AIDS and HIV in Canada

This page was reviewed or revised on Saturday, October 26, 2002.

According to the May 1997 AIDS Quarterly report from the Division of HIV/AIDS Surveillance in the Bureau of HIV/AIDS and STD, as of April 15, 1997, there have been a cumulative total of 14,836 cases of AIDS in Canada reported since the beginning of the epidemic. Of these, 14,677 were adults and 159 were children (less than 15 years). After adjusting for under-reporting and delayed reporting, we estimate, that by the end of 1996, there had actually been about 20,000 AIDS cases in Canada since the epidemic began.

When applying these reporting adjustments for 1996, the estimated incidence of AIDS cases last year was about 20% lower than in 1995.

This decrease is thought to be due to a real decline in AIDS cases in Canada because of improved HIV treatments and drug prophylaxis for opportunistic infections delaying the onset of AIDS, and possibly because of increased reporting delays.

AIDS deaths have also declined in 1996. AIDS deaths in 1996 were 15 to 20% less than the annual number during 1993-95. To March 31 1997, there had been a cumulative total of 10,837 deaths reported in Canada. To date some 73% of the reported AIDS cases are reported to have died.

There have been some important relative changes in the proportions of reported AIDS cases over time in different risk categories.

The proportion of AIDS cases in women has increased. The proportion of all cases of AIDS occurring in women since the beginning of the AIDS epidemic, and before 1990 was 6.2%; between 1990 and 1995, it was 6.9%, and in 1996, 9.5%. While the majority of AIDS in women are still related to heterosexual transmission, much of this rising trend among women can be attributed to the Injection drug use (IDU) exposure category (6.5% before 1990, 19.5% between 1990 and 1995, and 25% in 1996).

There has been a marked increase in AIDS cases attributed to IDU. IDU accounted for 1.5% of all reported cases of AIDS before 1990, 4.9% between 1990 and 1995, and 10.3% in 1996.

An increasing trend is also noted in the AIDS cases attributed to heterosexual transmission (2.2% of all AIDS cases before 1990, 5.6% between 1990 and 1995, and 9.2% in 1996).

A decreasing proportion of reported AIDS cases is occurring in the men who have sex with men (MSM) risk category (77.7% of all AIDS cases before 1990, and 68.6% of the cases between 1990 and 1995, and 62.2% in 1996).

HIV in Canada

The Bureau of HIV/AIDS and STD estimates that as of the end of 1996, a cumulative total of 50,000-54,000 Canadians has been infected with HIV since the onset of the epidemic and that at the end of 1996, 36,000-42,000 Canadians were currently living with HIV infection (including those living with AIDS). This compares to previous estimates of 42,500-45,00 cumulative infections to the end of 1994 with an estimated 32,000-36,000 living with HIV infection at that time.

The number of new HIV infections that occurred in Canada in 1996 is estimated to be between 3,000 and 5,000 which is higher than the estimated average number of 2,500-3,000 per year for the period 1989-94. The majority of this increase in HIV infections appears to be occurring among injection drug users and young gay men. However, available data also suggest increasing HIV infections among non-IDU heterosexuals (especially women) and Aboriginal peoples.
Comment

The important and good news of declining AIDS cases and AIDS deaths in Canada combined with the disturbing information that the incidence of new HIV infections has increased since the early 1990's, means that the number of Canadians currently living with HIV is increasing. This rising prevalence means there is an increased need for care and support for persons living with HIV and a potential increased risk of HIV transmission in Canada. Improved data are urgently needed to better monitor the HIV epidemics in Canada and to guide prevention and care programs and related policy.