OHESI releases new report on HIV testing trends in Ontario

OHESI is pleased to announce the release of a new report titled “HIV testing in Ontario, 2016”.

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HIV testing is an early step in the HIV prevention, engagement and care cascade and an important gateway to a continuum of services. A person who receives an HIV-negative test result can be linked to supports to remain HIV-uninfected, while those receiving an HIV-positive result can be promptly linked to care and treatment. As we have learned more about HIV prevention strategies for HIV-negative individuals (for example, pre-exposure prophylaxis and services to address syndemic health issues), and the role of earlier treatment of people living with HIV in improving health and reducing HIV transmission, the importance of HIV testing has only increased.

The Ontario HIV/AIDS Strategy prioritizes the reduction of barriers to HIV testing in order to achieve its goals of preventing new HIV infections and promoting early HIV diagnosis. Over the past decade, several initiatives have been implemented in Ontario to achieve these goals, such as the expansion of anonymous testing sites in 2006, an HIV testing blitz program aimed at gay and other men who have sex with men in Toronto and Ottawa in 2011-2012 and the release of HIV testing frequency guidelines in 2012. In this time, new testing technologies have also been developed and made available in Ontario, including point-of-care tests that can provide results within minutes and HIV tests with shorter window periods.

The newly released OHESI report being announced today supports the strategy in monitoring trends in HIV testing. This new report contains data on the number of HIV tests from 2007 to 2016 and breaks this information down by age, sex, test type (i.e. nominal, anonymous, coded), exposure category and geography. This report also contains information on the percent of HIV tests that were HIV-positive (i.e. positivity rates). Testing trends are not only important for evaluating the success of testing initiatives and identifying populations for prioritization, but also provide insight into trends in new HIV diagnoses (published in a separate OHESI report).

We hope this report is useful for evaluating and guiding HIV policy and programming work across the province.

OHESI releases new report on cascade trends by sex, age and health region

OHESI is pleased to announce the release of a new report titled “HIV care cascade in Ontario by sex, age and health region: Linkage to care, in care, on antiretroviral treatment and virally suppressed”.

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In recent years, the HIV care cascade has become a core framework for those working in HIV. In its simplest form, the cascade refers to the continuum of steps that people living with HIV progress through in order to achieve viral suppression, including testing and diagnosis, linkage to and retention in care, and initiation of and adherence to antiretroviral treatment. As more research has shown the importance of viral suppression for both improving health and eliminating the risk of HIV transmission to a sex partner, the cascade has become an essential framework for evaluating and identifying gaps in HIV care.

With the release of the Ontario HIV/AIDS Strategy in 2016, Ontario joined other jurisdictions around the world in re-orienting HIV policies and programming to focus on the HIV cascade. In support of the priorities set out in the strategy, OHESI published a report summarizing trends in HIV cascade engagement among the approximately 16,000 people with diagnosed HIV living in Ontario. Importantly, this report was the first to draw upon a new data source that was created using centralized diagnostic and viral load testing databases housed at Public Health Ontario. The analyses in the report demonstrated improvement in the proportion of people with diagnosed HIV who were in care, on antiretroviral treatment and virally suppressed over time. Missing from the report, however, were cascade estimates by demographics and other breakdowns important for informing policy and front-line programming.

The newly released OHESI product being announced today builds upon this previous report by presenting cascade estimates by sex, age and health region in Ontario. The good news is that estimates have generally improved over time for both sexes, as well as across age categories and health regions. However, the report also demonstrates lower cascade estimates for people of younger ages and those living in the Northern health region, and slightly lower estimates for females and those living in Ottawa. These results support the need to understand reasons for variations in cascade engagement, which could lead to prioritizing interventions for specific populations.

Stayed tuned for an OHESI factsheet based on the findings from this report, as well as another knowledge exchange product presenting cascade estimates by priority populations, where possible. These populations are outlined in Ontario HIV/AIDS strategy and include gay, bisexual and other men who have sex with men, including trans men; African, Caribbean and Black people; Indigenous people; people who use drugs; and women at-risk, including trans women.

Preliminary update on new HIV diagnoses in Ontario

The Ontario HIV Epidemiology and Surveillance Initiative (OHESI) is pleased to announce the release of a preliminary update on new HIV diagnoses in Ontario.

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In this update you will find the number, rates, and breakdowns of new HIV diagnoses for 2016 and trends over time. This update is intended to provide information to support public health professionals, clinicians, health system planners, policy makers and the leadership of AIDS service organizations, as well as other engaged stakeholders. The update is based on HIV diagnostic test results from public health laboratory systems.

A full report on HIV diagnosis and testing is currently being developed. If you have any questions contact ohesi@ohtn.on.ca.