June 1, 2011 Despite significant clinical advances in HIV care, an estimated 25 per cent of new HIV infections in Ontario from 2006 to 2008 were among women, according to a health study by researchers from the Institute for Clinical Evaluative Sciences (ICES) and St. Michael's Hospital. The researchers say 93 per cent of new infections among women are acquired through sexual transmission and seven per cent through injection drug use. About 60 per cent of newly infected women are immigrants. The findings, the latest from the POWER (Project for an Ontario Women's Health Evidence-Based Report) study, suggest targeted prevention and intervention efforts are necessary to eliminate gaps and inequities in care for HIV patients.
"We have made real progress in preventing HIV infection and in treating people living with HIV, but we also identified several groups for whom important disparities persist, including older women, Aboriginal women, and women who have immigrated from countries where HIV is endemic," says Dr. Ahmed Bayoumi, lead author on the chapter and a physician at St. Michael's Hospital. "We also identified differences related to poverty, injection drug use, and geography. Our findings suggest that addressing such factors will be important for delivering universal, high-quality HIV care in Ontario."
The POWER Study -- a joint study from St. Michael's Hospital and ICES -- is the first in the province to provide a comprehensive overview of women's health in relation to income, education, ethnicity and geography. The findings are detailed in the report titled HIV Infection-the 11th chapter to be released as part of the study. Findings can be used by policymakers and health-care providers to improve access, quality and outcomes of care for Ontario women. The POWER Study was funded by Echo: Improving Women's Health in Ontario, an agency of the Ontario Ministry of Health and Long-Term Care.
"The POWER Study HIV Infection chapter reveals important gaps in prevention, access and clinical care," says Pat Campbell, CEO, Echo: Improving Women's Health in Ontario. "Findings support the need for strategies to promote HIV prevention and testing directed at hard to reach groups. We also need to improve access to care for women aged 55 and older to ensure earlier diagnosis and/or earlier entry to care. At the same time findings are helping to track improvements in care, evident in the high prenatal HIV screening rate (95%)."
The POWER study chapter, released June 1, examined the impact of HIV infection on Ontarians. Key findings include:
- More than 4,700 women are living with HIV in Ontario, most of whom acquired HIV through sexual contact. This represents 18% of the estimated HIV infections in the province.
- Women who emigrated from a country where HIV is endemic account for more than half of all new infections in 2008 among women.
- Women reported lower rates of condom use than men.
- Women who inject drugs report riskier injection behaviours than men.
- One third of users of community based HIV services are women
- Over 90% of HIV-positive pregnant women who knew their HIV status received antiretrovirals during pregnancy, which could prevent transmission to the newborn.
"High rates of prenatal HIV screening show that when we have an organized and targeted program we can achieve measurable improvements in care," says Dr. Arlene Bierman, a physician at St. Michael's Hospital and principal investigator of the study. "We need to develop programs that ensure that all women who are at risk are screened and when tests are positive that they receive HIV care in a timely manner. Routine monitoring of quality indicators will allow us to evaluate these programs," adds Dr. Bierman, also an ICES investigator.
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