Study Reports HIV Prevalence Among Vancouver Sex Workers, IDUs, MSM

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs;  Women's Health / Gynecology
Article Date: 09 Mar 2009 - 1:00 PDT

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A recent study conducted by the British Columbia Centre for Excellence in HIV/AIDS found that 26% of Vancouver's up to 520 female commercial sex workers and 17% of the city's injection drug users are HIV-positive, the Vancouver Sun reports. The overall prevalence of the virus in Vancouver is about 1.21% -- six times the national average -- and the HIV prevalence among the city's estimated 20,000 men who have sex with men, including male sex workers, is estimated at 15%, the Sun reports. The study -- published in the Harm Reduction Journal -- is the first in Canada to estimate the per capita prevalence of HIV for high-risk groups. Researchers used software from the United Nations and the World Health Organization, in addition to 2006 Statistics Canada data and other sources such as population surveys, according to the Sun.

Study author Julio Montaner, president of the International AIDS Society and head of the division of HIV/AIDS at the University of British Columbia, said that drugs and sexual activity are the "preferred routes" for HIV transmission. According to Montaner, sex workers often are paid more for unprotected sex with clients. He added that it is difficult to know HIV/AIDS prevalence rates among the clients of female sex workers. Montaner said that researchers "don't have any way of accessing the [clients] to ask them those questions," adding that if clients are seen in clinics, "it's not like they volunteer" that they contracted HIV through unprotected sex with a sex worker. "They would be more likely to report that they got it through having casual sex, or with multiple partners," he said.

Montaner added, "We always knew we had a significant problem, because of factors like our benign climate causing people to drift here, being a port city, and having so much poverty and so many homeless people on the Downtown Eastside." He also said that there "should be public advisories everywhere" about the new data. Patricia Daly, chief medical health officer for Vancouver Coastal Health, said she had not read the report yet and could not say if a targeted public health campaign for those involved in the commercial sex industry is required. She said that commercial sex work is a "high-risk activity for all kinds of infections and, therefore, you need to practice safe sex." She added, "Our message has always been that you should assume sex trade workers are HIV-positive."

Some HIV/AIDS experts have suggested that the provincial government "seek out and treat" the people living with HIV who are not on medications, Montaner said. The Sun reports that an estimated 13,000 British Columbia residents are HIV-positive but that less than one-third are taking HIV medications. "We need an outreach program that brings treatment to the people, to make it more accessible," Montaner said, adding that if the number of people taking medications were around 7,500, the number of annual new HIV cases would be reduced by 300 to 400. The current system puts off treatment until the immune system cells deplete to a certain level, thus reducing the program's cost and delaying potential side effects of the medication, the Sun reports.

A strategy Montaner's group proposed would provide highly active antiretroviral therapy to HIV-positive people in the early stages of the virus so the chances of spreading it are diminished. Montaner said the government, health minister and premier "have been very supportive about this kind of progressive approach," but the current economic downturn has placed the approach in "a waiting mode" (Fayerman, Vancouver Sun, 3/5).

An abstract of the study is available online.

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