HIV and AIDS in Canada

Surveillance Report to June 30, 2005

November 2005

Surveillance and Risk Assessment Division
Centre for Infectious Disease Prevention and Control
Public Health Agency of Canada

PDF Version
76 Pages - 2,261 KB

© Her Majesty the Queen in Right of Canada,
represented by the Minister of Health (2005)
(On-line) Cat No. HP37-2/2005-1-PDF ISBN 0-662-69388-4

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Acknowledgements: 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 Centre for Infectious Disease Prevention and Control acknowledges the provincial/territorial HIV/AIDS coordinators, laboratories, health care providers and reporting physicians for providing the non-nominal confidential data that enable this report to be published. Without their close collaboration and participation in HIV and AIDS surveillance, the publication of this report would not have been possible. A complete listing of these contributors is available in Appendix 5.

We also thank Scientific Publication and Multimedia Services of the Communication Directorate, for its contribution in editing and producing the report on the internet.

N.B. This document must be cited as the source for any information extracted and used from it.

Suggested citation: Public Health Agency of Canada. HIV and AIDS in Canada. Surveillance Report to June 30, 2005. Surveillance and Risk Assessment Division, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, 2005.

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Surveillance and Risk Assessment Division
Centre for Infectious Disease Prevention and Control
Public Health Agency of Canada
Tunney's Pasture, AL 0602B
Ottawa, Ontario, K1A 0K9
Tel: (613) 954-5169 Fax: (613) 957-2842

Information to the readers of HIV and AIDS in Canada

On behalf of the HIV/AIDS Surveillance Section, I would like to present you with the HIV and AIDS in Canada: Surveillance Report to June 30, 2005. This report is part of a semi-annual series providing a review of available HIV and AIDS surveillance data in Canada.

The HIV/AIDS Surveillance section is part of the Surveillance and Risk Assessment Division, at the Centre for Infectious Disease Prevention and Control. This section is responsible for data collection and management, analysis and report production. In addition, we continue to improve data quality, define and set surveillance standards, as well as support the use of these data to influence programmatic and policy action.

The main findings of the surveillance data are outlined in the section entitled At a Glance, and this is followed by a series of tables summarizing the underlying data. Technical notes in addition to references and data sources are available in the Appendices. Explanatory details specific to provincial or territorial surveillance data issues are located at the beginning of each section.

A further description of HIV and AIDS surveillance data is available in the HIV/AIDS Epi Updates reports that are also available on our website listed on the front cover of this report.

The publication of this report would not be possible without the submission of HIV and AIDS surveillance data from all provinces and territories. Their ongoing contribution to national HIV and AIDS surveillance is gratefully acknowledged and is further listed in Appendix 5.

Sincerely,

Jennifer Pennock, MSc
Acting Manager
HIV/AIDS Surveillance Section
Surveillance and Risk Assessment Division

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Table of Contents

At a Glance
Tables
Section I HIV in Canada: Positive HIV Test Reports to June 30, 2005 and reported to CIDPC up to August 8, 2005
1.	Number of positive HIV test reports by year of test (all ages)
2.	Cumulative number of positive HIV test reports occurring in adults and children by gender between November 1, 1985, and June 30, 2005
3.	Number of positive HIV test reports among adults (≥ 15 years) by year of test and gender
4A.	Number of positive HIV test reports by age group and year of test
4B.	Number of positive HIV test reports among males by age group and year of test
4C.	Number of positive HIV test reports among females by age group and year of test
5A.	Number and percentage distribution of positive HIV test reports among adults (≥ 15 years) by exposure category and year of test
5B.	Number and percentage distribution of positive HIV test reports among adult males (≥ 15 years) by exposure category and year of test
5C.	Number and percentage distribution of positive HIV test reports among adult females (≥ 15 years) by exposure category and year of test
5D.	Number and percentage distribution of positive HIV test reports among children (< 15 years) by exposure category and year of test
5E.	Number of positive HIV test reports by exposure category and age group between January 1, 2005, and June 30, 2005
6A.	Number of positive HIV test reports by province/territory and gender between November 1, 1985, and June 30, 2005 (all ages)
6B.	Number of positive HIV test reports by province/territory and year of test (all ages)
7.	Number of postitive HIV test reports by exposure category and province/territory between January 1, 2005, and June 30, 2005 (all ages)
8.	Number of positive HIV test reports by year of test and ethnic status for those provinces/ territories that submitted ethnicity data between 1998 and June 30, 2005 (all ages)
Section II Report of the Canadian Perinatal HIV Surveillance Program
Section III AIDS in Canada: AIDS Surveillance to June 30, 2005 and reported to CIDPC up to August 8, 2005
13.	Number of reported AIDS cases by year of diagnosis (all ages)
14.	Cumulative number of reported AIDS cases occurring in adults and children by gender between 1979 and June 30, 2005
15.	Number of reported AIDS cases among adults (≥ 15 years) by year of diagnosis and gender
16A.	Number of reported AIDS cases by age group and year of diagnosis
16B.	Number of reported AIDS cases among males by age group and year of diagnosis
16C.	Number of reported AIDS cases among females by age group and year of diagnosis
17A.	Number and percentage distribution of reported AIDS cases among adult (≥ 15 years) by exposure category and year of diagnosis
17B.	Number and percentage distribution of reported AIDS cases among adult males (≥ 15 years) by exposure category and year of diagnosis
17C.	Number and percentage distribution of reported AIDS cases among adult females (≥ 15 years) by exposure category and year of diagnosis
17D.	Number and percentage distribution of reported AIDS cases among children (< 15 years) by exposure category and year of diagnosis
17E.	Number of reported AIDS cases among adults (≥ 15 years) by exposure category and age group between 1979 and June 30, 2005
17F.	Number of reported AIDS cases among children (< 15 years) by exposure category and age group between 1979 and June 30, 2005
18A.	Number of reported AIDS cases by province/ territory and gender between 1979 and June 30, 2005 (all ages)
18B.	Number of reported AIDS cases by province/ territory and year of diagnosis (all ages)
18C.	Number of reported AIDS cases among males by province/territory and year of diagnosis (all ages)
18D.	Number of reported AIDS cases among females by province/territory and year of diagnosis (all ages)
19.	Number and percentage distribution of reported AIDS cases by province/territory and exposure category to June 30, 2005 (all ages)
20.	Number of reported AIDS cases by year of diagnosis and ethnic status (all ages)
SECTION IV Mortality due to HIV/AIDS in Canada: Surveillance to June 30, 2005
21.	Reported deaths among reported AIDS cases by year of death (all ages)
22.	Cumulative number of reported deaths among reported AIDS cases occurring in adults and children by age of death and gender up to June 30, 2005
23.	Reported deaths among reported AIDS cases among adults (≥ 15 years) and children by year of death
24.	Reported deaths among reported AIDS cases among adults (≥ 15 years) by year of death and gender
Section V International Statistics on AIDS
Appendices
	Appendix 1. Technical Notes
	Appendix 2. Data Limitations
	Appendix 3. Terminology
	Appendix 4. References
	Appendix 5. Data Sources

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At a Glance

Introduction

The following report outlines HIV and AIDS surveillance data providing a description of persons who have been diagnosed with HIV and AIDS in Canada. Surveillance data understate the magnitude of the HIV epidemic and consequently do not represent the number of people infected with HIV (prevalence) or the number infected each year (incidence). Some of the reasons for this include the fact that surveillance data are subject to delays in reporting, underreporting and changing patterns in HIV testing behaviours (who comes forward for testing). In addition, surveillance data can only tell us about persons who have been tested and diagnosed with HIV or AIDS and not those who remain untested and undiagnosed. Because HIV is a chronic infection with a long latent period, many persons who are newly infected in a given year may not be diagnosed until later years.

It is important to be cautious when interpreting the surveillance data for the first half of the reporting year due to small sample sizes, delays and underreporting. A full description of the limitations of these data is outlined in Appendix 2. The Centre for Infectious Disease Prevention and Control (CIDPC) will continue to monitor the surveillance data and will clarify whether these findings are sustained when the full year is reported.

HIV Surveillance Data

A total of 58,929 positive HIV tests have been reported to CIDPC from November 1985, (when reporting began) up to June 30, 2005. For the first six months of 2005, a total of 1,234 positive HIV tests were reported to CIDPC, which are 128 fewer than the first six months of 2004. The number of positive HIV test reports has remained at about 2,500 per year during the 2002 to 2004 reporting period.

In terms of exposure category, Figure 1 shows that the relative composition of positive HIV test reports continues to change. Specifically, the proportion of tests attributed to injecting drug use (IDU) has decreased slightly in recent years, while the proportion of tests attributed to the men who have sex with men (MSM) and heterosexual contact exposure categories have both increased. In the first six months of 2005, MSM accounted for 43% of positive HIV test reports, and the heterosexual contact exposure category accounted for a third (30%).

Previous surveillance reports^1,2 have documented the increase in positive HIV test reports in women, particularly in the age category of 15 to 29 years. Before 1996, women accounted for just over ten per cent (10.5%) of positive HIV test reports. By 2004, women accounted for over one-quarter (26.6%) of positive tests. When exposure category data among women are considered over time, changes are observed (Figure 2). Before 1997, the heterosexual and injecting drug use (IDU) exposure categories accounted for a similar proportion of positive HIV test reports attributed to women (about 40 to 50% of positive HIV test reports each). After 1997, the proportion of positive HIV test reports attributed to the heterosexual exposure category began to increase, accounting for over two thirds (64%) of positive HIV test reports among women in 2004. During this same time, the proportion of positive HIV test reports attributed to IDU decreased, accounting for just over one-third (32%) positive tests among women in 2004. During the first six months of 2005, the heterosexual and IDU exposure categories accounted for 52% and 38% of positive HIV test reports among women, respectively.

FIGURE 1
Positive HIV test reports by exposure category and year of test

FIGURE 2
Proportion of positive HIV test reports among adult females by exposure category and year of test

AIDS Surveillance

As outlined in Section III, the province of Quebec has not submitted AIDS data to CIDPC since December 31, 2003. For this reason, annual trends as well as figures for reported AIDS diagnoses beyond the year 2003 are limited. A total of 20,146 AIDS diagnoses have been reported to CIDPC up to June 30, 2005 (Table 11). In 2003, the heterosexual exposure category eclipsed the MSM exposure category for proportion of AIDS diagnoses (Figure 3), but data submitted to CIDPC since that time have not demonstrated an extension of this trend. In the first six months of 2005, the MSM exposure category accounted for 44% of AIDS diagnoses, while the heterosexual exposure category accounted for 30% of diagnoses. It is important to note that due to antiretroviral therapy, AIDS diagnoses are now more indicative of failures in diagnosis and/or care than of underlying infection rates.

FIGURE 3
AIDS diagnoses by exposure category and year of test

Interpretation

The data presented in this report provide information on how the HIV/AIDS epidemic is changing in Canada. Some of the most notable changes observed in the surveillance data are:

• Increases in the proportion of positive HIV test reports within certain exposure categories (specifically, MSM and heterosexual contact);
• Increases in the proportion of women among positive HIV test reports; and,
• Changes in the exposure category distribution among positive HIV test reports attributed to women, where heterosexual contact accounts for an increasing proportion of tests and injecting drug use continues to decrease.

The 2005 data presented in this report are only for the first half of the year, so any reported trends must continue to be monitored, particularly as year-end data become available. Changes in the exposure category distribution for women are connected to the emerging heterosexual component of the HIV/ AIDS epidemic in Canada, and this is another facet of the evolving epidemic to be taken into consideration by HIV prevention and control programs.

 

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¹ Public Health Agency of Canada. HIV and AIDS in Canada. Surveillance report to June 30, 2004. Surveillance and Risk Assessment Division, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, 2004.

² Public Health Agency of Canada. HIV and AIDS in Canada. Surveillance report to December 31, 2004. Surveillance and Risk Assessment Division, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, 2005.

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