HIV-positive immigrants fall through cracks: Study

July 18, 2008

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Terri Theodore

THE CANADIAN PRESS

VANCOUVER–Immigrants with HIV account for a large portion of new infections of the disease in Canada and they're slipping between the health-care cracks, a report warns.

Although Citizenship and Immigration Canada is considering making HIV a reportable disease, currently it is not, meaning it is not considered a public health risk and it is not mandatory to report infections to public health officials.

The recent report by the B.C. Centre for Disease Control found about 16 per cent of all new infections in Canada are linked to people from countries where HIV is prevalent, yet they make up only 1.5 per cent of the Canadian population. The 2005 figure means the infection rate was almost 13 times greater for immigrants, or those connected to them, from HIV-endemic countries than for Canadians.

Tuberculosis and syphilis are considered reportable diseases by the federal immigration department, but HIV has only been designated a "notifiable" disease. There are no mandatory conditions for follow-up for immigrants who test positive for HIV. However, every province and territory lists HIV as a reportable disease.

"Targeted testing of immigrants, therefore, will increase the opportunity to ensure that HIV-positive immigrants are made aware of their status and support expedient counselling, prevention and treatment," said the report.

But critics say making HIV a reportable disease is an unnecessary intrusion on privacy.

When a disease is designated "reportable," all health-care professionals must immediately report any incidence because it's considered a public health risk.

The source of the disease is investigated to prevent others from getting infected and transmitting the disease.

Dr. Mark Gilbert, co-author of the report, said the goal would be to connect with new immigrants who may not know that treatment help is available.

"From a public-health perspective, if HIV were treated as a reportable infection through Citizenship and Immigration Canada, that would be one way of improving the timeliness of connecting with these folks when they come to Canada," Gilbert said in an interview.

Karen Shadd, a spokesperson for the immigration department, said officials have read the report. "It is under consideration, but we're in discussions on the issues that were raised in the report," she said.

Since 2002, the immigration department has required a medical exam for immigrants and certain visitors including an HIV test for those 15 years and older. Examinations include physician counselling if a person tests positive for HIV.

Between 2002 and 2006 there were 2,567 immigration applicants who tested positive for HIV during their medical exams among the 1.2 million immigrants to Canada accepted during the same period.

Of those HIV-positive applicants, 89 per cent were determined to be medically admissible to Canada.

Toronto Star

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