The session was opened by  Canadian Minister of Health Leona Aglukkaq and US Secretary of Health and Human Services Kathleen Sebelius.

A large contingent of Canadian activists protested,  announcing at the beginning of the Minister’s speech they would stand with backs toward her to call highlight what they said was the Harper government’s turning its back on HIV with health cutbacks and hostility to science-based prevention  - a protest joined by nearly half the audience.

Minister Aglukkaq cited progress made in prevention and care, and touted Canada’s international role, research, USA/Canadian cooperation, and civil society participation. She noted the need for focused prevention for some groups, including MSM, aboriginal peoples, and recent immigrants.

Secretary Sebilius cited prevention and treatment progress, including PMCT and services in Indian country. She noted that the United States had long required other countries to adopt national AIDS strategies as a condition of funding, but never adopted one itself until 2 years ago. That strategy is now being used to redirect program priorities and resources.

In the USA, MSM continue to constitute a majority of cases, especially young black gay men. Black men are 6x more likely to become infected than white men. African-American women face disproportionate prevalence and incidence. Geographic concentrations of the epidemic in the northeastern and southern states were noted, with “hyper-endemic levels” in some urban neighbourhoods. Only 28% of HIV+ people in the US have suppressed viral load, pointing to large gaps in treatment access. Government commitment to “high impact prevention” was highlighted.

Canada’s epidemic is characterized by concentration in particular populations. While incidence among MSM has declined over the years, they remain the largest impacted population, needle sharing is still an important contributor to new infections, and heterosexual transmission has grown.  Some migrant communities face significant HIV burden. But, most alarming has been the escalating HIV epidemic seen in some aboriginal communities, both on rural reserves and in urban areas. Canada’s universal health coverage was credited with high uptake of testing/treatment.

Panelists and audience members challenged some statements of government members – focusing on the aboriginal peoples, political commitment, gaps in health care in both countries, continuing stigma within communities, programs for drugs users, and other significant barriers to progress.