HIV/AIDS is a global threat that knows no boundaries. An estimated 33.3 million people worldwide are living with HIV, 15.9 million of whom are women. There were 2.6 million people estimated to be newly infected in 2009, 400,000 of them children. In 2009 alone, AIDS claimed an estimated 1.8 million lives.
In Canada, the impact of HIV is also increasing with more people living with HIV infection (prevalent infections). At the end of 2008, an estimated 65,000 people were living with HIV infection (including AIDS), representing an increase of about 14 per cent from 2005.
Research is critical to combating the HIV epidemic. The Federal Initiative to Address HIV/AIDS in Canada funds a broad range of research and surveillance activities that are increasing our understanding of the social, economic, biomedical, clinical, health and public policy aspects of HIV/AIDS. The Canadian HIV Vaccine Initiative contributes to domestic and international research and research capacity focused on the discovery of HIV vaccines and related issues.
The Canadian Institutes of Health Research (CIHR) - the Government of Canada's agency for health research - sets priorities for and administers the Federal Initiative's extramural research program. Within CIHR, the Institute of Infection and Immunity (CIHR-III) is the lead institute for HIV/AIDS research.
The CIHR HIV/AIDS Research Initiative funds meritorious research grants and research personnel awards across the entire spectrum of HIV/AIDS research, including biomedical research; clinical research; research respecting health systems and services; and research into the health of populations, societal and cultural dimensions of health, and environmental influences on health.
In addition to being eligible for the dedicated funding and programs under the Federal Initiative, HIV/AIDS-related proposals are eligible to apply to all of CIHR's regular research funding and personnel award programs.
There are four funding streams for the Federal Initiative support for the CIHR HIV/AIDS Research Initiative. The Biomedical/Clinical and Health Services/Population Health streams support HIV/AIDS research grants and awards in these pillars of health research. The HIV/AIDS Community-Based Research Program supports knowledge development and capacity building initiatives of relevance to communities engaged in the fight against HIV/AIDS. The Community-Based Research Program has two streams -- the Aboriginal stream and the general (non-Aboriginal) stream. CIHR also provides core funding from the Federal Initiative to support the work of the Canadian HIV Trials Network.
CIHR also plays a leadership role, in collaboration with CIDA, in delivering the Advancing Basic Science component of the Canadian HIV Vaccine Initiative, which aims to strengthen Canada’s contribution to research and research capacity focused on the discovery of HIV vaccines and on related social and behavioural issues. A key objective is to promote greater involvement and collaboration among researchers in Canada and in low- and middle-income countries.
Under the Federal Initiative, CIHR is responsible for identifying Priorities for Extramural HIV/AIDS Research. These priorities were developed by the CIHR HIV/AIDS Research Advisory Committee in consultation with other stakeholders, and will be used to guide the development of CIHR's strategic research funding opportunities in HIV/AIDS. CIHR is also working with the Public Health Agency of Canada to develop a comprehensive national research plan that includes all domains of research. This national HIV/AIDS Research Plan will bring together many funders of HIV/AIDS research in Canada, research programs conducted in federal, provincial and territorial laboratories, users of research knowledge, and other stakeholders in developing a shared vision for the future of HIV/AIDS research in Canada.
New programs are also being developed to enhance research on new prevention technologies, such as vaccines and microbicides, and increased attention will be focused on research that provides evidence for population specific approaches.
For example, Towards a World Without AIDS: The Canadian HIV Vaccines Plan was published in July 2006. Developed by a multi-sectoral steering committee, the document outlined a vision for Canada’s future involvement in the global effort to develop HIV vaccines and deliver them to all people who need them. Building upon Towards a World Without AIDS and on Canada’s ongoing commitment to a comprehensive and long-term approach in the global fight against HIV/AIDS, the Government of Canada announced the Canadian HIV Vaccine Initiative in February 2007.
HIV/AIDS Epi Updates – published every few years by the Centre for Communicable Diseases and Infection Control (CCDIC) Surveillance and Epidemiology Division - summarize recent trends and developments related to the HIV epidemic in Canada. HIV/AIDS Epi Updates are based on non-nominal confidential data provided to CCDIC by provincial/territorial HIV/AIDS coordinators, public health units, laboratories, health care providers and reporting physicians. Topics include national HIV estimates, HIV testing and reporting, population-specific analyses and risk behaviours.
Semi-annual surveillance reports published by the Surveillance and Epidemiology Division provide a snapshot of persons who have been diagnosed with HIV and AIDS in Canada. These reports include a summary of main findings, followed by a more detailed breakdown of positive HIV test reports, the HIV status of infants exposed perinatally to HIV infection, reported AIDS diagnoses in Canada, mortality due to HIV/AIDS in Canada, and international statistics on HIV and AIDS. With the exception of the international statistics section, the reports are based on non-nominal confidential data provided to the Centre for Infectious Disease Prevention and Control (CCDIC) by provincial/territorial HIV/AIDS coordinators, public health units, laboratories, health care providers and reporting physicians.
The Surveillance and Epidemiology Division also collaborates with the National HIV and Retrovirology Laboratories and participating provincial partners to conduct national HIV strain and drug resistance surveillance. PHAC's National HIV and Retrovirology Laboratories provide a comprehensive range of laboratory science services and expertise, including surveillance research and quality assurance, to laboratories in Canada and abroad.
The Surveillance and Epidemiology Division is responsible for routine and enhanced sexually transmitted infections (STI) and community-acquired hepatitis C surveillance, epidemiology and research. Routine surveillance of STI encompasses three nationally notifiable bacterial infections: chlamydia, gonorrhea and infectious syphilis. The Surveillance and Epidemiology Division contributes to broader initiatives within the Centre for Infectious Disease Prevention and Control for enhanced surveillance of populations vulnerable to sexually-transmitted and blood-borne infections and enhanced surveillance in specific populations/infections.
For more information on STIs, visit Sexual Health and Sexually Transmitted Infections.
Tuberculosis in Canada, an annual publication produced by the Surveillance and Epidemiology Division, reports new active and relapsed tuberculosis cases that come to PHAC through the Canadian Tuberculosis Reporting System (CTBRS) from the ten provinces and three territories and contains information on HIV co-infection.
For more information on TB, visit Tuberculosis Prevention and Control.
Hepatitis B and Hepatitis C
HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) are blood-borne viruses and share transmission routes among at-risk populations, specifically injection drug use and remote blood transfusions before modern donor screening for these pathogens, making co-infection common. Morbidity and mortality from infection with HCV in HIV-infected patients are increasing and have become a major challenge in the management of such patients. Find out more about Hepatitis B and Hepatitis C.
The Surveillance and Epidemiology Division, along with participating sentinel surveillance sites from across Canada and the National Microbiology Laboratory, support the Enhanced Hepatitis Strain Surveillance System.