Executive summary: Population-specific status report: HIV/AIDS and other sexually transmitted and blood borne infections among youth in Canada

Executive Summary

This report is the sixth in a series of Population-Specific Status Reports and examines how HIV and other sexually transmitted and blood borne infections (STBBIs) impact youth in Canada.  While the majority of youth in Canada make the transition to adulthood free from HIV and other STBBIs, some do not. Some youth are more vulnerable to infection than others due to a variety of challenges, obstacles and conditions within their social, cultural, economic and physical environments.

Current data on HIV and other STBBIs among youth in Canada

Chapter 2 presents a demographic profile of youth in Canada and examines data on the physical and mental health of this population in order to contextualize issues related to HIV and other STBBIs. Data related to young people’s vulnerability to HIV and other STBBIs presented in this chapter include social demographics (e.g. gender, marital status, sexual orientation, ethnicity), education, employment, income, physical health status, mental health and risk behaviours.

Chapter 3 presents epidemiological data to depict trends in HIV, AIDS and other STBBIs among youth in Canada. In 2011, 2,208 HIV cases were reported to the Public Health Agency of Canada with information on age, of which 531 cases (24%) were among youth. The youth category was the third most frequently reported age group in 2011. Over the past 10 years, the proportion of positive HIV test reports attributed to youth in Canada has remained relatively stable. Since reporting began in 1985, males have accounted for the vast majority of annual positive HIV test reports among youth aged 15-29. Consistent with the distribution of HIV test reports across all ages in Canada, the men who have sex with men (MSM) exposure category accounts for the largest proportion of cumulative positive HIV test reports among youth.  The second and third most common HIV transmission routes reported within this age group are heterosexual sexual contact and injection drug use.

Other STBBIs disproportionately affect youth in Canada. In 2010, reported rates of chlamydia were highest among youth aged 20-24.  Reported rates of chlamydia among females in this age group were more than twice as high as those among males. Youth aged 15-24 also accounted for nearly half of all reported cases of gonorrhea in 2010; although the highest rates that year were reported among females aged 15-19.

Factors that impact youth’s resiliency and vulnerability to HIV/AIDS and other STBBI

Vulnerability to or resilience against HIV and other STBBIs is both directly and indirectly impacted by various determinants of health including: education; income; employment; gender and gender norms; culture; unstable housing or homelessness; access to health services; and social environments. Chapter 4 of this report examines how these various determinants interact in complex ways to both positively and negatively affect youths’ vulnerability to or resilience against HIV and other STBBI. Consideration of these determinants of health can help in evaluating how and why particular groups of youth in Canada, such as street-involved youth, youth who use injection drugs, and Aboriginal youth are particularly vulnerable to infection.

Current research and response to HIV/AIDS among youth

Chapter 5 of this report identifies 59 research projects underway between 2008 and 2011 focused on youth and HIV/AIDS in Canada. General areas of research included: social determinants of health and HIV (particularly social environments, health and social services, and personal health practices and coping skills); HIV prevention and interventions; the community-based response to HIV among youth; and knowledge transfer. The research addressed a number of different youth populations, including: Aboriginal youth; youth who use drugs; street-involved youth; newcomer, immigrant and racialized youth; youth living with HIV; and youth in general. The chapter also identifies areas where future research could be focused to address gaps in knowledge about youth and HIV/AIDS.

Canada’s response to HIV/AIDS has grown in scope and complexity since the early days of the infection in the 1980s. Chapter 6 examines the response to HIV/AIDS among youth at the policy and programmatic levels between 2009 and 2011. Included among these are: population-specific strategies at the national, provincial and territorial levels; population-specific networks, coalitions and advisory bodies; and organizations and projects focused on the delivery of programs addressing HIV/AIDS among youth. In total, 105 time-limited initiatives were identified over this period. Strategies addressing youth and HIV (as well as other sexually transmitted and blood borne infections) were found to exist at the national level and in nine provinces and territories. Three youth-specific networks, coalitions and advisory bodies were identified at the national levels which address HIV, sexual health and related health issues among youth. However, only one such organization was identified at the provincial level, in Nova Scotia.