HIV screening for potential immigrants to Canada - Term Paper Example

HIV Screening for potential immigrants to Canada Introduction In 2005, 58,000 people in Canada were living with HIV (human immunodeficiency virus), (Coyte and Thavorn, 2010). It is a pandemic that remains an enormous challenge in Canada and around the world. In the early days of the HIV/AIDS epidemic fear was widespread and little was known about the disease. Later on, it became very well known, that this virus is passed from one person to another through body fluids such as blood, vaginal fluid, semen, other body fluids containing blood and, sexual contact. As a result to incurability, Canada has made important efforts in moving beyond the medical aspects of the disease trying to address the social and economic challenges and inequities that leave people vulnerable to HIV. Over the last few years, Canada has responded to the HIV/AIDS pandemic with strong strategic leadership, a generous financial commitment and, a coordinated approach to HIV programming, but are we statistically better off than previous years? And what measures did the government implement to cease its spread? After a brief discussion of the prevalence of HIV/AIDS in Canada over the years, the following article will study the input of the Canadian healthcare system with regards to testing and screenings procedures, while showing the burdens of the disease on the economy and society. The developed stage of the disease AIDS (acquired immune deficiency syndrome), will be used interchangeably with the word HIV. Statistical record of HIV/AIDS prevalence in Canada There has generally been a continuous increase in the patients of HIV/AIDS in Canada over the years. Since the year 1985 when the reporting commenced, the number of HIV positive test reports that have been notified to PHAC till 31 December 2010 were 72,226. “At the end of 2002, an estimated 56 000 people in Canada were living with HIV infection - 12 per cent more than at the end of 1999” (Public Health Agency of Canada, 2006). In the year 2005, there were nearly 57,000 patients of HIV/AIDS in Canada and just over a period of four years, a 14 per cent increase in the population of patients of HIV/AIDS was noticed in Canada with the total population in the year 2009 being 65,000. “Although estimates of the number of new HIV infections are quite uncertain, it appears that the number of new infections in 2009 (estimated range between 2,300 and 4,300) was about the same as or slightly greater than the estimated range in 2005 (2,200 to 4,200)” (actoronto.org, 2010). In the year 2009, the number of cases of HIV positive reported were 2416 and with the total number of HIV positive cases being 2358 in the year 2010, a 2.4 per cent decrease was noticed (phac-aspc.gc.ca, 2010). Most vulnerable populations 21 per cent of the victims of the new HIV infections in Canada in the year 2008 were the people who injected drugs. The population that was found to be the biggest victim of new HIV infections in the year 2009 with their percentage being 44 per cent were the gay men. Combined proportion of the new infections among both female and male heterosexuals in the year 2009 that were from countries with low HIV rates was 25 per cent whereas the combined proportion of female and male heterosexuals that were from the countries that had high HIV rates was 5.5 per cent. From 2005 to 2009, the proportion of new HIV infections in women was consistently 26 per cent without any change. The aboriginal people comprised 11 per cent of the total number of new HIV infections in 2009. The need for HIV/AIDS screening in Canada To start with, The Joint United Nations Programme on HIV/AIDS (acquired immune deficiency syndrome) estimated that by the end of the year 2009, the total number of people living with HIV/AIDS was 33.3 million worldwide (Public Health Agency of Canada, 2012). From this point came the need to monitor and screen new immigrants coming to Canada in order to minimize its presence and transmission from countries where high records of HIV infections take place. Researches have presented a better understanding of HIV/AIDS transmission, disease progression, outcomes and treatment options. The transmission of HIV from the mothers to children has been almost completed eradicated in Canada. New HIV infections among the general population have been minimized, and the blood system has been made as safe as possible from contamination by HIV However, some groups of Canadian society like same sex population and drug addicted people represent a higher risk of exposure to HIV. Globally, some endemic countries have a prevalence of HIV among adults (age 15-49 years) of 1.0 per cent or greater, which is why it is very essential to screen newcomers to Canada for STD’s (sexually transmitted diseases). The reason we have to take each country apart and look at its demographic and HIV percentage individually, is that immigrants to Canada comprise an important proportion of the Canadian population. According to Statistics Canada (2006, p. 31), approximately one in five Canadians is foreign-born which represent 6.2 million or 19.8 per cent of the Canadian population. In the year 2002, 75 people suffering from HIV/AIDS were turned away by Canada as a result of the plans of the federal government to place more demands on the services that were publically funded. On the other hand, Canada allowed another 207 people with HIV/AIDS to enter primarily for the exemptions to the provisions of excessive demand (Garmaise, 2003). The government’s policy of the potential immigrants’ mandatory testing of the HIV-antibody has been criticized by the HIV/AIDS organizations and they have also expressed concerns regarding the way of calculation of the excessive demand. Evaluation of the effectiveness of the HIV/AIDS prevention programs in Canada Mandatory immigration HIV screening was introduced in 2002, and not all applicants who tested positive for the disease were refused admission. In spite of the fact that 4,374 people tested HIV-positive in the year 2002, the CIC agents deemed only 453 of these people inadmissible for a Canadian visa based on a hypothetical estimate of costs for their care over a ten-year period (Coyte, 2010). This provides evidence for a big disturbing regulation. When visa acceptance to Canada has to undergo HIV screening, the question that surfaces is; why some immigrants with a positive results end up acquiring a visa to remain in Canada? In her article Bisaillon (2011) defined this segment as people who apply as refugee or family class applicants. Her data showed that between the years 2006 and 2007, 1,050 HIV-positive applicants sought permanent residence, of which 994 were refugee or family class applicants. Screening is unavailable in some countries where HIV testing presents barriers in the country of origin, caused by poor living conditions, legal status and discrimination based on social status and inequalities and inability to afford treatments and counseling (Alvarez-Del et al., 2012). In some countries in the Middle East, for example, HIV screening is not much requested in a somewhat conservative culture compared to a North American lifestyle, and if present, people suffer from discrimination, and unaffordable high treatment cost. The ineffectiveness of the HIV/AIDS prevention programs in Canada can be assessed from the fact that the number of people affected with the virus has increased dramatically, and improvement to prevent its widespread made in late nineties have not been sustained. Although gay men are the group most affected by HIV in Canada (Minister of Public Works and Government Services Canada, 2004), the epidemic has also gained access to other vulnerable people, including drug users, aboriginal people, inmates, at-risk youth and women, and people from countries where HIV is high/endemic. Barriers to effective implementation of the HIV/AIDS prevention programs in Canada Although there has been a lot of success recorded in Canada, pertaining the antiretroviral treatment which has prolonged and improved the quality of life of many HIV infected Canadians, difficulties in accessing treatment, treatment failures, toxic side effects and drug resistance have become more and more common, presenting barriers to getting ahead of the epidemic (Public Works and Gov. Services Canada, 2004). Screening errors also presented a challenge, because a mistakenly positive or negative result can have health aggravated complications and numerous self/others damage. The way forward Since prevention was not effectively accomplished through all these years, Canadian government is spending most of its health care budget on the incurable treatments, rather then its prevention. That means that HIV prevention programs should be initiated to give information, and provide access to essential tools such as condoms or sterile injecting equipment to reduce the risk of getting infected. Programs include HIV testing and counseling, circumcision, condom use, and family planning and sex education. HIV prevention programs aim to implement and scale-up these HIV prevention methods at the community, local and national level. Comprehensive sex education is the most important part of HIV prevention. Presently, the responsibility of the community-based education upon HIV/AIDS is assumed by Health Canada. In collaboration with the Public Health Agency of Canada, Health Canada also assumes the responsibility to coordinate the engagement activities at the global level under the activities of program evaluation and also the Federal Initiative. Communities should be provided with training in life skills such as learning about healthy sexual relationships, as well as information about how to practice safe sex. Studies have shown that this kind of comprehensive sex education is more effective at preventing sexually transmitted infections than education that focuses solely on teaching abstinence from engaging in sexual relationships (Minister of Public Works and Government Services Canada, 2004). Also, condoms should be used consistently and correctly, because they are highly effective at preventing HIV infection. Therefore condoms should be made readily and consistently available to all those who need them. In fact, many people don’t fit into only one “risk category”. For example, injecting drug users need access to condoms and safer sex counseling as well as support to reduce the risk of transmission through blood. Likewise, an HIV positive pregnant woman needs a holistic different aspect of preventative care for herself and for the baby. The requirements of a refugee claimant who seeks protection in Canada are also different. However, each of those groups are sectioned under individuals who seek “excessive” demand from the Canadian health or social services (Bisaillon, 2011). From this perspective, people with HIV are a potential economic burden on the Canadian health services since the cost increases with the passage of time. Based on the data presented by Bisaillon (2011), estimate of the economic burden presented by new immigrants with HIV are divided over three different time horizons (5-years, 10-years, and their remaining lifetime). This estimate is directly related to the CD4 cells in the immune system which are T-lymphocyte helper cells and, their job is to control messages and immune responses after an infection takes place. As the number of these cells increases, cost of health care per month decrease as well ($3000 when CD4 Read More