Foreword: Population-specific status report: HIV/AIDS and other sexually transmitted and blood borne infections among youth in Canada
The Public Health Agency of Canada (the Agency), with the support of its many partners, is pleased to release this report as the sixth in a series intended to summarize current knowledge about the impact of HIV/AIDS among key populations in Canada.Footnote i This series of status reports was initiated to support the actions set out in The Federal Initiative to Address HIV/AIDS in Canada (Federal Initiative),Footnote ii and to provide an evidence base for other partners and stakeholders involved in the Canadian response. Launched in 2005, the Federal Initiative identifies the need for more effective interventions and improved HIV/AIDS prevention, research, diagnosis, care, treatment and support initiatives for specific populations living with, and vulnerable to, HIV and AIDS. The populations identified in the Federal Initiative include: gay and other men who have sex with men; people who use injection drugs; people from countries where HIV is endemic; Aboriginal Peoples; people in prisons; youth at risk; women at risk; and people living with HIV/AIDS.
Although the Federal Initiative outlines a framework for addressing HIV/AIDS specifically, HIV and other sexually transmitted and blood borne infections (STBBIs) share common transmission routes (i.e. exposure to infected body fluids), common risk behaviours (i.e. unprotected sexual activity and sharing of drug use equipment) and common determinants (e.g. poverty, stigma and discrimination, untreated mental illness and addictions). In addition, the presence of one infection can increase the risk of infection with another. Therefore, while this status report is focused mainly on HIV, it also addresses STBBIs more broadly.
In particular, this report focuses on how HIV and other STBBIs affect youth in Canada. The transition from childhood to adulthood is marked by many changes including physical maturation, increased independence, completion of high school and entry into post-secondary education or the labour force. It is a time when attitudes and norms of behaviour are established which ultimately put youth on various pathways to health and wellbeing. While most youth navigate this transition successfully, others face challenges and obstacles. The research presented in this report is intended to inform the reader about the many factors that place youth on various pathways and contribute to the vulnerability to or resilience against HIV and other STBBIs.
Individual behaviours that may lead to HIV and other STBBIs, including unprotected sex and unsafe injection drug use, are directly or indirectly affected by many social factors. This report focuses on the broad determinants of health that can influence health outcomes among youth, including: education; income; employment; gender and gender norms; unstable housing or homelessness; access to health services; and social environments. In so doing, this report supports the Agency’s efforts to identify and address health disparities among Canadians.
HIV and other STBBIs continue to be a major public health challenge that requires a concerted, collaborative and comprehensive response. An examination of the underlying factors and conditions that create resilience or increase vulnerability to HIV and other STBBIs is key to understanding how to best structure an effective response. Communities, governments, public health practitioners, non-governmental organizations, researchers and others are encouraged to use this report to inform the future direction of policy, programming and research with the goal of positively affecting the health and wellbeing of Canadian youth vulnerable to or living with HIV or other STBBIs.
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