HIV in Canada—surveillance report, 2019

Abstract

Background: Human immunodeficiency virus (HIV) is a global public health issue. HIV has been nationally notifiable in Canada since 1985. The Public Health Agency of Canada (PHAC) monitors trends in new HIV diagnoses. Objectives: The objective of this surveillance report is to provide an overview of the epidemiology of reported HIV cases in 2019 in Canada. The report highlights 10-year trends (2010–2019). Data on HIV diagnosed through Immigration Medical Exams (IME) and trends in perinatal transmission of HIV are also presented. Methods: PHAC monitors HIV through the HIV/AIDS Surveillance System, a passive, case-based system that collates non-nominal data submitted voluntarily by all Canadian provinces and territories. Descriptive analyses were conducted on national data. IME data were obtained from Immigration, Refugees and Citizenship Canada (IRCC), and data on HIV-exposed pregnancies were obtained through the Canadian Perinatal HIV Surveillance Program. Results: In 2019, a total of 2,122 HIV diagnoses were reported in Canada (5.6 per 100,000 population). Saskatchewan reported the highest provincial diagnosis rate at 16.9 per 100,000 population. The 30 to 39-year age group had the highest HIV diagnosis rate at 12.7 per 100,000 population. While the rates for both males and females fluctuated in the past decade, since 2010 the rates among males decreased overall, while the rate among females increased slightly. As in previous years, the diagnosis rate for males in 2019 was higher than that for females (7.9 versus 3.4 per 100,000 population, respectively). The highest proportion of all reported adult cases with known exposure were gay, bisexual and other men who have sex with men (gbMSM, 39.7%), followed by cases attributed to heterosexual contact (28.3%) and among people who inject drugs (PWID, 21.5%). The number of migrants who tested positive for HIV during an IME conducted in Canada was 626. The one documented perinatal HIV transmission related to a mother who had not received antepartum or intrapartum antiretroviral therapy prophylaxis. Conclusion: The number and rate of reported HIV cases in Canada has remained relatively stable over the last decade, with minor year-to-year variations. As in previous years, the gbMSM and PWID populations represent a high proportion of HIV diagnoses, although a sizable number of cases were attributed to heterosexual contact. It is important to routinely monitor trends in HIV in light of pan-Canadian commitments to reduce the health impact of sexually transmitted and blood-borne infections by 2030.

Use of HIV pre-exposure prophylaxis among urban Canadian gay, bisexual and other men who have sex with men: a cross-sectional analysis of the Engage cohort study

“…Although GBM account for 2%-3% of the Canadian population, they represent almost half of all prevalent and newly reported cases of HIV infection. [1][2][3] The disease burden is concentrated in Canada's 3 largest cities -Montréal, Toronto and Vancouver -where many GBM reside. 4,5 HIV pre-exposure prophylaxis (PrEP) with antiretroviral medication (tenofovir disoproxil fumarate or tenofovir alafenamide combined with emtricitabine) has been shown to be effective in preventing HIV infection in HIV-negative GBM.…”

A Pragmatic Pilot Study Of Cognitive Behavioural Therapy For Insomnia Among People Living With HIV

“…There were very few female-identified participants in the study, which also limits generalizability. One reason for this may be that in Canada, diagnostic rates for males are three times higher than for females, with 75.2% of reported HIV cases in 2017 being among males (Haddad, Li, Totten, & McGuire, 2017). With specific regard to the CBT-I pilot study, however, this sample is more likely to approximate treatment-seeking PWH in the community, as it is composed of individuals who saw and responded to advertisements seeking individuals with difficulty sleeping.…”

Automated STI/HIV risk assessments: Testing an online clinical algorithm in Ottawa, Canada

“…In Ottawa, Canada, where this study is based, for HIV, the most affected populations include gay, bisexual, and other men who have sex with men (gbMSM); persons of African, Caribbean, or Black (ACB) ethnicities; persons who use drugs; trans persons; and members of Indigenous communities. 2 For chlamydia, most infections are diagnosed in persons under 30 years of age, more often in females than males. 3 gbMSM are also unequally burdened by gonorrhea, 4 with research suggesting that up to 70% of such infections in gbMSM are in the oropharynx and rectum, not the genital tract.…”