Opinion: The end of the HIV crisis is within our grasp. We must apply the pandemic spirit to achieve it

By Sean Rourke and Bill Flanagan


Imagine having easy access to a home self-test for COVID-19. With instant results, you’d be able to make informed decisions about your health and decide whether you should stay in or go to work. Research teams around the world are devoting resources to making this a reality, in the hopes of helping to stop the months-old pandemic in its tracks. In the meantime, many Canadian jurisdictions are offering medically administered swab tests with quick turnaround times in accessible ways.

But this inspiring efficiency is in sharp contrast to how the HIV epidemic has been handled in Canada, where the rate of new HIV infections continues to rise – even as the numbers consistently decline in countries such as the United States, the United Kingdom, Australia and Japan.

The difference: Canada has not yet approved or implemented a full range of HIV testing options, including self-testing; we have not yet ensured linkage to care for all; and universal and free access to treatment is not consistently available across our country.

About 15 per cent of people living with HIV in Canada are undiagnosed: They have HIV but do not know it because they have not been tested. There is also a significant proportion of people who are diagnosed with HIV but are not in care. Recent estimates from the U.S. Centers for Disease Control indicate that about 80 per cent of new HIV infections result from gaps in testing and treatment.

This suggests that if more Canadians had access to home self-tests, and were then provided with effective treatment – which can allow people with HIV to live almost normal lifespans, and in almost all cases can entirely suppress the virus so that there is no risk of transmitting it to sexual partners – the reduction in spread could in effect end the HIV epidemic in this country.

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