In Canada, the responsibility for preventing HIV infection is shared by many different structures, which means that it is difficult to co-ordinate their efforts in an integrated overall action plan. On one hand, provincial organizations may be supported by different federal government authorities, whether in the area of sexual-health education and promotion or in the area of preventing HIV infection; on the other hand, many initiatives are first developed with provincial support, which varies widely, in form and amount, between provinces, depending on the structures in place. In this context it becomes particularly difficult to attest to the richness and diversity of Canada’s response to HIV infection, especially since most of the experiments in the area of sexual-health education and promotion have not been evaluated or made available through formal publication. Furthermore, although various federal, provincial, or regional policies provide direction in terms of priorities defined on the basis of epidemiological data and grant funds according to these priorities, in practice, action often takes a different form, depending more on the receptivity and sensitivity of a given setting, the conviction and will of the human resources in place, the ease of joining a given group through already existing structures, etc. These facts explain why, at present, the most vulnerable individuals and groups have rarely been reached, while others have been overexposed to a message they do not strongly identify with.

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