People not as concerned about contracting HIV
In the early 1980s, people were so paranoid about getting AIDS they wouldn't get into a taxi if the driver was Haitian.
"The levels of stupidity were mind-boggling," Dr. Mark Wainberg, told the North-eastern Opening Doors HIV/AIDS Conference on Tuesday.
Since then, we've gone from a deathly fear of HIV/AIDS, to almost a blase acceptance of the risks run by engaging in unprotected sex thanks to medical breakthroughs in the treatment of the human immunodeficiency virus.
"HIV infection rates are actually increasing because of behavioural disinhibition. People are not that concerned about getting HIV because they know the drugs work," Wainberg said. "They don't always work. That's what we need to get across. Having HIV is a terrible thing. It's not a panacea. It's a bad thing to have. Don't get HIVinfected."
Wainberg, a professor in the department of Microbiology and Immunology, Pediatrics and Medicine at McGill University, helped found the Canadian Association for HIV Research.
He was the first scientist in Canada to work directly on HIV and among the first in the world to identify the problem of HIV drug resistance.
On Tuesday, he addressed a crowd of about 100 as the keynote speaker at the 17th annual conference, which brings together people infected and affected with HIV, as well as students, nurses and healthcare providers from across Northern Ontario.
The conference, which began Monday and finishes today, covers a wide range of topics, from criminalization of HIV to the depression it may cause to needle exchange work being done to prevent the spread of the disease.
While HIV has gone from being a death sentence to a "chronic manageable condition" thanks to new drug therapies, particularly protease inhibitors, there are still big problems associated with contracting the virus: namely drug resistant strains of the virus, drug toxicities and the long-term health consequences such as heart disease and various cancers.
"The drugs work but don't work perfectly," Wainberg said.
The higher rates of cancers, such as lung (in non-smokers) and lymphomas, could be attributable to the fact that the virus attacks the immune system, he said. While 10 years ago, people held off on starting on drug therapy, now the emerging consensus is to start it immediately before the virus can gain a foothold, he said.
"Gay men still represent the highest majority of new cases in Canada with aboriginal women a close second," said Wainberg.
One study in Quebec using 600 primarily gay men volunteers, analyzed the virus in the newly infected (it mutates and is unrecognizable from its original form after about six months).
The study discovered up to half of the people who tested positive for virus likely got it from someone newly infected.
This finding shows the need for people to get diagnosed as quickly as possible, he said. One new measure that may help was the creation last fall of an anonymous testing clinic in Montreal's gay village that uses a one-minute test rather than the old one that took three weeks to get a result.
"During three weeks of waiting, people who don't know they're positive might be engaging in high-risk behaviour in transmitting the virus," he explained. "People will modify the risk (of spread HIV) if they know. They're less willing if they suspect."
Sudbury has offered this anonymous testing service using the one-minute test through the Sudbury and District Health Unit for the past two years.
A new clinical trial, being conducted in several countries, plans to put volunteers, who engage in risky behaviours on the anti-viral drugs as a way of preventing people from getting infecting.
So far, there's little immediate hope in attaining the "holy grail" of HIV prevention -- a vaccine.
Of concern outside our borders, is the use of "lousy, toxic drugs" in developing nations to fight HIV.
For instance, one that would never be prescribed in Canada causes disfigurement such as sunken cheeks. People tend to go off the drug so they won't suffer the stigma of having AIDS and be targeted by their neighbours.
However, if they go off their drug therapies, often they develop resistance to these drugs and can't return to a program.