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CATIE News
The epidemiology of HIV in Canada

<p>Sean R. Hosein</p>


November 30, 2012

This fact sheet provides a snapshot of the HIV epidemic in Canada. It is one of a series of fact sheets on the epidemiology of HIV and hepatitis C in Canada.

All epidemiological information is approximate, based on the best available data. The data contained in this fact sheet comes from the 2011 Estimates of HIV prevalence and incidence in Canada, published by the Public Health Agency of Canada (PHAC). More information about this data source can be found in the section “Where do these numbers come from?” at the end of the fact sheet.

The number of people living with HIV in Canada (prevalence) is increasing.

According to 2011 national HIV estimates:

  • An estimated 71,300 Canadians were living with HIV at the end of 2011.
  • This represents an increase of 7,300 people (11%) since 2008.

One quarter of people living with HIV in Canada are unaware that they have HIV.

According to 2011 national HIV estimates:

  • An estimated 17,980 people living with HIV remained undiagnosed in 2011.
  • This represents 25% of the estimated number of people living with HIV.

Almost 25,000 people living with HIV have died since the beginning of the epidemic.

According to 2011 national HIV estimates:

  • By the end of 2011, an estimated 24,300 people with HIV had died due to an HIV-related illness or other cause.

The HIV epidemic in Canada is concentrated in specific populations.

According to 2011 national HIV estimates, people living with HIV include an estimated:

  • 35,490 gay men and other men who have sex with men (MSM). This represents 50% of all people living with HIV in Canada. The estimate includes 33,330 men whose HIV status was attributed to men having sex with men and 2,160 men whose HIV status could be attributed to either men having sex with men or injection drug use (MSM-IDU).
  • 14,200 people who used injection drugs (IDU). This represents 20% of all people living with HIV in Canada. The estimate includes 12,040 people whose HIV status was attributed to injection drug use and 2,160 men whose HIV status could be attributed to either men having sex with men or injection drug use (please note that these 2,160 men are the same as those noted in the bullet point above).
  • 23,170 people whose HIV status was attributed to heterosexual sex. This represents 33% of all people living with HIV in Canada. Of these, 10,640 people (15% of all people living with HIV) were from a country where HIV is endemic (primarily countries in sub-Saharan Africa and the Caribbean).
  • 600 people whose HIV status could not be attributed to sex or injection drug use. This includes people who likely contracted HIV through blood transfusions or clotting factors, transmission from mother to child, or needle-stick injuries in the workplace. This represents less than 1% of all people living with HIV in Canada.
  • 6,380 Aboriginal people. This represents 9% of all people living with HIV in Canada.
  • 16,600 females. This represents 23% of all people living with HIV in Canada.

The number of new HIV infections in Canada has remained stable in the past several years but is not insignificant.

According to 2011 national HIV estimates:

  • An estimated 3,175 people became infected with HIV in Canada in 2011.
  • This is comparable to or slightly lower than the estimated 3,335 new infections in 2008.

The number of new HIV infections (incidence) may be decreasing among people who inject drugs, females and Aboriginal people.

According to 2011 national HIV estimates:

  • An estimated 435 new HIV infections (14% of new infections) were attributed to injection drug use compared to an estimated 565 new infections in 2008 (17% of new infections).
  • An estimated 755 new HIV infections (24%) occurred in females compared to an estimated 865 new infections in 2008 (26%).
  • An estimated 390 new HIV infections (12%) occurred in Aboriginal people compared to an estimated 420 new infections in 2008 (13%).

Aboriginal populations are over-represented in the HIV epidemic.

Despite the decrease in new HIV infections, Aboriginal people are still over-represented in the HIV epidemic. According to 2011 national HIV estimates:

  • Aboriginal people accounted for an estimated 12% of all new HIV infections in 2011 despite accounting for only 4% of the Canadian population in 2006.
  • The estimated HIV infection rate among Aboriginal people was 3.5 times higher than the HIV infection rate among non-Aboriginal people.

The number of new HIV infections (incidence) may be stable among MSM, MSM-IDU and people exposed to HIV through heterosexual sex.

According to 2011 national HIV estimates:

  • An estimated 1,480 new HIV infections (47% of new infections) were attributed to men having sex with men compared to an estimated 1,470 new infections in 2008 (44%).
  • An estimated 80 new HIV infections (3%) were attributed to men whose HIV status could be attributed to either men having sex with men or injection drug use (MSM-IDU) compared to an estimated 90 new infections in 2008 (3%).
  • An estimated 535 new HIV infections were attributed to heterosexual sex in people from a country where HIV is endemic in 2011 (17%) compared to an estimated 540 new infections in 2008 (16%).
  • An estimated 645 new HIV infections were attributed to heterosexual sex in people born in a country where HIV is not endemic, including Canada, in 2011 (20% of new infections) compared to an estimated 670 new infections in 2008 (20%).

People from countries where HIV is endemic are over-represented in the HIV endemic.

  • People from countries where HIV is endemic and whose HIV status is attributed to heterosexual exposure accounted for an estimated 17% of new HIV infections in 2011 while people born in an HIV-endemic country accounted for only 2% of the Canadian population in the 2006 census.
  • The estimated new HIV infection rate among people from countries where HIV is endemic is 9 times higher than among other Canadians.

Key definitions

HIV prevalence - The number of people who are living with HIV at a point in time. Prevalence tells us how many people have HIV.

HIV incidence - The number of new HIV infections in a defined period of time (usually one year). Incidence tells us how many people are getting HIV.

Where do these numbers come from?

All epidemiological information is approximate, based on the best available data. The data contained in this fact sheet comes from the 2011 HIV prevalence and incidence estimates published by the Public Health Agency of Canada (PHAC).

Estimates of HIV prevalence and incidence

National HIV estimates are produced by PHAC and published every three years. Estimates of HIV prevalence and incidence are produced by PHAC using statistical methods which take into account some of the limitations of surveillance data (number of HIV diagnoses reported to PHAC) and also account for the number of people living with HIV who do not yet know they have it. Statistical modeling, using surveillance data and additional sources of information, allows PHAC to produce HIV estimates among those diagnosed and undiagnosed. The most recent estimates available are for 2011. The next set of estimates will be available in 2015 and will pertain to the year 2014.

Acknowledgements

We would like to thank the Surveillance and Epidemiology Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada for their helpful comments and expert review of this fact sheet.

References

Public Health Agency of Canada. Summary: Estimates of HIV Prevalence and Incidence in Canada, 2011. Surveillance and Epidemiology Division, Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, 2012. Available at: http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/estimat2011-eng.php



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