If applicable, new HIV diagnoses are assigned to one of the priority populations outlined in Ontario’s Provincial HIV/AIDS Strategy. Unlike exposure categories, these populations are not mutually exclusive, and new HIV diagnoses can be classified as belonging to more than one population.
Assignment to these populations is based on information from the HIV test requisition forms and LEP forms, as follows:
• Gay, bisexual and other men who have sex with men (GBMSM): MSM or MSM-PWID exposure category
• People who inject drugs (PWID): PWID or MSM-PWID exposure category
• Indigenous men and women: First nations or Inuit or Métis ethnicities
• African, Caribbean, and Black (ACB): born in African or Caribbean HIV-endemic country and/or Black ethnicity
• At-risk women: All diagnoses with female sex.
Information on race/ethnicity and priority population is missing for about a third of new HIV diagnoses. Also, there is no option for transgender identity on the HIV test requisition form. Changes to the requisition form to be implemented in 2018 will hopefully decrease missing information and improve documentation of trans men and women.
If a specific priority population is more likely to be missing information on HIV risk factors or race/ethnicity, that population may be underrepresented in the data. Also, due to the extent of missing data, the number of diagnoses attributed to a specific race/ethnicity or priority population is likely an underestimate of the actual number.
Documentation of information on the requisition/LEP forms may vary from provider to provider. For example, some providers may ask the person getting tested about their HIV risk factors and race/ethnicity, while other providers may make assumptions.