Women and HIV in Canada - How are women becoming infected?

How are women becoming infected with HIV?

Heterosexual sex (unprotected vaginal intercourse) is the way in which the majority of women living with HIV in Canada were infected with HIV, followed by women who injected drugs and lastly, through blood and blood products - before the blood supply was routinely screened for HIV .
The Risks for HIV Infection:

Although statistics are useful in monitoring the rates of HIV transmission and prevalence among women in Canada, they do not tell us the whole story. All women who engage in unprotected vaginal or anal sex or use unclean needles for drug use, piercing or tattooing are at risk for HIV transmission. However, some women in our community are at increased risk because of social, economic and political factors such as their immigration status, poverty, homelessness and gender imbalance (the power differences between women and men).
HIV and Pregnancy

Unprotected sex (sex without the use of a latex condom), or sex during which the condom breaks or tears may lead to pregnancy. In addition, a woman is potentially exposed to HIV infected semen. Despite this reality, many pregnant women or women with children do not think of their risks for HIV infection.

In 1998, the Ontario Ministry of Health and Long-Term Care implemented a policy that all pregnant women and women considering pregnancy must be offered HIV testing as part of their routine prenatal (before birth) care. As with all tests, the universal prenatal screening program requires informed consent in which the health care provider explains the test, and options the woman can choose (including the option of being tested at an anonymous testing site). The HIV test can be done at the same time as other routine prenatal tests, or if a woman prefers, she can be tested at one of Ontario's anonymous HIV testing sites where identifying information is not collected and comprehensive, confidential counselling is guaranteed. Since adding HIV testing to the screening program, the provincial rate of prenatal HIV testing of pregnant women has increased to over 90 percent.

Pregnancy can be a time of much planning, and great excitement. However, an HIV-positive test result can lead to fear or depression. Testing HIV positive during pregnancy is a highly emotional and distressing experience. Newly HIV diagnosed women face an overwhelming amount of information and the urgent need to make major life decisions such as whether to start anti-HIV treatment. In Canada, many women choose to take HIV medications during pregnancy, as this can reduce the risk of transmission to the baby from approximately 25% to less than 2%.

To talk about HIV and women is to also talk about the diverse issues that affect the conditions in which women live and the choices we make. Women cannot separate the effects of our social, economic, and political status on our ability to make healthy choices and practice self care. Effectively reducing HIV risk among women, as well as providing relevant and appropriate care and treatment to HIV-positive women will require an holistic approach that addresses women’s economic, physical, emotional and spiritual health. Only a coordinated, integrated effort among all levels of government, the educational system, communities, and health and social service agencies will lead to seamless health promotion programs and services for women living with HIV and women at risk for HIV infection.

As result, there is a need for research into:
    • The social, economic and political status of women, and its impact on women’s health
    • Effects of anti-HIV medications on women
    • Effects of other women’s health issues (such as breast cancer and diabetes)
    • Barriers to providing relevant and appropriate services and programming within and between health and social service agencies
    • Identifying gaps in relevant and appropriate women’s health and social services

In addition, there is a need for community development strategies to help:
    • Coordinate existing community, health and social services accessed by women to enhance service provision
    • Provide relevant and appropriate training and resources for service providers
    • Develop projects in partnership with organizations (both within and outside of HIV services) to fill service gaps
    • Facilitate the skill and personal development of both at risk and HIV-positive women
    • Include at risk and HIV-positive women in the project and program planning and implementation
    • Advocate for funding and support for women-specific HIV-related research, treatment, care, support and health promotion campaigns and programs.