Cascade indicator summary

  • In 2015, there were 16,110 people with diagnosed HIV in the Ontario HIV Laboratory Cohort. This represents the cohort’s estimate of the number of people with diagnosed HIV who are living in the province (upper estimate: 17,423).
  • The number of people with diagnosed HIV living in Ontario has almost doubled compared to the 8,859 estimated to be living with diagnosed HIV in 2000 (upper estimate: 11,389).
  • Engagement in the cascade in Ontario has improved over time, with the percent of people with diagnosed HIV who are in care, on ART and virally suppressed all increasing from 2000 to 2015. Over this 15-year time period:
  • The percent of diagnosed people who are in care increased from 81% (lower estimate: 63%) to 87% (lower estimate: 81%).
  • The percent of diagnosed people who are on ART increased from 55% (range: 34 to 60%) to 81% (range: 70 to 82%).
  • The percent of diagnosed people who are virally suppressed doubled from 41% (range: 23 to 46%) to 80% (range: 67 to 81%).
  • Time from HIV diagnosis to linkage to care and viral suppression has also improved over time.
  • The percent of newly diagnosed individuals who are linked to care within 3 months of diagnosis increased from 67% in 2000 to 82% in 2014.
  • The percent of newly diagnosed individuals who achieve viral suppression within 6 months of diagnosis increased from 22% in 2000 to 41% in 2013.
  • Estimates for 2015 suggest that the majority of people with diagnosed HIV living in Ontario are currently on ART (81%, range: 70 to 82%), and over 90% of those on ART are virally suppressed.
  • The results from the Ontario HIV Laboratory Cohort represent the most complete province-wide cascade estimates for people with diagnosed HIV living in Ontario.
  • These estimates complement other data sources exploring cascade engagement among people living with HIV who are already in care in Ontario, including the Ontario HIV Treatment Network Cohort Study (OCS) and the Institute of Clinical Evaluative Sciences (ICES) administrative HIV cohort.
  • Overall, the Ontario HIV Laboratory Cohort demonstrates improved survival and cascade engagement among diagnosed people living with HIV, likely reflecting the availability of improved ART regimens that are more effective and easier to take, changes to treatment guidelines to recommend earlier initiation of ART after diagnosis, and the success of care and treatment initiatives.