Summary

 

HIV testing

  • In 2017, there were 574,035 HIV tests in Ontario – equivalent to an HIV testing rate of 40.4 tests per 1,000 people.
  • While the number of tests conducted remained relatively stable between 2008 and 2013, it increased by 29.9% between 2013 and 2017. The HIV testing rate per 1,000 people also increased by 24.1% during this time.
  • In 2017, the vast majority of HIV tests (95.9%) – including point-of-care (POC) tests – were nominal and the remainder were coded (1.6%) or anonymous (2.5%).
  • In recent years, the number and rate of HIV tests were similar among males and females. In 2017, 50.1% of people tested were males and 49.9% were females. For the first time in 2017, the number of HIV tests among males was greater than the number of HIV tests among females.
  • Between 2013 to 2017, the rate of HIV tests per 1,000 people was consistently highest in the 25 to 29 age category and increased for all age groups over time. Over this time period, the HIV testing rate per 1,000 people increased for all age groups by an average of 25%.
  • Between 2013 and 2017, the percent of HIV tests in males attributed to men who have sex with men (MSM) increased from 23.7% to 30.9%.
  • In 2017, the HIV testing rate per 1,000 people was highest in Toronto (68) followed by Ottawa (46). The number of HIV tests and the HIV testing rate increased between 2016 and 2017 in all health regions.
  • Between 2013 and 2017, the number of POC tests decreased by 31.7% from 29,362 to 20,068 through more targeted testing to priority populations, while the POC test positivity rate increased from 0.47% to 0.59%.
  • Between 2013 and 2017, the estimated number of prenatal HIV tests was stable and the estimated proportion of women receiving prenatal laboratory testing who had an HIV test increased from 97.3% to 97.8%.

To read the full report go here.

New HIV diagnoses

  • The number of new HIV diagnoses has increased each year since 2014. In 2017, there were a total of 916 new HIV diagnoses. When ‘out-of-province’ diagnoses were removed, there were 797 new HIV diagnoses.
  • Gay, bisexual and other men who have sex with men still account for the largest proportion of HIV diagnoses while women account for approximately 1 of 5 new HIV diagnoses.
  • Between 2012 to 2017, the proportion of new HIV diagnoses has decreased among White men and increased among Black men while, over the same period, the proportion of new diagnoses has increased among White women and decreased among Black women.
  • Toronto has the highest number and rate of new HIV diagnoses in Ontario, almost twice the rate of the next highest health region (Ottawa).

To read the full report go here.

Diagnosed, linkage to care, in care, on antiretroviral treatment, and virally suppressed

  • In 2015, there were 16,110 people living with diagnosed HIV in the Ontario HIV Laboratory Cohort. This represents the cohort’s estimate of the number of people with diagnosed HIV who are living in the province (upper estimate: 17,423).
  • The number of people with diagnosed HIV in Ontario has almost doubled compared to the 8,859 estimated to be living with diagnosed HIV in 2000 (upper estimate: 11,389).
  • Engagement in Ontario’s cascade has improved over time, with the percent of diagnosed people who were in care, on antiretroviral treatment (ART) and virally suppressed all increasing from 2000 to 2015. Over this 16-year time period:
    • The percent of diagnosed people who were in care increased from 81% (lower estimate: 63%) to 87% (lower estimate: 81%).
    • The percent of diagnosed people who were on ART increased from 55% (range: 34 to 60%) to 81% (range: 70 to 82%).
    • The percent of diagnosed people who were virally suppressed doubled from 41% (range: 23 to 46%) to 80% (range: 67 to 81%).
  • Time from HIV diagnosis to linkage to care and viral suppression has also improved over time.
    • The percent of newly diagnosed individuals who linked to care within three months of diagnosis increased from 67% in 2000 to 82% in 2014.
    • The percent of newly diagnosed individuals who achieved viral suppression within six months of diagnosis increased from 22% in 2000 to 41% in 2013.
  • Estimates for 2015 suggest that the majority of people with diagnosed HIV living in Ontario were on ART (81%, range: 70 to 82%), and over 90% of people on ART were virally suppressed.
  • Overall, the Ontario HIV Laboratory Cohort demonstrates improved survival and cascade engagement among diagnosed people living with HIV, likely reflecting the availability of ART regimens that are more effective and easier to take, changes to treatment guidelines to recommend earlier initiation of ART after diagnosis, and the success of care and treatment initiatives.

To read the full report go here
To read the report with cascade estimates by sex, age and health region go here