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Toronto Star, June 19 2001
Thousands have HIV . . . without knowing it
Virus `spreading like wildfire' in major cities
Prithi Yelaja and Robert Faulkner
STAFF REPORTERS
An alarming 15,000 Canadians are infected with HIV but don't know it,
says a national physicians organization.
Doctors, who have long known a significant number of people have the
virus that causes AIDS but are undiagnosed, say the figure is worrisome
because these people may unknowingly infect others with the deadly
disease.
``We're concerned about these individuals . . . because we know that
early treatment can help extend their life and ensure that they do not
infect others, including their newborn children,'' said Dr. Donald
Gelhorn, president of the College of Family Physicians of Canada.
HIV infection is ``spreading like wildfire in cities like Montreal,
Toronto and Vancouver,'' particularly among intravenous drug users, said
Dr. Dominique Tessier, president-elect of the college.
Moreover, ``this devastating disease is slowly spreading into the
general population. Increasingly, those with no known risk factors,
including women, are being infected. Therefore, looking at the risk
factors is not enough to identify all those infected,'' she said.
Two events highlighting the battle against HIV/AIDS kicked off Gay Pride
week yesterday.
The college, which has more than 15,000 members, launched national
guidelines to assist family doctors in caring for HIV/AIDS patients,
while the AIDS Committee of Toronto (ACT) unveiled a bold campaign aimed
at increasing condom use.
The family practice guidelines offer advice on counselling, testing and
treatment, and are intended to reduce patient visits to specialists.
``The primer should help doctors to screen more appropriately and
hopefully identify those who do not suspect they are infected,'' said
Tessier.
Four thousand copies of the primer containing the guidelines have been
distributed to doctors across Canada.
``The role of the family physician has increased from what it was 15
years ago because of the new medications, new technologies and increased
lifespan for people with HIV/AIDS,'' Gelhorn said. ``This is no longer
an acute disease that will kill people within a few months. It's a
chronic disease that needs to be taken care of for many years.''
Tessier, a family physician at a downtown Montreal clinic who helped
develop the guidelines, said when she first started treating HIV/AIDS
patients in the early 1980s, two or three died every month. Now she
loses at most one patient a year.
As of December, 1999, 45,534 Canadians had been diagnosed with HIV and
16,913 had AIDS, according to Health Canada.
But while the college doctors noted the number of Canadian deaths from
AIDS dipped to 106 in 1999 from a high of 1,422 in 1995, ACT released a
study showing an upward trend of HIV infection among gay men.
There are 9,100 gay men living with HIV in Toronto, and only
three-quarters of them know they are infected, says a study led by Dr.
Liviana Calzavara, deputy director of the HIV studies unit at the
University of Toronto.
Last year, the incidence of HIV infection among gay men in Toronto was 7
per cent higher than in 1999 and 34 per cent higher than 1996.
Toronto's rate of new HIV incidence among gay men is several times
higher than cities like Montreal, which also has a high concentration of
HIV cases.
Part of the problem in Toronto is the lack of funding for education and
prevention programs specifically aimed at gay men, said Charles Roy,
ACT's executive director.
``Historically, men having sex with men have been the group most
affected by HIV/AIDS in Canada,'' said Roy.
Numerous theories abound as to why HIV is once again on the rise,
prompting the need for ACT's new Welcome to Condom Country campaign.
The $400,000 ad campaign features men on horses and encourages the
sexually active to ``ride safely.''
The ads will run in transit shelters, subways and in newspapers. The
campaign is set to go national in the fall with public service spots on
television.
The introduction of highly potent antiretroviral drugs in 1996 reduced
AIDS mortality rates and may have contributed to the feeling that
HIV/AIDS is not a life-threatening disease.
But ACT and the college say these new drugs are giving people a false
sense of security.
``AIDS is no longer associated with a death sentence immediately,'' said
Gelhorn. ``People feel it's less serious . . . because there are drugs
that can help them. What they don't realize is these drugs are not a
cure.''
Safe sex burnout and the desire for greater intimacy between sexual
partners may also contribute to the decreasing use of condoms.
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