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UBCO study: Men in smaller cities reluctant to test for HIV

Study reveals 24 per cent of gay men living in smaller communities had never had an HIV test, compared to 14-17 per cent in urban centres.
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UBCO psychology professor Susan Holtzman in front of the rainbow staircase of inclusion at the Kelowna campus.

Men who live outside major Canadian cities and have sex with other men are less likely to get an HIV test than their metropolitan counterparts, a UBCO study shows.

The study, conducted at the UBC’ Okanagan campus, also shows that the lower testing rates are likely connected to internalized feelings of homophobia and a reluctance to disclose sexual preferences at a doctor’s office.

“This study shows that a lack of feeling accepted appears to not only pose mental health risks, it poses physical health risks,” said Susan Holtzman, UBCO associate professor of psychology. “

The fact that these men are reluctant to tell their doctor about their sexuality is something that requires attention in our health care system if we hope to increase the number of people tested for HIV.”

Holtzman’s study, conducted in cooperation with the Living Positive Resource Centre in Kelowna, surveyed 153 people recruited through online dating sites and events in the gay community.

The study found that 24 per cent of men living in smaller communities had never had an HIV test, compared to the 14 to 17 per cent of untested men living in large cities such as Vancouver and Toronto.

According to the Public Health Agency of Canada, men who have sex with men represented 53 per cent of total HIV infections in 2014, accounting for 39,630 people across the country.

Holtzman’s study was recently published in the journal AIDS Care.

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By Maja Karlsson

Contributor

I recently attended a talk given by Dr. Julio Montaner, one of B.C.’s experts on HIV. He mentioned that one of his patients had recently passed away.

I’m sure most of the people in the room were surprised to hear his description of the patient:  a 92-year old man who passed away in his sleep. His HIV had nothing to do with his death.

HIV treatment has become simpler, more effective and better tolerated, which has led to major improvements in health outcomes. Because the medications work to decrease the amount of virus in the blood and body fluids, people are healthier and more able to do the things they want to do. In addition to extending life expectancy, the medications make it less likely that people will transmit the virus to others.

Dr. Montaner and our Interior Health physicians regularly describe the “new face of HIV.” Canadians beginning HIV treatment today can expect to live into their early 70s or longer, and it is estimated that over 30 per cent of people living with HIV in Canada are now aged 50 or older, a number that is likely to increase given that between 1985 and 2012, more than 30 per cent of new HIV diagnoses were among people over the age of 40.

I remember talking with Andrew, a resident of B.C.’s Interior. He is one of those “new faces of HIV.” He has lived with the disease for 23 years and has witnessed many advances in diagnosis and treatment.

He told me he was pleased to see how far treatment has come but he also felt more could be done for those who are aging with HIV. He said now that many older adults are outliving HIV, the focus needs to shift to quality of life, elder care, and eliminating the social stigma that divides and isolates those who are HIV positive.

Now that people are living longer lives with HIV, some are experiencing health complications seen in older adults, such as cardiovascular disease, kidney disease and cancer. For many, living with HIV also means having to manage depression, social isolation, and social stigma. Fortunately, research has suggested that early diagnosis and initiation of HIV treatment can help mitigate the health complications that come with aging.

To support both the physical and mental health needs that come with HIV and aging, there are now additional resources that exist across the Interior Health, including specialized nurses who can provide outreach services for clients living with HIV and who also support HIV testing initiatives across the region.

New guidelines suggest that everyone should know their HIV status. If you don’t, no matter how old you are, or what kind of risk you think you may or may not have, if you’re going to the lab for blood work, ask your doctor to add an HIV test to the requisition.

If you want more information about the testing, treatment and supports available across Interior Health visit  www.myhealthissexy.com.

Maja Karlsson is the manager of HIV and health outreach services for Interior Health.