HIV pre-exposure prophylaxis (PrEP) in Ontario, 2020

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HIV pre-exposure prophylaxis (PrEP) is the use of daily antiretroviral medications by HIV-negative individuals to reduce their risk of HIV infection. PrEP is a highly effective HIV-risk reduction strategy and a critical part of a comprehensive approach to HIV prevention. To improve access to PrEP, it is important to monitor PrEP uptake. However, Ontario does not currently have a provincial-level monitoring system for PrEP.

To close this gap, the Ontario HIV Treatment Network is pleased to bring you this report summarizing PrEP uptake and PrEP prescribing in Ontario from 2016 to March 2020. This report contains projected provincial-level estimates which are based on Truvada (inclusive of generics) or Descovy dispensation data from more than 2,100 pharmacies across Ontario provided by IQVIA1. An update and expansion of the October 2019 PrEP report published by the OHTN (“HIV pre-exposure prophylaxis in Ontario”), this report describes:

  • the estimated number, proportion or rate of individuals dispensed PrEP overall, by sex, age, prescriber specialty, payment type, region, and as a ratio to number of first-time HIV diagnoses (“PrEP-to-need ratio”).
  • the estimated number, proportion or rate of physicians and nurse practitioners who prescribed PrEP overall, by sex, specialty, number of PrEP prescriptions written, region, and as a ratio to number of first-time HIV diagnoses (“PrEP prescriber-to-need ratio”).

The report also includes data on PrEP uptake among gay, bisexual, transgender, Two-Spirit, and queer (GBT2Q) men in Ontario from the 2019 Sex Now survey: an annual national online community survey of GBT2Q men’s health in Canada.

For more information about this report, email [email protected]. To learn more about PrEP, visit www.ontarioprep.ca. There you can learn more about PrEP and how to access PrEP regardless of drug coverage.


Some key findings

PrEP use is increasing

The estimated number of PrEP users in Ontario increased dramatically (6.6 times) between 2016 and 2019.

Most PrEP users are men

PrEP is indicated for gay, bisexual and other MSM who meet risk criteria. As we expect, the majority of PrEP users are male (97%). While, PrEP use has increased for both men and women, it is increasing faster for men.

Assessing successful uptake of PrEP in women is not straightforward, as overall risk for HIV in women is lower, and PrEP guidelines are less developed for women as compared to men.

Most PrEP users are people between the ages of 20 and 39

In 2019, 33% of PrEP users were aged 30-39 years and 26% of PrEP users were aged 20-29 years.

People mainly get PrEP from their family doctors and use private insurance to pay for it. In 2019…

of the estimated PrEP users were prescribed PrEP by family and general practitioners.

of the estimated PrEP users covered the cost of the prescription through private health insurance.

More physicians are prescribing PrEP

Between 2018 and 2019, the estimated number of physicians who prescribed PrEP increased by 32%.

Most PrEP prescribers are in Toronto and Ottawa

In 2019, Toronto and Ottawa had the largest number of physicians who prescribed PrEP – together accounting for 6 in 10 PrEP prescribers (60.7%) when these regions made up only 27.4% of Ontario’s population. This may be explained by Toronto and Ottawa having disproportionately more gay, bisexual, and other men who have sex with men (GBMSM) who are eligible for PrEP, and/or individuals traveling into these cities to obtain PrEP. Nevertheless, the number of PrEP prescribers increased between 2018 and 2019 for almost all regions in Ontario.

PrEP use is increasing for the people who need it the most

The PrEP-to-need ratio compares the number of PrEP users to the number of HIV diagnoses in a demographic group or geography. We use the PrEP-to-need ratio to determine whether groups with the greatest HIV burden are benefiting from the PrEP rollout. A higher ratio indicates that a group has greater PrEP coverage relative to its need.

Between 2016 and 2019, the PrEP-to-need ratio:

  • increased for males and females.
  • increased across all health regions and was highest in Ottawa in 2019.
  • was higher for males than for females.

Assessing successful uptake of PrEP in women is not straightforward, as overall risk for HIV in women is lower, and PrEP guidelines are less developed for women as compared to men.

GBT2Q men who meet prescribing criteria are taking PrEP

Among gay, bisexual, transgender, Two-Spirit and queer (GBT2Q) men in the Sex Now 2019 study who met the criteria for PrEP based on the Canadian guidelines, 36.0% were currently on PrEP.

Much more information is provided in the full report.


Footnotes

  1. IQVIA, formerly Quintiles and IMS Health, Inc., is an American multinational company serving the combined industries of health information technology and clinical research.

La prophylaxie pré-exposition (PrEP) contre le VIH en Ontario, 2020

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English version

La prophylaxie pré-exposition (PrEP) contre le VIH consiste, pour une personne séronégative, à prendre quotidiennement des médicaments antirétroviraux afin de réduire son risque d’infection par le VIH. La PrEP est une stratégie hautement efficace de réduction du risque d’infection et une composante centrale d’une approche complète à la prévention du VIH. Il est important de surveiller le recours à la PrEP afin d’améliorer son accessibilité. Toutefois, l’Ontario n’est pas doté d’un système de surveillance provinciale de l’utilisation de la PrEP.

Pour combler cette lacune, le Réseau ontarien de traitement du VIH (OHTN) est heureux de présenter ce rapport qui résume le recours à la PrEP et sa prescription en Ontario, de 2016 à mars 2020. Ce rapport contient des estimations projetées à l’échelle provinciale sur la base des données de dispensation de Truvada (y compris ses formes génériques) et de Descovy recueillies par IQVIA auprès de plus de 2 100 pharmacies ontariennes.1 Cette version actualisée et enrichie du rapport d’octobre 2019 de l’OHTN sur la PrEP (« HIV pre-exposure prophylaxis in Ontario ») décrit :

  • une estimation du nombre, de la proportion ou du taux de personnes auxquelles la PrEP a été dispensée, globalement; en fonction du sexe, de l’âge, de la spécialité du/de la prescripteur(-trice), du type de paiement et de la région; et sous forme de ratio par rapport au nombre de premiers diagnostics du VIH (« ratio PrEP-besoin »);
  • une estimation du nombre, de la proportion ou du taux de médecins et d’infirmière(-ier)s praticien-nes ayant prescrit la PrEP, globalement; en fonction du sexe, de la spécialité, du nombre d’ordonnances de la PrEP émises et de la région; et sous forme de ratio par rapport au nombre de premiers diagnostics du VIH (« ratio prescripteurs-besoin »).

Le rapport comprend également des données sur le recours à la PrEP chez les hommes gais, bisexuels, transgenres, bispirituels et queer (GBT2Q) en Ontario, venant du sondage Sexe au présent 2019, un sondage communautaire national annuel en ligne concernant la santé des hommes GBT2Q au Canada.

Pour plus d’informations sur ce rapport, veuillez écrire à [email protected]. Pour en savoir plus sur la PrEP, visitez www.ontarioprep.ca. Vous y trouverez des renseignements supplémentaires sur la PrEP et les moyens d’y accéder, indépendamment de la couverture d’assurance-médicaments.


Quelques résultats clés :

Le recours à la PrEP est en hausse

Le nombre estimé d’utilisateur(-trice)s de la PrEP en Ontario
a augmenté radicalement (de 6,6 fois) entre 2016 et 2019.

La plupart des utilisateurs de la PrEP sont des hommes

La PrEP est indiquée pour les hommes gais, bisexuels et autres HRSH qui répondent aux critères de risque. Comme on peut s’y attendre, la majorité des utilisateurs de la PrEP sont des hommes (97 %). Bien que l’utilisation de la PrEP ait augmenté tant chez les hommes que chez les femmes, l’augmentation est plus rapide chez les hommes.

Il n’est pas simple d’évaluer le recours réussi à la PrEP chez les femmes, car le risque global d’infection par le VIH est plus faible chez la femme et les lignes directrices relatives à la PrEP pour les femmes sont moins étoffées que pour les hommes

La plupart des utilisateur(-trice)s de la PrEP sont âgé-es de 20 à 39 ans

En 2019, 33 % des utilisateur(-trice)s de la PrEP étaient âgé-es de 30 à 39 ans et 26 %, de 20 à 29 ans.

Les gens obtiennent la PrEP principalement auprès de leur médecin de famille et ont une assurance privée pour la payer

du nombre estimé d’utilisateur(-trice)s de la PrEP ont obtenu leur prescription auprès de médecins de famille et d’omnipraticien-nes.

du nombre estimé d’utilisateur(-trice)s de la PrEP ont payé le coût de l’ordonnance au moyen d’une assurance privée.

Plus de médecins prescrivent la PrEP

Entre 2018 et 2019, le nombre estimé de médecins ayant prescrit la PrEP a augmenté de 32 %

La plupart des prescripteur(-trice)s de la PrEP sont à Toronto et à Ottawa

En 2019, Toronto et Ottawa comptaient le plus grand nombre de médecins ayant prescrit la PrEP – représentant collectivement six prescripteur(-trice)s de la PrEP sur 10 (60,7 %), bien que ces régions ne constituaient que 27,4 % de la population de l’Ontario. Cela peut s’expliquer par le fait que Toronto et Ottawa comptent un nombre plus élevé d’hommes gais, bisexuels et d’autres hommes ayant des rapports sexuels avec des hommes (HRSH) qui sont admissibles à la PrEP, et/ou le fait que des personnes se rendent dans ces villes pour l’obtenir. Il n’en demeure pas moins que le nombre de prescripteur(-trice)s de la PrEP a augmenté dans presque toutes les régions de l’Ontario entre 2018 et 2019.

Hausse du recours à la PrEP parmi les personnes qui en ont le plus besoin

Le ratio PrEP-besoin compare le nombre d’utilisateur(-trice)s de la PrEP au nombre de diagnostics du VIH dans un groupe démographique ou une région géographique donnée.

Nous utilisons le ratio PrEP-besoin pour vérifier si les groupes les plus affectés par le VIH bénéficient de l’expansion de la PrEP. Un ratio plus élevé dans un groupe indique une meilleure couverture de la PrEP en proportion de ses besoins.

Entre 2016 et 2019, le ratio PrEP-besoin :

  • a augmenté chez les hommes et les femmes;
  • a augmenté dans toutes les régions sanitaires et était le plus élevé à Ottawa, en 2019;
  • était plus élevé parmi les hommes que les femmes.

Il n’est pas simple d’évaluer le recours réussi à la PrEP chez les femmes, car le risque global d’infection par le VIH est plus faible chez la femme et les lignes directrices relatives à la PrEP pour les femmes sont moins étoffées que pour les hommes.

Les hommes GBT2Q qui répondent aux critères de prescription utilisent la PrEP

Parmi les hommes gais, bisexuels, transgenres, bispirituels et queer (GBT2Q) de l’étude Sexe au présent 2019 qui répondaient aux critères de la PrEP en vertu des lignes directrices canadiennes, 36 % l’utilisaient.

Vous trouverez une foule de renseignements supplémentaires dans le rapport complet.


Footnotes

  1. IQVIA, anciennement Quintiles et IMS Health, Inc., est une société multinationale étatsunienne au service des secteurs combinés de la technologie de l’information sur la santé et de la recherche clinique.

HIV epidemiology update for GBMSM in Ontario, 2019: factsheet and methods

Introduction

OHESI estimated the number of gay- or bisexual-identifying, and other men who have sex with men (GBMSM) living in Ontario for the time period of 2017-2019. This estimate is provided in the OHESI factsheet “HIV epidemiology update for gay, bisexual, and other men who have sex with men (GBMSM) in Ontario, 2019” (French version here). The estimate was then used to produce an estimated prevalence of diagnosed HIV specifically within GBMSM. Here, OHESI outlines the methods developed to produce the estimated number of GBMSM in Ontario and prevalence of diagnosed HIV among them.

GBMSM working group

The methods were developed in consultation with a working group of experts in GBMSM health.  This working group included:

  • Barry Adam; University of Windsor
  • David Brennan; University of Toronto
  • Todd Coleman, Wilfred Laurier University
  • Sean Colyer; Ontario HIV Treatment Network
  • Ken English; AIDS and Hepatitis C Programs, Ministry of Health
  • Dane Griffiths; Gay Men’s Sexual Health Alliance
  • Maya Kesler; Ontario HIV Treatment Network
  • Abigail Kroch; Ontario HIV Treatment Network
  • Nathan Lachowsky; University of Victoria, Community-Based Research Centre

Definition of GBMSM population

For the purposes of OHESI’s estimate, GBMSM included all gay-identifying men, all bisexual-identifying men, and any other men who reported anal sex with another man in the past 6 or12 months. The two recall periods (6 or 12 months) exist because the estimates were produced through averaging estimates produced using two data sources for points of adjustment (see below), each with a different recall period.

Data sources and indicators used

Canadian Community Health Survey (CCHS), Statistics Canada

  • Data collected using computer assisted personal and telephone interview software
  • Data across 2017 to 2019 annual surveys used to produce a single estimate across the three-year period
    • Each participant weighted to account for participation bias in the survey1
  • Participants aged 15 years or older
  • Questionnaire items used:
    • 2017, 2018: Do you consider yourself to be…?
      • Heterosexual (sexual relations with people of the opposite sex)
      • Homosexual, that is lesbian or gay (sexual relations with people of your own sex)
      • Bisexual (sexual relations with people of both sexes)
    • 2019: What is your sexual orientation….?
      • Heterosexual
      • Homosexual
      • Bisexual
      • Please specify
      • CCHS redistributed “please specify” to the first three response options where appropriate
    • Have you ever had sex? Please include vaginal and anal sex.
      • Yes / No / Refused / Don’t Know
    • (If ever had sex) In the past 12 months, have you had sex with a male?
      • Yes / No / Refused / Don’t Know (Yes considered sexually active)
    • More information about the CCHS can be found here.

Sex Now 2019 Survey, Community Based Research Centre (CBRC)

  • Online survey of gay, bisexual, transgender, Two-Spirit, and queer (GBT2Q) men’s health
  • Data collection Fall 2019, Canada-wide, Ontario-specific data used here
  • Inclusion criteria:
    • Cis or trans man aged 15 years or older living in Canada
    • non-straight sexual identity or straight and reported sex with another man in past five years
  • Questionnaire items used:
    • Would you reveal your sexual orientation if asked in a Statistics Canada survey?
      • Very likely
      • Likely
      • Somewhat unlikely
      • Totally unlikely
      • Likely items collapsed to give proportion likely to disclose
    • In the PAST 6 MONTHS how many men have you had sex with?
      • Numeric response
    • (If had any sex with man in past 6 months) How many did you have anal sex with?
      • Numeric response (>0 considered sexually active)
    • More information about the Sex now survey can be found here, and about past surveys (including 2019) and their data here.

Modeling methods

Summary of methods

The estimate of GBMSM in Ontario is based on a core estimate of the number of adult males (aged 15 and older) who identified as “homosexual” or “bisexual” from the Canadian Community Health Survey (CCHS). This core estimate undergoes two adjustments. First, it is adjusted for non-disclosure of sexual orientation to the CCHS. Second, it is adjusted to include men who do not identify as gay or bisexual but who report having had anal sex with another man in the previous 6 or 12 months. An overview of these adjustment steps is illustrated in Figure 1.

Figure I Summary of adjustment steps taken in modelling the estimate of GBMSM in Ontario. Studies listed in brackets indicate the data source(s) that inform the adjustment. Recent sex with another man is defined as anal sex in the past six (Sex Now) or twelve (CCHS) months. The letters in circles for each step correspond with the subheadings that follow. CCHS = Canadian Community Health Survey.

A. Unadjusted estimated count of men who identified as gay or bisexual from the CCHS

A custom data tabulation from the CCHS provided to us from Statistics Canada used data across 2017 to 2019 and each participant (aged 15 years and older) weighted to account for participation bias in the survey1. In 2017 and 2018, the question used to determine sexual orientation was: “Do you consider yourself to be…?” with the response options “Heterosexual (sexual relations with people of the opposite sex); Homosexual, that is lesbian or gay (sexual relations with people of your own sex); Bisexual (sexual relations with people of both sexes)”.  In 2019, the CCHS survey changed the wording to “what is your sexual orientation” with response options “Heterosexual”, “Homosexual”, “Bisexual”, or “Please specify”. Statistics Canada redistributed “please specify” to the first three response options where appropriate. The number of males that responded homosexual or bisexual were tabulated to produce an estimated base unadjusted count of men who identified as gay or bisexual.

B. Adjust for non-disclosure of gay or bisexual identity

The base estimate was first adjusted to account for non-disclosure of gay or bisexual identity to the CCHS. In the 2019 Sex Now survey, the questionnaire asked “Would you reveal your sexual orientation if asked in a Statistics Canada survey?” with the Likert scale response options “Very likely; Likely; Somewhat unlikely; Totally unlikely”.  The number of males that responded homosexual or bisexual to the CCHS were considered to constitute the proportion that responded “Very likely” or “Likely” to the Sex Now survey, and the estimates were correspondingly inflated.

C. Adjust for men who had sex with men but did not identify as gay or bisexual

The estimate was lastly adjusted to include men who have sex with men but did not identify as gay or bisexual.  Both the CCHS and the 2019 Sex Now surveys provided data to inform this adjustment. Among gay- and bisexual-identifying men and other men who reported recent anal sex with men (defined as >0 male anal sex partners but not gay or bisexual identity), the proportion that identified as gay or bisexual was calculated from both the CCHS and Sex Now surveys. The number of gay- and bisexual-identifying men adjusted for non-disclosure (B above) was deemed to constitute this proportion and the number was correspondingly inflated.

Recent anal sex with another man is defined as anal sex in the past six (Sex Now) or twelve (CCHS) months. Both the CCHS and Sex Now surveys provided data to inform this adjustment point. Each survey was used, creating two different estimates. These two estimates were then averaged to provide a single estimate.

Prevalence of diagnosed HIV among GBMSM in Ontario

Prevalence is defined as the proportion of a population that is affected with a particular disease at a given time. To calculate the prevalence of diagnosed HIV among GBMSM in Ontario, the number of GBMSM living with diagnosed HIV in Ontario in 2018 was divided by the total number of GBMSM estimated above.

The number of GBMSM living with diagnosed HIV in Ontario was estimated by summing the following three estimated numbers (1 + 2 + 3):

  1. The estimated number of individuals living with diagnosed HIV known to be GBMSM.
  2. The number of individuals estimated to be GBMSM from the total individuals living with linked diagnosed HIV with unknown priority population (and therefore unknown GBMSM status).
    • Estimated by applying the proportion attributed to GBMSM where priority population known to the total individuals where priority population was unknown.
  3. The number of individuals estimated to be GBMSM from the total individuals living with diagnosed HIV but for whom OHESI only has viral load testing data and no linked nominal diagnostic HIV test.
    • These were reasoned to predominantly represent individuals originally diagnosed through anonymous (unlinked) HIV testing; thus, the proportion of anonymous tests that were attributed to GBMSM was applied to these individuals to produce an estimate of how many were GBMSM.

The sum of these three estimates comprised the estimated number of GBMSM living with diagnosed HIV in Ontario in 2018, and was divided by the total number of GBMSM estimated above to produce an estimate of prevalence of diagnosed HIV in this population for 2018. More information about how the number of individuals living in Ontario with diagnosed HIV were estimated can be found in the OHESI report “HIV care cascade in Ontario: Linkage to care, in care, on antiretroviral treatment, and virally suppressed, 2018”.


  1. See https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226 for more information on CCHS methods and survey weighting.

OHESI releases new report on HIV care cascade in Ontario, 2018

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The Ontario HIV Epidemiology and Surveillance Initiative (OHESI) is pleased to announce the release of a new report titled “HIV care cascade in Ontario: Linkage to care, in care, on antiretroviral treatment, and virally suppressed, 2018”.

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The most effective way to improve the health of people living with HIV and reduce new transmissions is to diagnose HIV infection as early as possible, and engage people quickly in care and treatment. Highly effective antiretroviral therapy (ART) can suppress HIV viral load to the point where it is undetectable, cannot cause as much damage to the person’s immune system, and cannot be passed to a sexual partner (undetectable = untransmittable).

Analyzing HIV care cascade data in Ontario is critical to understanding our successes and ongoing challenges in meeting HIV care cascade targets. In the 2018 HIV care cascade report, OHESI describes Ontario’s status in meeting the 2020 UNAIDS 90-90-90 targets, as well as trends between 2000 and 2018 in the number of people living with diagnosed HIV as well as trends in the numbers of people in HIV care, on antiretroviral treatment, virally suppressed and time from HIV diagnosis to being linked to care and achieving viral suppression.

Some of the key findings of the report:

Cascade summary:

  • An estimated 22,439 people were living with HIV in Ontario in 2018. Of these, an estimated 19,128 people (85.2%) knew their HIV status (i.e. were diagnosed).
  • In 2018, Ontario made progress compared to previous years on the 2nd and 3rd 90s, with 84.8% of people diagnosed on treatment (ART), and 97.3% of people on treatment (ART) were virally suppressed.

Diagnosed:

  • An estimated 19,128 people were living with diagnosed HIV in Ontario in 2018.
  • The total number of people diagnosed with HIV almost doubled from 2000 to 2018 due to ongoing transmission and people living with HIV living longer. This number also includes people who were diagnosed for the first-time both in Ontario and people first diagnosed elsewhere who now live in Ontario.

Linkage to care and in care:

  • The number of people with diagnosed HIV in care has increased steadily over time: from 8,008 in 2000 to 16,899 in 2018 (i.e. 16,899 individuals had at least one viral load test in 2018). This increase highlights a persistent and increasing demand for HIV-related services.
  • More people are in care. The percent of people with diagnosed HIV who were in care increased from 73% in 2000 to 88% in 2018.
  • People diagnosed with HIV are linked to care more quickly. The percent of newly diagnosed individuals who were linked to care within three months of HIV diagnosis increased from 67% in 2000 to 85% in 2017.

On antiretroviral treatment:

  • More people living with HIV are on treatment. The percent of people with diagnosed HIV who were on ART increased from 49% (5,359 people) in 2000 to 85% (16,214 people) in 2018.

Virally Suppressed:

  • More people are virally suppressed. Between 2000 and 2018, the percent of people with diagnosed HIV who were virally suppressed more than doubled from 35% (3,816 people) to 83% (15,775 people).
  • The percent of newly diagnosed individuals who had a suppressed viral load within 3 months of HIV diagnosis increased from 6% in 2000 to 33% in 2017 and within 6 months almost tripled from 23% to 66%.

Stay tuned for future reports from OHESI!


L’OHESI publie un nouveau rapport sur la cascade des soins du VIH en Ontario en 2018

L’Initiative d’Épidémiologie et de Surveillance du VIH en Ontario (OHESI) est heureuse d’annoncer la publication d’un nouveau rapport intitulé “Cascade des soins du VIH en Ontario : Arrimage aux soins, prise en charge, sous traitement antirétroviral et suppression virale, 2018”.

Télécharger le rapport

Le moyen le plus efficace pour améliorer la santé des personnes vivant avec le VIH et réduire les nouvelles transmissions est de diagnostiquer l’infection par le VIH le plus tôt possible afin que ces personnes puissent rapidement avoir accès aux soins et au traitement. Une thérapie antirétrovirale (TAR) très efficace peut supprimer la charge virale du VIH au point de la rendre indétectable, ne pouvant pas causer de dommages au système immunitaire de la personne et elle ne peut pas être transmis à un partenaire sexuel (indétectable = intransmissible).

L’analyse des données sur la cascade des soins du VIH en Ontario est essentielle pour comprendre nos réussites et les défis continus que nous devons relever pour atteindre les objectifs de la cascade des soins du VIH. Dans le rapport 2018 sur la cascade des soins du VIH, l’OHESI décrit l’état d’avancement de l’Ontario dans l’atteinte des objectifs 90-90-90 de l’ONUSIDA pour 2020, ainsi que les tendances entre 2000 et 2018 concernant le nombre de personnes vivant avec un diagnostic de VIH, sans oublier les tendances concernant le nombre de personnes bénéficiant des soins pour le VIH, sous traitement antirétroviral, avec suppression virale et le temps écoulé entre le diagnostic du VIH et le moment où l’on a accès aux soins et l’on atteint la suppression virale.

Quelques-unes des principales conclusions du rapport :

Résumé de la Cascade :

  • On estime à 22 439 le nombre de personnes vivant avec le VIH en Ontario en 2018. Parmi elles, on estime que 19 128 personnes (85,2 %) connaissaient leur statut sérologique (c’est-à-dire qu’elles avaient reçu un diagnostic).
  • En 2018, l’Ontario a fait des progrès par rapport aux années précédentes sur les 2e et 3e 90, avec 84,8 % des personnes diagnostiquées sous traitement (ART), et 97,3 % des personnes sous traitement (ART) étaient en suppression virale.

Diagnostiquées :

  • On estime à 19 128 le nombre de personnes vivant avec un diagnostic de VIH en Ontario en 2018.
  • Le nombre total de personnes diagnostiquées séropositives a presque doublé de 2000 à 2018 en raison de la transmission continue et du fait que les personnes vivant avec le VIH vivent plus longtemps. Ce nombre comprend également les personnes qui ont été diagnostiquées pour la première fois en Ontario et les personnes diagnostiquées pour la première fois ailleurs et qui vivent maintenant en Ontario.

Arrimage aux soins et prise en charge :

  • Le nombre de personnes dont le VIH a été diagnostiqué et qui sont prises en charge a augmenté de façon constante au fil du temps : il est passé de 8 008 en 2000 à 16 899 en 2018 (c’est-à-dire que 16 899 personnes ont subi au moins un test de charge virale en 2018). Cette augmentation met en évidence une demande persistante et croissante des services liés au VIH.
  • Plus de personnes sont prises en charge. Le pourcentage de personnes diagnostiquées séropositives et qui étaient prises en charge est passé de 73 % en 2000 à 88 % en 2018.
  • Les personnes diagnostiquées séropositives sont arrimées plus rapidement aux soins. Le pourcentage de personnes nouvellement diagnostiquées qui ont été mises en relation avec les soins dans les trois mois suivant le diagnostic du VIH est passé de 67 % en 2000 à 85 % en 2017.

Sous traitement antirétroviral :

  • Plus de personnes vivant avec le VIH sont sous traitement. Le pourcentage de personnes diagnostiquées séropositives et qui étaient sous traitement antirétroviral est passé de 49 % (5 359 personnes) en 2000 à 85 % (16 214 personnes) en 2018.

Suppression virale :

  • Plus de personnes bénéficient une charge virale supprimée. Entre 2000 et 2018, le pourcentage de personnes diagnostiquées séropositives et qui étaient sous suppression virale a plus que doublé, passant de 35 % (3 816 personnes) à 83 % (15 775 personnes).
  • Le pourcentage de personnes nouvellement diagnostiquées qui ont obtenu une suppression virale dans les 3 mois suivant le diagnostic du VIH est passé de 6 % en 2000 à 33 % en 2017 et a presque triplé dans les 6 mois, passant de 23 % à 66 %.

 

Restez à l’écoute des prochains rapports de l’OHESI !

OHESI releases new report on HIV Testing in Ontario 2019 / 2019 en Ontario, l’OHESI publie un nouveau rapport sur le dépistage du VIH

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The Ontario HIV Epidemiology and Surveillance Initiative (OHESI) is pleased to announce the release of a new report titled “HIV Testing in Ontario, 2019”.

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A robust HIV testing program ensures that individuals at risk receive regular HIV tests and that people who are living with HIV can learn their status and be linked to care. HIV testing is also an important gateway to prevention services for people who test HIV-negative. Understanding trends in HIV testing can also help Ontario measure the success of its HIV testing initiatives.

In the 2019 HIV Testing Report, OHESI describes the trends in HIV testing in Ontario over the past decade (2010-2019), with a focus on HIV tests in 2019. The report includes analyses broken down by type of test (nominal, coded, and anonymous), sex, age, HIV exposure category, and geographic location (health regions), as well as information specific to rapid/point-of-care (POC) and prenatal HIV testing. New to this report are analysis by HIV test submitter type and by transgender identity and race/ethnicity (based on the new HIV test requisition implemented in 2018). Metrics described in the report include the number and percent of HIV tests, rates of HIV tests per 1,000 people, and HIV test positivity rates (i.e. the percentage of HIV diagnostic tests with a confirmed HIV-positive result).

Some key findings:

  • In 2019, 677,251 HIV tests were conducted in Ontario – equivalent to an HIV testing rate of 46.6 tests per 1,000 people. Of note, negative prenatal HIV tests were analyzed separately in this report.
  • While the number of tests conducted remained relatively stable between 2010 and 2013, it increased 53.3% between 2013 and 2019. The HIV testing rate per 1,000 people also increased 42.4% during this time.
  • In 2019, the number of HIV tests was slightly greater among males (333,521) than females (325,317). Only in 2017 and 2019 was the number of HIV tests among males greater than among females.
  • While the HIV test positivity rate decreased over time for both sexes, it was consistently three to five times higher among males than females. In 2019, the HIV test positivity rate was 0.15% for males and 0.05% for females.
  • Between 2015 and 2019, the HIV testing rate per 1,000 people increased for all age groups by an average of 34% and was consistently highest in the 25 to 29 age category.
  • The HIV test positivity rate in 2019 was highest in the 55-59 age category for both males (0.26%) and females (0.09%); however, people testing in this age category tested at a lower rate and had a relatively lower number of positive tests.
  • In 2019, the vast majority of HIV tests (96.3%) were nominal and the remainder were coded (1.2%) or anonymous (2.4%).
  • While the HIV test positivity rate has decreased over time for all test types, it was consistently at least four times higher among people who tested anonymously than those who tested nominally. In 2019, the HIV test positivity rate was 0.09% for nominal testing, 0.14% for coded testing and 0.48% for anonymous testing.
  • Between 2015 and 2019, the proportion of HIV tests in males attributed to men who have sex with men (MSM) increased from 10.8% to 13.1%. Approximately 63% of HIV tests among males had unknown exposure category.
  • In 2019, the HIV testing rate per 1,000 people was highest in Toronto (80.0) followed by Ottawa (53.0). In the other five health regions, the HIV testing rate ranged from 31.4 (Eastern) to 40.2 (Central East). The number of HIV tests and the HIV testing rate per 1,000 people increased between 2018 and 2019 in all health regions, with the exception of the South West region.
  • In 2019, HIV tests submitted by “other physicians/clinics/labs” comprised the largest proportion of HIV tests (44.2%), followed by immigration physicians/clinics (14.1%) and HIV treating physicians/clinics (11.5%).
  • In 2019, the largest number of positive results among males were submitted by “other physicians/clinics/labs” (140, 27.2%), and among females were submitted by immigration physicians/clinics (53, 31.4%).
  • In 2019, of the 223,198 HIV tests submitted via the new test requisition with known sex, 178 (0.08%) were among transgender females, and 114 (0.05%) were among transgender males.
  • In 2019, among the 226,716 HIV tests submitted via the new HIV test requisition, the largest proportion of HIV tests was among White individuals (29.3%), followed by Black (5.8%), East/Southeast Asian (4.9%), and South Asian (3.6%) individuals. Approximately half (49.7%) of these tests had unknown or missing race/ethnicity information.
  • Between 2014 and 2019, the number of point-of-care (POC) tests decreased from 30,117 to 19,414 tests, while the POC HIV test positivity rate fluctuated between 0.42% (2015) and 0.69% (2018) before decreasing to a low of 0.32% in 2019.
  • In 2019, the vast majority of HIV tests (97.1%) were standard, laboratory tests and the remainder were POC (2.9%); the majority of POC tests are provided anonymously.
  • Between 2012 and 2019, the estimated proportion of all pregnant people who received a prenatal HIV test increased from 94.2% to 97.4%.

Stay tuned for future reports from OHESI!


L’Initiative d’Épidémiologie et de Surveillance du VIH en Ontario (OHESI) a le plaisir d’annoncer la publication d’un nouveau rapport intitulé “2019, le dépistage du VIH en Ontario“.

Télécharger le rapport

Un solide programme de dépistage du VIH permet de s’assurer que les personnes à risque subissent régulièrement des tests de dépistage du VIH et que les personnes qui vivent avec le VIH puissent connaître leur statut et soient arrimer aux soins. Le dépistage du VIH est également une passerelle importante vers les services de prévention pour les personnes dont le test est négatif. La compréhension des tendances en matière de dépistage du VIH peut également aider l’Ontario à mesurer le succès de ses initiatives de dépistage du VIH.

Dans le rapport 2019 sur le dépistage du VIH, l’OHESI décrit les tendances du dépistage du VIH en Ontario au cours de la dernière décennie (2010-2019), en mettant l’accent sur les tests de dépistage du VIH en 2019. Le rapport comprend des analyses ventilées selon le type de test (nominal, codé et anonyme), le sexe, l’âge, la catégorie d’exposition au VIH et l’emplacement géographique (régions sanitaires), ainsi que des informations spécifiques au dépistage rapide/point de service (PS) et au dépistage prénatal du VIH. Les nouveautés de ce rapport se situent au niveau des analyses par type de personne ayant soumis le test VIH et par identité transgenre et race/origine ethnique (sur la base de la nouvelle demande de test de dépistage du VIH mise en œuvre en 2018). Les métriques décrites dans le rapport comprennent le nombre et le pourcentage des tests de dépistage du VIH, les taux sur 1 000 personnes et les taux de positivité des tests de dépistage du VIH (c’est-à-dire le pourcentage des tests diagnostiques du VIH avec un résultat positif confirmé).

Quelques principales conclusions :

  • En 2019, 677 251 tests de dépistage du VIH ont été effectués en Ontario – ce qui équivaut à un taux de dépistage du VIH de 46,6 tests sur 1 000 personnes. Il convient de noter que les tests de dépistage du VIH prénataux négatifs ont été analysés séparément dans ce rapport.
  • Bien que le nombre de tests effectués soit resté relativement stable entre 2010 et 2013, il a augmenté de 53,3 % entre 2013 et 2019. Le taux de dépistage du VIH sur 1 000 personnes a également augmenté de 42,4 % au cours de cette période.
  • En 2019, le nombre de tests de dépistage du VIH était légèrement supérieur chez les hommes (333 521) que chez les femmes (325 317). Ce n’est qu’en 2017 et 2019 que le nombre de tests de dépistage du VIH chez les hommes était supérieur à celui des femmes.
  • Bien que le taux de positivité des tests de dépistage du VIH ait diminué au fil du temps pour les deux sexes, il était constamment de trois à cinq fois plus élevé chez les hommes que chez les femmes. En 2019, le taux de positivité des tests de dépistage du VIH était de 0,15% chez les hommes et de 0,05% chez les femmes.
  • Entre 2015 et 2019, le taux de dépistage du VIH sur 1 000 personnes a augmenté pour tous les groupes d’âge de 34 % en moyenne et était systématiquement plus élevé dans la catégorie des 25 à 29 ans.
  • En 2019, le taux de positivité des tests de dépistage du VIH était le plus élevé dans la catégorie d’âge des 55 à 59 ans, tant pour les hommes (0,26 %) que pour les femmes (0,09 %) ; toutefois, les personnes testées dans cette catégorie d’âge l’ont été à un taux plus faible et ont eu un nombre relativement plus faible de tests positifs.
  • En 2019, la grande majorité des tests de dépistage du VIH (96,3 %) étaient nominatifs et les autres étaient codés (1,2 %) ou anonymes (2,4 %).
  • Bien que le taux de positivité des tests de dépistage du VIH ait diminué au fil du temps pour tous les types de tests, il a toujours été au moins quatre fois plus élevé chez les personnes ayant effectué un test anonyme que chez celles ayant effectué un test nominal. En 2019, le taux de positivité des tests de dépistage du VIH était de 0,09 % pour les tests nominaux, de 0,14 % pour les tests codés et de 0,48 % pour les tests anonymes.
  • Entre 2015 et 2019, la proportion des tests de dépistage du VIH chez les hommes attribués aux hommes ayant des relations sexuelles avec des hommes (HSH) a augmenté de 10,8% à 13,1%. Environ 63 % des tests de dépistage du VIH chez les hommes avaient une catégorie d’exposition inconnue.
  • En 2019, le taux de dépistage du VIH sur 1 000 personnes était le plus élevé à Toronto (80,0 %), suivi d’Ottawa (53,0 %). Dans les cinq autres régions sanitaires, le taux de dépistage du VIH variait de 31,4 % (Est) à 40,2 % (Centre-Est). Le nombre des tests de dépistage du VIH et le taux de dépistage du VIH sur 1 000 personnes ont augmenté entre 2018 et 2019 dans toutes les régions sanitaires, à l’exception de la région du Sud-Ouest.
  • En 2019, les tests de dépistage du VIH soumis par les “autres médecins/cliniques/laboratoires” représentaient la plus grande proportion de tests de dépistage du VIH (44,2 %), suivis par les médecins/cliniques de l’immigration (14,1 %) et les médecins/cliniques traitant le VIH (11,5 %).
  • En 2019, le plus grand nombre de résultats positifs chez les hommes a été soumis par les “autres médecins/cliniques/laboratoires” (140 soit 27,2 %), et chez les femmes par les médecins/cliniques de l’immigration (53 soit 31,4 %).
  • En 2019, parmi les 223 198 tests de dépistage du VIH soumis via la nouvelle demande de test avec le sexe connu, 178 (0,08 %) concernaient des femmes transgenres et 114 (0,05 %) des hommes transgenres.
  • En 2019, parmi les 226 716 tests de dépistage du VIH soumis dans le cadre de la nouvelle demande de test du VIH, la plus grande proportion de tests de dépistage du VIH concernait les Blancs (29,3 %), suivis par les Noirs (5,8 %), les Asiatiques de l’Est/Sud-Est (4,9 %) et les Asiatiques du Sud (3,6 %). Environ la moitié (49,7 %) de ces tests comportaient des informations sur la race ou l’origine ethnique inconnues ou manquantes.
  • Entre 2014 et 2019, le nombre de tests au point de service (PS) a diminué, passant de 30 117 à 19 414 tests, tandis que le taux de positivité des tests de dépistage du VIH au PS a fluctué entre 0,42 % (2015) et 0,69 % (2018) avant de baisser à un faible taux de 0,32 % en 2019.
  • En 2019, la grande majorité des tests de dépistage du VIH (97,1 %) étaient des tests de laboratoire standard, le reste étant des tests des PS (2,9 %) ; la majorité des tests des PS sont fournis de façon anonyme.
  • Entre 2012 et 2019, la proportion estimée de toutes les personnes enceintes ayant bénéficié d’un test prénatal de dépistage du VIH est passée de 94,2 % à 97,4 %.

 

Restez à l’écoute des prochains rapports de l’OHESI !

World AIDS Day 2020

On this World AIDS Day, OHESI remembers those who have lost their lives to HIV, and we recognize the efforts of our community to prevent HIV infection and improve the lives of people living with HIV.

Over the past 40 years, we have seen great progress in the effort to stop the spread of HIV. As a result of effective treatment, people living with HIV can now suppress the virus to undetectable levels, which means they can lead long healthy lives and cannot pass the virus to their sexual partners (undetectable = untransmittable or U=U). Due to the development of pre-exposure prophylaxis or PrEP, people can now take one pill a day to protect themselves from getting HIV.

To understand the impact of these prevention interventions, Ontario has refined its surveillance data to calculate the number of first-time diagnoses annually: this is our best indicator of the number of people who are learning their HIV status for the first time and were likely to have been infected in the province. In 2019, for the first time in more than a decade, we saw a decrease in both the number and rate of first-time HIV diagnoses among males in Ontario. In 2019, about 9,000 Ontario males were dispensed PrEP1, almost three times the number in 2018. This promising trend among males tells us that the combination of treatment (U=U) and PrEP are working to decrease local transmissions. More work is needed to further these gains, as females received only 2.5% of all dispensed PrEP in 20191.

In 2019:

  • There were 687 first-time HIV diagnoses in Ontario, down from 738 in 2018.
  • The rate of first-time HIV diagnoses per 100,000 people was 4.7, the lowest since 1986.
  • There were 515 (7.2/100,000) first-time HIV diagnoses among males and 169 (2.3/100,000) first-time HIV diagnoses among females.
  • This is the lowest number and rate of first-time HIV diagnoses among males since 1986.
  • About three-quarters (75.3%) of first-time HIV diagnoses were in males and one-quarter (24.7%) were among females.
  • Breaking down the percent of diagnoses by priority populations* and sex, 53.6% of first-time diagnoses were in gay, bisexual and other men who have sex with men, 15.1% were in African, Caribbean and Black males, 11.9% in African, Caribbean and Black females, 7.9% in males who inject drugs, 4.3% in females who inject drugs, 2.9% in Indigenous males and 2.0% in Indigenous females.
  • Within the gay, bisexual and other men who have sex with men priority population, 15% of first-time HIV diagnoses were also identified as being part of the African, Caribbean and Black priority population.

By building on the successes of effective HIV treatment and PrEP, we can continue to drive down the number of new HIV diagnoses in Ontario and work to ensure that HIV prevention, testing and treatment are accessible to all Ontarians.


Sources: HIV diagnostic data from Public Health Ontario, HIV Datamart; 1: IQVIA Ontario pharmacy dispensation records.

Notes: First-time HIV diagnoses are those who are learning their status for the first-time in Ontario, excluding people already diagnosed out of province and repeat testing in Ontario. Due to missing data on test history, this number can be a slight overcount. The time of diagnosis does not tell you when a person acquired HIV (i.e. rate of diagnosis is not a direct proxy for incidence of infection).
*Priority populations are not mutually exclusive.


En cette journée mondiale du sida, nous nous souvenons de ceux qui ont perdu la vie à cause du VIH et nous reconnaissons les efforts de notre communauté pour prévenir l’infection par le VIH et améliorer les conditions de vie des personnes vivant avec le VIH.

Au cours des 40 dernières années, nous avons constaté de grands progrès dans les efforts visant à arrêter la propagation du VIH. Grâce à un traitement efficace, les personnes vivant avec le VIH peuvent désormais voir le virus supprimer jusqu’à des niveaux indétectables, ce qui signifie qu’elles peuvent mener une longue vie saine et ne peuvent pas transmettre le virus à leurs partenaires sexuels (indétectable = intransmissible ou I=I). Grâce au développement de la prophylaxie Pré-Exposition ou PrEP, les gens peuvent désormais prendre une pilule par jour pour se protéger contre le VIH.

Pour comprendre l’impact de ces interventions de prévention, l’Ontario a affiné ses données de surveillance afin de calculer le nombre de premiers diagnostics annuels : c’est notre meilleur indicateur du nombre de personnes qui apprennent leur statut VIH pour la première fois et qui étaient susceptibles d’avoir été infectées dans la province. En 2019, pour la première fois depuis plus d’une décennie, nous avons observé une diminution du nombre et du taux de premiers diagnostics de VIH chez les hommes en Ontario. En 2019, environ 9 000 hommes Ontariens ont reçu la PrEP1, soit près de trois fois plus qu’en 2018. Cette tendance prometteuse chez les hommes nous indique que la combinaison du traitement (I=I) et de la PrEP contribue à réduire les transmissions locales. Des efforts supplémentaires restent à faire pour poursuivre ces progrès, car les femmes n’ont reçu que 2,5 % de toute la PrEP dispensée en 2019.

En 2019 :

  • Il y a eu 687 premiers diagnostics de VIH en Ontario, contre 738 en 2018.
  • Le taux de premiers diagnostics de VIH pour 100 000 personnes était de 4,7, le plus bas depuis 1986.
  • Il y a eu 515 (7,2/100 000) premiers diagnostics de VIH chez les hommes et 169 (2,3/100 000) premiers diagnostics de VIH chez les femmes.
  • Il s’agit du nombre et du taux les plus bas de premiers diagnostics de VIH chez les hommes depuis 1986.
  • Environ trois quarts (75,3 %) des nouveaux cas de VIH ont été diagnostiqués chez les hommes et un quart (24,7 %) chez les femmes.
  • En ventilant le pourcentage de diagnostics selon les populations prioritaires* et le sexe, 53,6 % des premiers diagnostics ont été diagnostiqués chez des hommes homosexuels, bisexuels et autres hommes ayant des rapports sexuels avec des hommes, 15,1 % chez des hommes Africains, Caribéens et Noirs, 11,9 % chez des femmes Africaines, Caribéennes et Noires, 7,9 % chez des hommes qui s’injectent des substances, 4,3 % chez des femmes qui s’injectent des substances, 2,9 % chez des hommes Autochtones et 2,0 % chez des femmes Autochtones.

En nous appuyant sur les succès des traitements efficaces contre le VIH et de la PPrE, nous pouvons continuer à faire baisser le nombre de nouveaux diagnostics de VIH en Ontario et nous efforcer de faire en sorte que la prévention, le dépistage et le traitement du VIH soient accessibles à tous les Ontariens.


Sources : Données de diagnostic du VIH de Santé Public Ontario, HIV Datamart ; 1 : Dossiers de dispensation des pharmacies IQVIA Ontario.

Notes : Les personnes diagnostiquées pour la première fois pour le VIH sont celles qui apprennent leur statut pour la première fois en Ontario, à l’exclusion des personnes déjà diagnostiquées hors de la province et des tests répétés en Ontario. En raison de données manquantes sur l’historique des tests, ce nombre peut être légèrement surestimé.  Le moment du diagnostic ne permet pas de savoir quand une personne a contracté le VIH (c’est-à-dire que le taux de diagnostic n’est pas un indicateur direct de l’incidence de l’infection).

*Les populations prioritaires ne sont pas mutuellement exclusives.

OHESI releases new report on HIV Testing in Ontario 2018

The Ontario HIV Epidemiology and Surveillance Initiative (OHESI) is pleased to announce the release of a new report titled “HIV Testing in Ontario, 2018”.

View (or Download) Report

Analyzing HIV testing data in Ontario is critical to measuring our success in the HIV prevention, engagement and care cascade. A robust testing program ensures that individuals at risk receive regular HIV tests and that people who are living with HIV can learn their status and be linked to care. HIV testing is also an important gateway to prevention services for people who test HIV-negative. Trends in HIV testing can also help Ontario measure the success of its HIV testing initiatives.

In the 2018 HIV Testing Report, OHESI describes the trends in HIV testing in Ontario over the past decade (2009-2018), with a focus on HIV test in 2018. The report includes analyses broken down by type of test (nominal, coded, and anonymous), sex, age, HIV exposure category, and geographic location (health regions), as well as information specific to rapid/point-of-care (POC) and prenatal HIV testing. Metrics described in the report include the number and percent of HIV tests, rates of HIV tests per 1,000 people, and HIV test positivity rates (i.e. the percent of HIV diagnostic tests with a confirmed HIV-positive result), among other analyses.

Some of the key findings of the report:

  • In 2018, there were 637,780 HIV tests in Ontario – equivalent to an HIV testing rate of 44.5 tests per 1,000 people.
  • While the number of tests conducted remained relatively stable between 2009 and 2013, it increased 44.4% between 2013 and 2018. The HIV testing rate per 1,000 people also increased 36.2% during this time.
  • From 2013 to 2018, the number of HIV tests among males and females was very similar (309,163 vs. 308,844, respectively). However, in 2017, the number of HIV tests among males was greater than the number among females.
  • While the HIV test positivity rate decreased over time for both sexes, it was consistently three to four times higher among males than females. In 2018, the positivity rate was 0.19% for males and 0.05% for females.
  • Between 2014 and 2018, the HIV testing rate per 1,000 people increased for all age groups by an average of 37% and was consistently highest among people ages 25 to 29.
  • The HIV test positivity rate in 2018 was highest in the 55-59 age category for both males (0.24%) and females (0.15%).
  • In 2018, the vast majority of HIV tests (96.6%) – including POC tests – were nominal and the remainder were coded (1.3%) or anonymous (2.2%).
  • While the HIV test positivity rate has decreased over time for all test types, it was consistently at least four times higher among people who tested anonymously compared to those who tested nominally. In 2018, the test positivity rate was 0.10% for nominal testing, 0.12% for coded testing and 0.71% for anonymous testing.
  • Between 2014 and 2018, the percent of HIV tests in males attributed to men who have sex with men (MSM) increased from 26.0% to 32.3%.
  • In 2018, the HIV testing rate per 1,000 people was highest in Toronto (75.3) followed by Ottawa (53.0). The number of HIV tests and the HIV testing rate increased between 2017 and 2018 in all health regions.
  • Between 2014 and 2018, the number of point-of-care (POC) tests decreased by 39.8% from 30,117 to 18,142 through more targeted testing to priority populations, while the positivity rate from POC testing increased from 0.42% to 0.69%.
  • Between 2012 and 2017, the estimated percent of all pregnant people who received a prenatal HIV test increased from 94.2% to 96.2% (estimate for 2018 not available).

Stay tuned for future reports from OHESI!

OHESI releases new report on HIV testing in Ontario 2017

The Ontario HIV Epidemiology and Surveillance Initiative (OHESI) is pleased to announce the release of a new report titled “HIV testing in Ontario, 2017”.

View report

Reporting on HIV testing data in Ontario is critical to measuring our success in the HIV prevention, engagement and care cascade. A robust testing program ensures that high risk individuals receive regular HIV tests and that people who are living with HIV can learn their status and be linked to care. HIV testing is also an important gateway to services for people who are HIV-negative to be linked to prevention services. Trends in HIV testing can be useful for measuring the success of HIV testing initiatives.

In the 2017 HIV Testing Report, OHESI describes the trends in HIV testing in Ontario over the past decade (2008-2017), with a focus on HIV tests in 2017. The report includes analyses broken down by type of test (nominal, coded, and anonymous), sex, age, HIV exposure category, and geographic location (health regions), as well as information specific to rapid/point-of-care (POC) and prenatal HIV testing. Metrics described in the report include the number and percent of HIV tests, rates of HIV tests per 1,000 people, and HIV test positivity rates (i.e. the percent of HIV diagnostic tests with a confirmed HIV-positive result), among other analyses. For more information on HIV diagnoses in Ontario, please see the OHESI new report on HIV diagnoses in Ontario, 2017

Some of the key findings of the report:

  • In 2017, there were 574,035 HIV tests in Ontario – equivalent to an HIV testing rate of 40.4 tests per 1,000 people.
  • While the number of tests conducted remained relatively stable between 2008 and 2013, it increased by 29.9% between 2013 and 2017. The HIV testing rate per 1,000 people also increased by 24.1% during this time.
  • In 2017, the vast majority of HIV tests (95.9%) – including POC tests – were nominal and the remainder were coded (1.6%) or anonymous (2.5%).
  • In recent years, the number and rate of HIV tests were similar among males and females. In 2017, 50.1% of people tested were males and 49.9% were females. For the first time in 2017, the number of HIV tests among males was greater than the number of HIV tests among females.
  • Between 2013 to 2017, the rate of HIV tests per 1,000 people was consistently highest in the 25 to 29 age category and increased for all age groups over time. Over this time period, the HIV testing rate per 1,000 people increased for all age groups by an average of 25%.
  • Between 2013 and 2017, the percent of HIV tests in males attributed to men who have sex with men (MSM) increased from 23.7% to 30.9%.
  • In 2017, the HIV testing rate per 1,000 people was highest in Toronto (68) followed by Ottawa (46). The number of HIV tests and the HIV testing rate increased between 2016 and 2017 in all health regions.
  • Between 2013 and 2017, the number of point-of-care (POC) tests decreased by 31.7% from 29,362 to 20,068 through more targeted testing to priority populations, while the POC test positivity rate increased from 0.47% to 0.59%.
  • Between 2013 and 2017, the estimated number of prenatal HIV tests was stable and the estimated proportion of women receiving prenatal laboratory testing who had an HIV test increased from 97.3% to 97.8%.

The information in this report can also be found in the Data and figures section of the OHESI website.

Stay tuned for future reports from OHESI!

OHESI releases new report on HIV diagnoses in Ontario 2017

The Ontario HIV Epidemiology and Surveillance Initiative (OHESI) is pleased to announce the release of a new report titled “New HIV diagnoses in Ontario, 2017”.

View Report 

This report describes, updates and expands on the trends in HIV diagnoses in Ontario over the past decade (2008-2017) with a focus on new HIV diagnoses in 2017. It presents analyses by sex, age, race/ethnicity, geographic location and priority populations (i.e. subgroups of Ontarians who experience a higher risk of HIV).

This report is the first to use data from the Laboratory Enhancement Program (LEP) to better understand trends in new HIV diagnoses in Ontario. This new information allowed us to:

  • reduce double counting by removing HIV diagnoses with a documented history of a previous HIV-positive test result within Ontario
  • Identify HIV diagnoses with a documented history of a previous HIV-positive test result outside of Ontario (‘out-of-province’ diagnoses). These individuals were initially diagnosed (and likely infected) outside of the province, and then moved to Ontario and were tested again. To help target prevention programs, it is important to exclude these diagnoses for some analyses. At the same time, it is important to report on all new HIV diagnoses so the health system can plan services for all people living with HIV in the province.

 

A few key findings of the report include:

  • The number of new HIV diagnoses has increased each year since 2014. In 2017, there were a total of 916 new HIV diagnoses. When ‘out-of-province’ diagnoses were removed, there were 797 new HIV diagnoses.
  • Gay, bisexual and other men who have sex with men still account for the largest proportion of HIV diagnoses while women account for approximately 1 of 5 new HIV diagnoses.
  • Between 2012 to 2017, the proportion of new HIV diagnoses has decreased among White men and increased among Black men while, over the same period, the proportion of new diagnoses has increased among White women and decreased among Black women.
  • Toronto has the highest number and rate of new HIV diagnoses in Ontario, almost twice the rate of the next highest health region (Ottawa).

 

Stay tuned for the 2017 HIV Testing Report, coming soon!

 

OHESI releases Women & HIV in Ontario factsheet

We are excited to announce the release of a factsheet about women and HIV in Ontario. This factsheet was developed in collaboration with the Women & HIV/AIDS Initiative (WHAI), the Ontario HIV Epidemiology and Surveillance Initiative (OHESI), and the OHTN Cohort Study (OCS). The purpose of this factsheet is to highlight which women are most at risk for HIV and the service needs and challenges for women living with HIV in Ontario.

Download Women & HIV in Ontario factsheet.

The intent of the fact sheet is not to be exhaustive, but to provide an overview of the key issues we must address to end the HIV epidemic for women in Ontario. The information is gathered from multiple sources, including surveillance data, communicated research findings, published literature, and conference proceedings. We included the most recent and rigorous data available to draw attention to specific issues.

We hope this factsheet helps support the development and implementation of services and policies that meet the needs and priorities of women living with or at risk of HIV.

For more information on WHAI or to contact a WHAI coordinator, visit WHAI.ca
For more information on the OHTN Cohort Study (OCS), visit ohtncohortstudy.ca