One in five Canadians with HIV unaware of their condition

To help people know for sure, the federal government is taking steps to improve access to tests

One in five Canadians with HIV unaware of their condition
According to the World Health Organization (WHO), almost two million people were newly infected with HIV in 2016. Among those at risk are young women and girls, sex workers, prisoners, gay men, and injecting drug users — and it’s not just in Africa.

“It remains a problem domestically here in Canada,” Paul Sandstrom, director of the National HIV and Retrovirology Laboratory in Winnipeg, told CBC News. “There are still populations that are more vulnerable … people who are undiagnosed.”

It’s estimated that one out of every five infected Canadians don’t even know they’re infected. Part of the problem is an ongoing stigma; many assume that people who get tested engage in undesirable behaviours. It will take more than an ordinary public-information campaign to solve the problem — and that’s what the Public Health Agency of Canada (PHAC) wants to do.

“[It's] trying to normalize the testing to some extent so all individuals are not only provided with the opportunity to be tested, but [also accept] the testing because it's not necessarily associated with a particular behaviour,” Sandstrom said.

As part of PHAC’s efforts, the agency trains people in remote communities to collect blood using a non-invasive technique. Known as dry blood spot collection, it involves pricking a fingertip and dabbing blood into five circles printed on a card. The blood is allowed to dry, then is mailed to PHAC’s state-of-the-art Level 2 laboratory.

“You do not have to be a nurse to use this technique, and you do not have to be trained in taking blood through a needle,” said John Kim, head of the National HIV Reference Services Lab.

Another key element in the protocol, which is also being taught in First Nations communities, is sensitivity to the patient. “Even if there is a second person involved in collecting the blood, no one knows the test results,” Kim said. “Especially in a remote area where everyone knows everyone else, stigma can be a huge factor in not wanting to get tested.”

To help people who need faster results, particularly those who are transitory or homeless, PHAC researchers are also piloting a compact testing machine. Not much bigger than a toaster, it can be sent to clinics, needle-exchange sites, or safe-injection venues in big cities as well as remote communities.

“Our goal is to really take the machines and diagnostics out of the lab and move it into the populations that are affected by HIV the most," said Blake Ball, head of the national lab for HIV immunology. “We have a couple of pilot projects about to start in the next couple of months, engaging with communities to find out how they will work in the Canadian setting.”

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