According to the Public Health Agency of Canada, there are about 71,000 HIV-positive people in Canada, 26% of whom do not know their HIV status. It is in this context that expanding opportunities for offering HIV testing should be seen as helpful because they can do the following:
- help uncover undiagnosed HIV infections
- reinforce education about safer sex and substance-using behaviours during the counselling that accompanies HIV testing
- inform newly diagnosed HIV-positive people about the benefits of early treatment and offer avenues for them to explore this
This latter point is important for at least the following reasons:
- Early initiation of potent combination HIV therapy (commonly called ART or HAART) helps to preserve the immune system and places the HIV-positive person on a path to better health. The impact of ART is so profound that a young adult who is diagnosed with HIV today in Canada and similar countries, who has minimal or no co-existing health conditions and who takes ART every day exactly as directed, is expected to live for several decades.
- The other benefit of early initiation of ART is that it can greatly reduce the amount of HIV in the blood (viral load) and genital fluids. This reduces the sexual infectiousness of ART users. If many HIV-positive people take ART, this has the potential to reduce the future spread of HIV in a large city or region.
Using ART to help improve a person’s health and to reduce his or her sexual infectiousness is called Treatment as Prevention (TasP). In Canada, HIV testing and TasP are being offered in British Columbia, where research suggests that this strategy is generally working by reducing the rate of new HIV infections, particularly among injection drug users and heterosexual people. A key part of the BC initiative is the offer of an HIV test.