In December of 2018, researchers from the Public Health Agency of Canada released the 2017 HIV Surveillance Report. In the Canadian Communicable Disease Report (CCDR) article, the researchers downplay the impact of rising HIV rates, and indeed even downplay the existence of such an increase. Canada’s HIV response needs to be strengthened to address these realities, and not be allowed to languish in an atmosphere of complacency. The fight against HIV is not over, and we cannot be complacent when an average of 6.6 new HIV diagnoses are given daily.
Number of new infections
In perhaps the most incongruous interpretation of the data, the researchers state that a 3% increase in the number of new HIV infections from 2016 to 2017 is “slight”. However, by looking closer at their data, we can see that from 2014 to 2017 there has been a 17.1% increase in new HIV infections in Canada, signifying that there has been a major upward trend new cases that continued in 2017.
We can note the following from the data given on number of cases and rate of infection:
- The number of new infections in 2016 was the largest year-over-year increase since 1997.
- The number of new infections had been going down since 2009, but have been going back up for the last four years.
- The rate of infections per 100,000 people had been staying the same or going down for 7 years, but saw a sharp increase of 10.3% in 2016, which, like the number of cases, is the largest increase in the data. This increase continued in 2017, when there was a 1.6% increase in the number of new infections per 100,000.
In general, the interpretation in the CCDR article is straightforward. We can note the following from the data given in the article:
- The two provinces with the largest proportion of new infections are Ontario (935 new infections, 38.9% of the overall total) and Quebec (670 new infections, 27.9% of the overall total).
- The two provinces with the highest rate of infection are Saskatchewan (15.5 new infections per 100,000 people) and Quebec (8.0 new infections per 100,000 people).
- The difference between the largest share of infections and the highest rate of infection demonstrates that not only is reducing the number of infections important, but also taking into account the impact that HIV can have on a community when rates of infection are high.
In the supplementary tables, the information on age is broken down by both gender and geographical location. We can note the following from the data:
- Children aged under 15 years, adults aged 30-39, and adults aged 40-49 saw an increase in the number of new infections from 2016 to 2017, while youth aged 15-19, adults aged 20-29, and adults aged 50+ saw a decrease in the number of new infections.
- Youth aged 15-29 accounted for:
- 23% (545) of cases in 2017
- 25% (574) of cases in 2016
- 27% (558) of cases in 2015
- 23% (475) of cases in 2014
- 24% (504) of cases in 2013
- 25% (514) of cases in 2012
- Between 2016 and 2017 youth aged 15-19 had a 17% increase while youth aged 20-29 had a 4% decrease.
- This is why it is important to address both groups, as the same number of infections can have a very different impact on the total.
- Adults aged 30-39 had the largest increase in the total number of cases (73 new infections).
- Among people over 50, both the number of cases and the proportion of the total new infections they represent has been on the rise since 2012, with a slight decrease in 2017. We must continue to follow this number to analyze the specific needs of an HIV diagnosis in older adults.
Note: The gender binary was assumed in much of the data given. In some charts there was a third option, but it lumped together sex not reported, transsexual and transgender.
- Since 2012, the proportion of people newly diagnosed with HIV who identify as female has remained steady at around 22-25%.
Exposure category distribution
Although there has been an increase in the number and proportion of new HIV infections attributable to people who use injection drugs, this category is not the only one increasing, and is not the largest or most steady increase of the last five years. Other exposure categories have also been increasing, including heterosexual sex among people not from a country where HIV is endemic, which has been increasing in both number of new infections and the proportion of the total. If we focus only on harms from the opioid epidemic, then we risk leaving people behind who may mistakenly assume they are not at risk. There has been a slight increase in the number of infections among immigrants from a country where HIV is endemic, but this can be attributed to higher rates in general.
Selected Raw Data
Number of reported HIV Cases, 1996-2016
Data on the number of cases and rate per 100,000 people is taken from Haddad et al 2018, Figure 1; rates of change are calculated based on that information.
|Year||# of cases||% change from previous year||rate per 100,000||% change from previous year|
Sex/Gender data given
Number of cases data taken from Supplementary Table 5, percentages calculated.
|Males||Females||Sex not reported/ transsexual/transgender||Total|