HIV is a reality in Ontario. In 2008, more than 26,000 people in the province were living with HIV and an estimated 1,618 people had newly acquired the virus. Around the world children and young people are helping their communities to stop new HIV infections and to create caring societies for people living with and affected by HIV. This guide provides information and ideas to help you make a difference in your community. Get Informed! HIV Quick Facts You need to understand the issues before you can make a difference. What are HIV and AIDS? HIV stands for human immunodeficiency virus. It is the virus that can cause AIDS, which stands for acquired immunodeficiency syndrome. With anti-retroviral therapy (ART), most people living with HIV can avoid getting AIDS and stay healthy for a long time. If HIV is not treated, the person s immune system gets weaker and eventually they become sick from life-threatening infections. When this happens, the person may be diagnosed as having AIDS. How is HIV passed between people? The two most common ways that HIV is passed from one person to another is unprotected anal or vaginal sex and sharing injecting equipment. The HIV Transmission Equation provides a basic overview of how HIV is passed from a person living with HIV to another person. Can HIV be cured? No. HIV is a life-threatening infectious disease that cannot be cured. HIV can be controlled with ART, which are drugs that make it hard for the HIV virus to create more copies of itself. ART gives the body s immune system a chance to get stronger so that it can better fight off infections.
HIV Transmission Equation There is a chance that HIV will be passed from a person living with HIV to another person when there is: A body fluid with HIV Only five body fluids can contain enough HIV to transmit the virus: semen (including pre-semen), vaginal fluid, rectal mucous, blood, and breast milk. + A way into the bloodstream HIV can get into the bloodstream through the vagina, rectum, urethra, and foreskin; injection sites; and for fetuses and infants the placenta, mouth, and throat. + An activity that moves body fluids between people Unprotected sexual activity (such as vaginal sex, anal sex, oral sex, and sharing sex toys), sharing drug equipment (such as needles and crack pipes), unsafe bodywork (such as sharing needles for tattoo and piercing, ink, and piercing jewellery), and for fetuses and infants pregnancy and birthing, and breastfeeding. = Risk of HIV infection What affects the risk of HIV being passed from one person to another? Risk means that there is a chance of a certain outcome happening. The risk of HIV infection is complex and can be affected by many factors. For example: Different activities carry varying degrees of risk for HIV infection. People are more likely to come into contact with the HIV virus when many people in a population are living with HIV. The risk that HIV will be passed from a person living with HIV to another person goes up when there is a lot of the virus in a person s bloodstream (like when they are newly infected or not taking ARTs). Sexually transmitted infection (STIs) and unhealthy mucous membranes such as irritated vaginal walls during a yeast infection increase the risk of HIV infection.
Why does HIV affect some groups of people in Ontario more than others? Ontario has what is known as a concentrated HIV epidemic. This means there is a higher HIV prevalence the proportion of a population affected by HIV among specific groups of people but a low HIV prevalence in the overall population. When some groups are more affected by a disease or infection, it is called a health disparity. There are three key reasons for these health disparities. First, there is a greater chance that a person will have a partner who is HIV-positive when a high proportion of a population is living with HIV. For example, if 25 per cent of the population is HIV-positive, then there is a 1 in 4 chance of having a partner who is living with HIV. This means that people from, or who have partners from, the most at-risk population are more likely to have a partner who is HIV-positive and to be exposed to HIV if they engage in a risk activity compared to people in the general population. Determinants of health are the second key reason that there is a higher prevalence among some groups than others. Determinants of health are the things we need to live comfortably, to feel valued and respected by our community, to take part in society, to feel good about ourselves, and to have control in our intimate and romantic relationships. The groups in Ontario who are most vulnerable to HIV face various forms of stigma and discrimination such as homophobia, racism, and gender inequalities that makes it hard for them to access the determinants of health. Limited access to determinants of health increases the chances that people will engage in risk-taking behaviours that can lead to HIV and experience other negative health outcomes such as depression and addictions. The third reason is that the groups who are most affected by HIV in Ontario are small in size and relatively selfcontained. Due either to stigma and discrimination or to a shared identity or shared interests, the social and sexual networks of people from most at-risk populations are often made up of people who share the same identity. If someone in the network contracts HIV, the virus is able to spread much more easily than in the general population and the prevalence of HIV grows. How can you prevent HIV from being passed between people? Preventing new HIV infections requires both personal and social actions. People can reduce their risk of HIV infection by removing one or more components of the transmission equation: for example, by choosing low-risk sexual activities. People, organizations, and governments can prevent new HIV infections by addressing the underlying determinants of health. Poverty, homelessness, prejudice and discrimination against marginalized groups, and limited numbers of supports for people with mental health issues leave people vulnerable to HIV and other health issues. How do you know if you are living with HIV? People can have HIV and other STIs without knowing it. The only way to know if you are living with HIV is to get tested. Getting tested regularly for HIV and other STIs is an important part of taking care of your sexual health and that of your partner(s). For information on HIV testing, call the AIDS and Sexual Health Info Line at: 1-800-668-2437 (English) or 1-800-267-7432 (French).
Take Action! What? You can be part of the HIV response in Ontario by practising safer sex, encouraging your peers and community members to practise safe sex, speaking out against HIV stigma and the root causes of HIV vulnerability, and working to create inclusive communities. How? There are many fun and creative ways that youth can make a difference in their community. Here are just a few to consider: Get people talking over condom pins. The Condom Project gets people making condom art pins as a way to get them talking about condoms and safer sex. You ll need a table, a supply of condoms (talk to your public health unit or AIDS Service Organization) with pins hot glued on, lots of colourful paper, scissors, glue, and other art supplies. Make your own videos, PhotoVoice projects, and fotonovelas. You can do a lot with a cell phone or digital camera, a computer, and a bit of creativity. Join or set up a Rainbow Alliance in your school. Use commemorative days to raise awareness. Plan events, contests, and other activities to engage your peers. Commemorative days include: World AIDS Day, Sexual and Reproductive Health Day, Day of the Girl, Day of Pink, Black History Month, National Aboriginal Day, the National Day of Remembrance and Action on Violence Against Women, International Day against Homophobia, and Trans Day of Remembrance. Volunteer at or raise money for your local AIDS Service Organization. Become a peer educator. Youth listen to other youth. Contact your school counsellor, public health unit, or sexual health organization to find out how you can get trained to provide work shops and information to your peers. Search the internet Check out these tools designed to help youth make a difference around HIV: TakingITGlobal s HIV/AIDS Youth Guide to Action World AIDS Campaign s Youth Toolkit and Youth e-course Youth Action Network, Gendering Adolescent AIDS Prevention, and Centre for Urban Health Initiative s Empower: Youth, Arts and Activism: An HIV/AIDS Arts Activism Manual for Youth by Youth The Youth, the Arts, HIV & AIDS Network Find out more! www.spiderbytes.ca www.youthco.org www.planetahead.ca www.livepositive.ca www.sexualityandu.ca www.youthline.ca
Understanding The Risks Understanding the risks of HIV transmission associated with activities can help you make informed decisions about how to take care of your health and well-being. This table explains the risk that HIV will pass from one person to another through different activities. The activities in the table are personal in nature. Each person has to figure out whether, which, when, and under what circumstances they want to engage in these activities. An important part of figuring this out is thinking about one's goals and personal, family, cultural, and spiritual values. Level of Risk Definition Example Activities No risk None of the five body fluids that can transmit HIV are involved in these activities. This means there is no chance that HIV can pass from one person to another. Sharing dishes and glasses Kissing and hugging Touching a penis or vulva Using drugs (including steroids) with new, sterile equipment Tattooing and piercing with sterilized and new equipment Negligible risk between people, but it is hard for HIV to get into the body through these activities. There are no documented infections linked to these activities. Receiving oral sex Performing oral sex with a condom or dental dam Fingering a vagina or anus Tattooing and piercing with shared equipment Sharing toothbrushes and razors Low risk between people. A few people have been infected with HIV through these activities. Performing oral sex without a condom or dental dam Vaginal or anal sex with a condom Using cleaned needles to inject drugs (including steroids) Tattooing with non-professional equipment High risk between people. A significant number of people have been infected with HIV through these activities, and scientific studies have repeatedly linked these activities to HIV infection. Vaginal or anal sex without a condom Using shared needles to inject drugs (including steroids) *Adapted from the Canadian AIDS Society s HIV Transmission Guidelines for Assessing Risk.