will continue to increase and
place significant demands on health care and social service
systems. It is therefore appropriate to use the number and rate
of people testing newly positive for HIV as a means of tracking
the epidemic.
Some of the recent trends in HIV infection reported by the BCCDC include:
MSM and IDUs
Towards the end of 1997, there was a rapid drop in the number of injection drug users (IDUs) testing newly positive for HIV. It seems likely that this number may actually fall below the number of men who have sex with men (MSM) testing newly positive over the course of 1998. This decline is felt to be consistent with epidemic saturation, rather than a triumph of preventive programs.
Aboriginal People
Aboriginal people continue to make up a significant proportion of people testing newly positive for HIV. There has been no major change within this trend, though it must be emphasized that aboriginal women carry a greater burden than aboriginal men with respect to issues of HIV/AIDS.
Women
There was a slight decline in 1998 in the number of women testing positive for the first time. This is probably simply a reflection of the decline in overall numbers of injection drug users (one-third of whom are women) who are testing newly positive.
Infants
Also noted is a substantial drop in the number of infants born to HIV-positive women who are themselves infected, as a result of antiretroviral treatment during pregnancy, labour and post-partem.
Transgendered Persons
Data on transgendered persons are best obtained through specific research projects in the transgendered communities. BCCDC information from laboratory-based HIV surveillance tends to miss transgendered persons as an identifiable group because gender is identified by physicians rather than by patients themselves.
Sex Trade Workers
A significant number of sex trade workers have continued to test positive, most of them also injection drug users. Another important phenomenon observed during 1998 is that of eight heterosexual men testing newly positive who are believed to have contracted the virus through contact with sex trade workers. It is BCCDC’s hypothesis that the epidemic of infectious syphilis among sex trade workers in the Downtown Eastside may be facilitating heterosexual transmission of HIV.
Youth
No age group is seeing a clear increase in the rate of testing and this includes those between the ages of 15 to 19. However, there must always be a question as to how well voluntary testing samples individuals in this age group.
