Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #121508

Camille Achonu, MHSc, Effie Gournis, MPH, MSc, Jo-Ann Ackery, Barbara Yaffe, MD, MHSc, and Rita Shahin, MD, MHSc. Communicable Disease Control, Toronto Public Health (TPH), 277 Victoria St., Toronto, ON M5B 1W2, Canada, 416-392-7423, cachonu@toronto.ca

Background: Slower rates of HIV to AIDS progression over the last decade have been attributed to the introduction of highly active antiretroviral therapies (HAART) and improved access to these drugs. Until recently, the median time for progression to AIDS from HIV was increasing to a high of 7.4 years recorded in Toronto for 2000. However, this median period has been virtually halved and not exceeded 4 years since 2002. Objective: To identify epidemiological factors related to the recent decrease in time to AIDS progression, so that targeted improvements to HIV screening and treatment programs are recommended. Methods: A retrospective review of AIDS cases reported to Toronto Public Health from 1993 to 2004 was conducted. Demographic and risk exposure data were extracted from the provincial database (RDIS), and tested in univariate and multivariate models. Results: There were 6560 HIV cases reported from 1993 to 2004; 2363 (36%) had an AIDS diagnosis on record. Risk exposure category, AIDS diagnosis year, and age at HIV diagnosis were significant factors in predicting time to AIDS, independently and after controlling for sex. HIV cases from endemic countries increased from 13.2% in 2001 to 34.1% in 2002. Discussion: Canada introduced HIV screening for immigrants in 2002, which identified several HIV cases at various stages of progression. The contribution of this screening, potential differential access to HIV treatment and care, changes in testing frequency and timing, possibly more virulent HIV subtypes, and whether shorter disease progression times result in shorter survival times need to be further understood.

Learning Objectives:

• At the end of this session, participants will have a better understanding of the descriptive factors associated with recent decreases in time between HIV diagnosis and AIDS in Toronto.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.