OHESI is pleased to announce the release of a new report titled “HIV care cascade in Ontario by sex, age and health region: Linkage to care, in care, on antiretroviral treatment and virally suppressed”.
In recent years, the HIV care cascade has become a core framework for those working in HIV. In its simplest form, the cascade refers to the continuum of steps that people living with HIV progress through in order to achieve viral suppression, including testing and diagnosis, linkage to and retention in care, and initiation of and adherence to antiretroviral treatment. As more research has shown the importance of viral suppression for both improving health and eliminating the risk of HIV transmission to a sex partner, the cascade has become an essential framework for evaluating and identifying gaps in HIV care.
With the release of the Ontario HIV/AIDS Strategy in 2016, Ontario joined other jurisdictions around the world in re-orienting HIV policies and programming to focus on the HIV cascade. In support of the priorities set out in the strategy, OHESI published a report summarizing trends in HIV cascade engagement among the approximately 16,000 people with diagnosed HIV living in Ontario. Importantly, this report was the first to draw upon a new data source that was created using centralized diagnostic and viral load testing databases housed at Public Health Ontario. The analyses in the report demonstrated improvement in the proportion of people with diagnosed HIV who were in care, on antiretroviral treatment and virally suppressed over time. Missing from the report, however, were cascade estimates by demographics and other breakdowns important for informing policy and front-line programming.
The newly released OHESI product being announced today builds upon this previous report by presenting cascade estimates by sex, age and health region in Ontario. The good news is that estimates have generally improved over time for both sexes, as well as across age categories and health regions. However, the report also demonstrates lower cascade estimates for people of younger ages and those living in the Northern health region, and slightly lower estimates for females and those living in Ottawa. These results support the need to understand reasons for variations in cascade engagement, which could lead to prioritizing interventions for specific populations.
Stayed tuned for an OHESI factsheet based on the findings from this report, as well as another knowledge exchange product presenting cascade estimates by priority populations, where possible. These populations are outlined in Ontario HIV/AIDS strategy and include gay, bisexual and other men who have sex with men, including trans men; African, Caribbean and Black people; Indigenous people; people who use drugs; and women at-risk, including trans women.