- A 2018 survey asked Canadians about sexually transmitted and blood-borne infections
- The survey included questions about knowledge, awareness and attitudes
- Results indicated knowledge gaps and stigmatizing attitudes related to HIV and hepatitis C
Canadians’ knowledge of and attitudes toward HIV and hepatitis C can provide insights into factors such as stigma that may impact prevention, testing and transmission rates. Since 2003, the Public Health Agency of Canada (PHAC) has been regularly monitoring knowledge and attitudes of Canadians about issues related to HIV. The most recent iteration of this survey was conducted in 2018 and also covered hepatitis C and other sexually transmitted and blood-borne infections (STBBIs).1
The survey found that most Canadians have a low to moderate knowledge of HIV and hepatitis C and that stigmatizing attitudes toward people with HIV and hepatitis C persist. The survey also found that perceived risk of HIV and hepatitis C and testing for these infections among Canadians is low.
Study details
The survey was conducted with 2,452 Canadians aged 16 years and older between February and March 2018. The survey asked Canadians questions about awareness, knowledge, attitudes and behaviours related to HIV, hepatitis C, hepatitis B and sexually transmitted infections (STIs; such as chlamydia, gonorrhea and infectious syphilis). The majority of responses were collected by phone interview, with six percent of responses collected online.
While the 2018 survey builds upon previous PHAC surveys, it was largely redesigned to reflect PHAC’s current program objectives, limiting direct comparisons with the last survey conducted in 2012.2
Key findings
Overall knowledge of STBBIs
Canadians felt they were most knowledgeable about HIV and other STIs but had less knowledge about hepatitis C:
- 44% of Canadians rated their knowledge of HIV as high
- 42% of Canadians rated their knowledge of STIs as high
- 24% of Canadians rated their knowledge of hepatitis C as high
Knowledge of HIV
The survey looked at knowledge of specific topics related to HIV. The findings included low awareness of pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), with only 16% of Canadians agreeing that there is a pill to help prevent getting HIV. There was also low awareness that treating HIV infection can prevent HIV transmission, with only 26% agreeing that a person who has HIV and is on treatment can reduce the amount of virus in their body so they cannot transmit the virus to others. Finally, only 56% correctly identified that HIV treatment is highly effective at helping people with HIV lead long and normal lives.
Knowledge of hepatitis C
The survey also looked at knowledge of specific topics related to hepatitis C. Only 29% of respondents correctly identified that there is a cure for hepatitis C. In addition, only 28% correctly identified that there is no vaccine to prevent hepatitis C. Finally, only 25% of Canadians identified sharing drug use equipment as a risk factor for hepatitis C transmission, despite this behaviour accounting for the majority of new infections in Canada.
Attitudes toward people with HIV or hepatitis C
The survey assessed attitudes toward HIV and hepatitis C through a variety of questions. Responses indicate that stigma toward people with HIV and hepatitis C is still present among Canadians.
Despite there being no risk for transmission, only 33% of Canadians said they would be very comfortable working around or having casual contact with someone who is living with hepatitis C.
In more encouraging news, only 15% of Canadians said they are afraid of HIV infection when they know they are near someone living with HIV. However, only 51% would use the services of a dentist or doctor who is HIV positive. In addition, 94% agreed that it is the responsibility of people living with HIV to tell sexual partners that they have HIV.
Perceived risk of HIV, hepatitis C and STIs
Only a very small minority of Canadians felt that they were at high risk for HIV (2%), hepatitis C (2%) and STIs (3%).
STBBI testing
When asked about their testing history, 36% of Canadians said they have been tested for HIV, 33% said they have been tested for hepatitis C and 38% said they have been tested for sexually transmitted infections. Fifty percent said they have never been tested for HIV, hepatitis C or STIs. Among those who had been tested, 26% have done so within the last 12 months.
Canadians were asked to identify from a list what they thought were the best methods for encouraging HIV or hepatitis C testing. Two of the most frequently chosen methods for both HIV and hepatitis C were: “knowledge about seriousness of illness and methods of transmission” and “knowing that testing is fairly easy and privacy is protected.”
“Information about sexual health and seeking testing that is free of judgment and culturally sensitive” was also important for HIV testing, and “knowing that people can be infected and not know that there is treatment/possible cure” was also important for hepatitis C testing.
Implications for HIV and hepatitis C programming
The survey provides a current snapshot of Canadian knowledge and attitudes that can be used to inform the response to HIV and hepatitis C, including addressing stigma, promoting prevention and encouraging testing.
—Erica Lee
REFERENCES:
- EKOS Research Associates Inc. Canadians’ Awareness, Knowledge and Attitudes Related to Sexually Transmitted and Blood-Borne Infections: 2018 Findings Report. Available at: http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/public_health_agency_canada/2018/056-17-e/report.pdf
- EKOS Research Associates Inc. 2012 HIV/AIDS Attitudinal Tracking Survey. Final Report. October 2012. Available at: http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/public_health_agency_canada/2012/072-11/report.pdf