HIV and Aids in Canada

Surveillance Report to June 30, 2000

Information to the readers of HIV and AIDS in Canada

The Division of HIV/AIDS Epidemiology and Surveillance of the Bureau of HIV/AIDS, STD and TB at the Centre for Infectious Disease Prevention and Control, Health Canada, is pleased to provide you with the HIV and AIDS in Canada: Surveillance Report to June 30, 2000. 

This report presents data that reveal a shift in reported HIV diagnoses toward relatively fewer cases attributed to injection drug use and relatively more cases attributed to men who have sex with men. These data are preliminary, and we will be following this situation closely to see if it is sustained for the rest of the year.

On July 1^st, 2000, Health Canada was realigned to better serve Canadians, meet the challenges of the new millennium, and improve collaboration with health professionals, and internal and external stakeholders. As a result of the realignment process, the Bureau of HIV/AIDS, STD and TB is now part of the newly created Centre for Infectious Disease Prevention and Control (CIDPC) of the new Public Health Agency of Canada (PHAC).

In addition to changes at the centre and branch level of Health Canada, HIV/AIDS activities within the Bureau of HIV/AIDS, STD and TB have also been re-organized.  All activities of the former Division of HIV/AIDS Surveillance have been divided and merged into other divisions. The Division of Retrovirus Surveillance is now responsible for the collection of HIV/AIDS surveillance data, and all modelling and projection activities have been moved to the newly created Division of Modelling and Projection. The analyses of HIV/AIDS surveillance data, including the writing of this surveillance report, have become the responsibility of the Division of HIV Epidemiology.  To reflect this change, the Division of HIV Epidemiology has been renamed the Division of HIV/AIDS Epidemiology and Surveillance.

National level HIV and AIDS surveillance is possible as a result of all provinces and territories participating in, and setting directions for, HIV and AIDS surveillance.  Accordingly, the Bureau of HIV/AIDS, STD and TB would like to acknowledge the contributions of all provinces and territories in Canada towards the production of this report. Without their close collaboration and participation in HIV and AIDS surveillance, its publication would not have been possible.

Please note that AIDS data for the first six months of 2000 for the province of Ontario were not available at the time of publication and will be included in the April 2001 report. In addition, the number of positive HIV test reports for the province of Quebec is based on the minimum number of HIV positive individuals.  Please refer to the Limitations outlined in Section I.

We are continually working towards improving this report to reflect changing requirements for HIV/AIDS surveillance.  We welcome and appreciate your comments and suggestions.

Yours sincerely,

Table of Contents

Commentary on Surveillance of Positive HIV Test Reports and AIDS Diagnoses
TECHNICAL NOTES
SECTION I HIV in Canada: Positive HIV Test Reports to June 30, 2000, Reported to CIDPC up to August 11, 2000
Table 1.	Number of positive HIV test reports by year of test
Table 2.	Cumulative number of positive HIV test reports occurring in adults and children by gender between November 1, 1985 and June 30, 2000
Table 3A.	Number of positive HIV test reports among males by age group and year of test
Table 3B.	Number of positive HIV test reports among females by age group and year of test
Table 3C.	Number of positive HIV test reports by age group and year of test
Table 4A.	Number of positive HIV test reports among adult males by exposure category and year of test
Table 4B.	Number of positive HIV test reports among adult females by exposure category and year of test
Table 4C.	Number of positive HIV test reports among adults by exposure category and year of test
Table 4D.	Number of positive HIV test reports among children by exposure category and year of test
Table 4E.	Number of positive HIV test reports between January 1, 1998, and June 30, 2000, by exposure category and age group
Table 5A.	Total number of positive HIV test reports by province/territory and gender between November 1, 1985 and June 30, 2000
Table 5B.	Number of positive HIV test reports by province/territory and year of test
Table 6.	Number of positive HIV test reports between January 1, 1998, and June 30, 2000, by exposure category and province/territory
SECTION II Report of the Canadian Perinatal HIV Surveillance Program
Table 7.	Number of Canadian perinatal HIV- exposed infants by year of birth and maternal exposure category, 1984-1999
Table 8.	Number of Canadian perinatal HIV-exposed infants by year of birth, current status and use of antiretroviral therapy (ART) for prophylaxis, 1984-1999
Table 9.	Cumulative number of Canadian perinatal HIV-exposed infants by geographic region and current status, 1984-1999
SECTION III AIDS in Canada: AIDS Cases Diagnosed up to June 30, 2000, Reported to CIDPC up to August 11, 2000
Table 10.	Number of AIDS cases by year of diagnosis
Table 11.	Number and cumulative total of adult AIDS cases by year of diagnosis and gender
Table 12.	Cumulative number of AIDS cases occurring in adults and children, diagnosed up to June 30, 2000, by gender
Table 13A.	Number of male AIDS cases by age group and year of diagnosis
Table 13B.	Number of female AIDS cases by age group and year of diagnosis
Table 13C.	Number of AIDS cases by age group and year of diagnosis
Table 14A.	Number and percentage distribution of adult male cases of AIDS by exposure category and year of diagnosis
Table 14B.	Number and percentage distribution of adult female cases of AIDS by exposure category and year of diagnosis
Table 14C.	Number and percentage distribution of adult cases of AIDS by exposure category and year of diagnosis
Table 14D.	Number and percentage distribution of child cases of AIDS by exposure category and year of diagnosis
Table 14E.	Total number of AIDS cases diagnosed up to June 30, 2000, by exposure category and age group
Table 15A.	Number and male:female ratio of AIDS cases, diagnosed up to June 30, 2000, by province/territory and gender
Table 15B.	Number of male AIDS cases (all ages) by province/territory and year of diagnosis
Table 15C.	Number of female AIDS cases (all ages) by province/territory and year of diagnosis
Table 15D.	Total number of AIDS cases (all ages) by province/territory and year of diagnosis
Table 16.	Number and percentage distribution of all AIDS cases, diagnosed up to June 30, 2000, by province/territory and exposure category
Table 17.	Number and percentage distribution of all AIDS cases by ethnic status
Table 18.	Number and cumulative total of deaths due to AIDS by year of death
SECTION IV International Statistics on AIDS
Appendix 1. Data Sources

Commentary on Surveillance of Positive HIV Test Reports and AIDS Diagnoses

Reported Positive HIV Tests
In the six-month period from January to June 2000, there were 1,111 positive HIV test reports (with duplicates removed to the degree possible) reported to CIDPC by August 11, 2000 (Table 1). For the same period last year, 1,122 positive HIV tests were reported.

Annually, there were 2,233 positive HIV test reports in 1999 compared with 2,329 in 1998, 2,539 in 1997, 2,781 in 1996 and 2,989 in 1995 (Table 1).

Positive HIV test reports among women
As of June 30, 2000, adult women account for 13.1% of all positive HIV test reports for which age and gender are known (Table 2).  The proportion of positive HIV test reports among adult women remains at about 20% each year. In the first six months of 2000, 21.3% of all positive HIV tests among adults were in women.  In 1999, 1998 and 1997, this number was 24.3%, 21.7% and 19.8%, respectively (Tables 3A and 3B).

Positive HIV test reports among heterosexuals
There is a steady increase in positive HIV reports attributable to heterosexual sexual contact. In the first six months of 2000, 17.9% of all positive HIV tests among adults for which exposure category was known were attributable to heterosexual contact. In 1999, 1998 and 1997, this exposure category accounted for 18.9%, 17.2% and 16.0% of positive HIV test reports, respectively (Table 4C).

Positive HIV test reports among injection drug users
The proportion of positive HIV reports has increased among injection drug users, from 8.9% (of all adult positive HIV test reports for which exposure category was known) during 1985-1994 to 29.8% in 1995 and 33.5% in 1997 (Table 4C). For 1999 and the first six months of 2000, the proportion of positive HIV test reports in this exposure category was 28.3% and 21.9% respectively (Table 4C). Continued monitoring will clarify whether this relative decline is sustained.

Positive HIV test reports among men who have sex with men
In contrast, men who have sex with men (MSM) have accounted for a decreasing proportion of the positive HIV test reports among all adults: 74.7% of reports for which exposure category was indicated during 1985-1994 as compared with 44.3% in 1995 and 37.7% in 1999 (Table 4C).  However, there was an increase to 47.6% in the first six months of 2000.  This increase is more evident among adult males only: from 49.3% in 1999 to 59.9% in the first six months of 2000 (Table 4A). We will be monitoring this trend closely to see if it is still evident at the year-end report.

Reported AIDS Diagnoses
A cumulative total of 17,165 AIDS cases were diagnosed in Canada up to June 30, 2000, and reported to CIDPC by August 11, 2000 (Table 10); Of these, 16,968 were adults and 197 were children (<15 years)(Table 12).

Reported AIDS Deaths
A cumulative total of 11,824 AIDS-related deaths (68.9% of all AIDS cases) were reported to CIDPC (Table 18). The first six-month period of 2000 saw 36 AIDS deaths reported. These numbers underestimate the actual number of AIDS-related deaths in Canada because of reporting delays and an unknown degree of underreporting.

Please note, AIDS data for the first six months of 2000 for the province of Ontario were not available at the time of publication, and will be included in the April 2001 report. As a result, all proportions produced from the AIDS tables presented in this report may not be representative of the national situation.