Incidence of HIV on the rise

Southam Newspapers OTTAWA The incidence of HIV is on the
rise in Canada despite more than a decade of public education
campaigns aimed at halting spread of the disease.

A new federal report to be presented Friday at a national conference
on HIV and AIDS estimates that 3,000 to 5,000 Canadians became
infected with HIV last year, up from 2,500 to 3,000 new infections
annually between 1989 and 1994.

"Everybody hoped we wouldn't see this," Dr. Donald Sutherland,
director of the bureau of HIV/AIDS and sexually transmitted diseases
at the Laboratory Centre for Disease Control, said in an interview
Thursday.

According to the LCDC report, HIV is reemerging across the
country, with the majority of the increase appearing among injection
drug users and young gay men.

In fact, the rate of infection among IV drug users is rising so rapidly
that the National Task Force on HIVAIDS and Injection Drug Use
recommends heroin and cocaine be decriminalized and doctors be
allowed to prescribe narcotics to drug users to reduce the risk of
buying and using drugs on the street.

But Sutherland said there is evidence HIV infections are also rising
among non drugusing heterosexuals and aboriginal peoples. Another
report to be presented this weekend by federal researchers shows
rapidly rising rates of HIV infection among aboriginal women.

The disturbing new figures are tempering more positive reports that
the number of actual AIDS cases and deaths due to AIDS in Canada
appears to be falling dramatically. Improved HIV treatment is
delaying the onset of fullblown AIDS and helping people live longer,
so much so that researchers who have gathered in Ottawa this
weekend are beginning to talk about AIDS as a chronic disease and
not a death sentence.

According to the LCDC report, there was a 20percent drop in the
number of AIDS cases reported last year over 1995, and about 20
per cent fewer deaths. (The study cautions, however, that healthcare
workers may not be reporting all AIDS deaths because of "reporter
fatigue.")

But it's the growing prevalence of HIV in Canada that has experts
alarmed.

"This is a deadly disease, despite the new optimistic information about
treatment," said Sutherland, who is chairing a conference session
Friday on the changing demographics of HIV and AIDS in Canada.

HIV "is still a serious, longterm disease and we don't know whether
the new treatment effects are temporary or longterm," Sutherland
said. "And beyond that, it's a very expensive disease."

In fact, a new study by the Canadian Policy Research Networks
estimates that Canada has already spent more than $1 billion caring
for people living with HIV or AIDS. The future costs for these same
people will be an additional $2.1 billion to $3 billion.

That's because the price of treating one case of HIV infection with
today's expensive new combination drug therapies is estimated to be
between $131,000 and $178,000, compared to the lifetime cost of
$75,000 for the older treatments.

The indirect costs, such as future income loss, are estimated to be an
additional $30 billion, the study says.

"The bottom line is that this is all potentially preventable," said Dr.
Gary Garber, head of infectious diseases at the Ottawa General
Hospital and cochair of this year's conference. "We're talking about
the absolute basics of human behavior."

Yet despite the $83 million the Canadian Policy Research Network
estimates was spent in Canada last year on HIV and AIDS
prevention, "we have not been all that effective in modifying
behavior," Garber said.

As of April this year, 14,836 cases of AIDS had been reported in
Canada since the first case was noted in the early 1980s. Of those,
10,837 have died.

One of the most alarming increases in new infections is among
injection drug users. That group accounted for 25 per cent of all
AIDS cases last year, up from 6.5 per cent in 1990. The rising
infection rate is believed partly due to a shift from heroin to cocaine
among drug users. Cocaine is injected more frequently than heroin,
which increases the risk of infection.

The disease is also rising significantly among heterosexuals.
According to the LCDC report, heterosexual transmission accounted
for 2.2 per cent of all AIDS cases before 1990. Last year, it hit 9.2
per cent. Many of the new infections are in women.

And while the number of new AIDS cases is falling among
homosexual men in general, the incidence appears to be rising in
young gay men. Sutherland says young people are more apt to get
involved in risky behavior and still don't consider HIV a significant
threat.
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