Summary – OHESI

Data source: Ontario HIV Laboratory Cohort

Key points

Use of antiretroviral treatment (ART) has increased over time, with the percent of people with diagnosed HIV living in Ontario who wereon ART increasing from 55% in 2000 (range: 34 to 60%) to 81% in 2015 (range: 70 to 82%).
This increase may be due to several factors, including improved access to ART, changes to guidelines to recommend earlier initiation of ART after diagnosis and to warn against treatment interruptions, and interventions to support people to start and remain on ART.
ART status is documented on viral load (VL) test requisitions by the ordering provider and is missing for 17 to 20% of requisitions. Those with missing data were assumed to be on ART if virally suppressed.

Figures

Figure 1 Number of people with diagnosed HIV living in Ontario who were on ART, 2000 to 2015

Snapshot: The number of people with diagnosed HIV who were on ART increased from 4,880 in 2000 (range: 3,909 to 5,335) to 13,059 in 2015 (range: 12,181 to 13,059). See Table 1 below for data and definitions.

Figure 2 Percent of people with diagnosed HIV living in Ontario who were on ART, 2000 to 2015

Snapshot: The percent of people with diagnosed HIV who were on ART increased from approximately 55% in the early 2000s to 81.1% in 2015 (range: 69.9% to 82.0%). See Table 1 below for data and definitions.

Notes: Solid line represents main estimate and shaded area represents range of estimates.

Tables and definitions

Table 1 Number and percent of people with diagnosed HIV living in Ontario who were on antitretroviral treatment, 2000 to 2015

Year	Main estimate: Diagnosed (n)	Upper estimate: Diagnosed (n)	Lower estimate: Diagnosed (n)	Main estimate: On ART (n)	Main estimate: On ART (%)	Upper estimate: On ART (n)	Upper estimate: On ART (%)	Lower estimate: On ART (n)	Lower estimate: On ART (%)
2000	8,859	11,389	8,859	4,880	55.1	5,335	60.2	3,909	34.3
2001	9,367	11,787	9,367	5,178	55.3	5,585	59.6	4,183	35.5
2002	9,945	12,317	9,945	5,555	55.9	6,012	60.5	4,556	37.0
2003	10,574	12,742	10,574	5,932	56.1	6,333	59.9	4,914	38.6
2004	11,125	13,219	11,125	6,385	57.4	6,735	60.5	5,376	40.7
2005	11,672	13,648	11,672	6,861	58.8	7,213	61.8	5,853	42.9
2006	12,318	14,104	12,318	7,432	60.3	7,723	62.7	6,446	45.7
2007	12,832	14,477	12,832	8,003	62.4	8,294	64.6	6,997	48.3
2008	13,377	14,951	13,377	8,769	65.6	9,006	67.3	7,712	51.6
2009	13,819	15,298	13,819	9,397	68.0	9,618	69.6	8,276	54.1
2010	14,255	15,712	14,255	9,994	70.1	10,220	71.7	8,955	57.0
2011	14,699	16,162	14,699	10,685	72.7	10,864	73.9	9,699	60.0
2012	14,999	16,527	14,999	11,310	75.4	11,489	76.6	10,350	62.6
2013	15,346	16,764	15,346	11,920	77.7	12,064	78.6	10,970	65.4
2014	15,694	17,035	15,694	12,447	79.3	12,602	80.3	11,584	68.0
2015	16,110	17,423	16,110	13,059	81.1	13,212	82.0	12,181	69.9

Estimate of percent on ART	“On ART” definition (numerator)	“Diagnosed” definition (denominator)
Main	Documented on ART, or ART status missing and suppressed, on last VL test (Main estimate)	Nominal HIV-positive diagnostic test or HIV viral load test, and not administratively lost to follow-up after 2 years (Main estimate)
Upper	Documented on ART, or ART status missing and suppressed, on any VL test (Upper estimate)	Nominal HIV-positive diagnostic test or HIV viral load test, and not administratively lost to follow-up after 2 years (Main estimate)
Lower	Documented on ART, or ART status missing and suppressed, on all VL tests (Lower estimate)	Nominal/non-nominal HIV-positive diagnostic test or HIV viral load test, and not administratively lost to follow-up after 3 years (Upper estimate)

Notes: Data provided by Public Health Ontario Laboratory. ART status is documented on viral load (VL) test requisitions by the ordering provider and is missing for 17 to 20% of requisitions. ART=antiretroviral treatment.