HIV in Canada: A primer for service providers

People who inject drugs

Key Points

  • An estimated 89,855 people injected drugs in Canada in 2014.
  • People who inject drugs are 59 times more likely to get HIV than people who do not inject drugs.
  • Injection drug use accounted for an estimated 13% of new HIV infections in 2014 (incidence).
  • New HIV infections in people who use injection drugs may have decreased since 2011.
  • Injection drug use accounted for an estimated 19% of all Canadians living with HIV in 2014 (prevalence).
  • 11% of Canadians who inject drugs are HIV positive (based upon studies in 11 Canadian cities).

There were an estimated 89,855 people who injected drugs in Canada in 2014. This accounts for 0.3% of the Canadian population 15 years of age and older.

Injection drug users are 59 times more likely to get HIV than people who do not inject drugs. According to national 2014 estimates, there were 439 new HIV infections for every 100,000 people who inject drugs in Canada. This compares to only 7.5 new HIV infections for every 100,000 people who do not inject drugs in Canada.

Of all the new HIV infections in 2014, an estimated 335 (13%) were in people who inject drugs. This includes an estimated 270 new HIV infections attributed solely to injection drug use in 2014 (11% of all estimated new infections) and an estimated 65 new HIV infections (3%) in men for whom either having sex with men or using injection drugs could have been responsible for the infection (MSM-IDU).

HIV incidence may be decreasing for people who inject drugs but it has been stable for MSM-IDU since 2011. In 2011 the estimated number of new HIV infections attributed to injection drug use was 384 and 73 in MSM-IDU.

At the end of 2014 an estimated 19% of people living with HIV in Canada may have acquired their HIV injection through injection drug use (13,960 people). This estimate includes 11,560 people (15%) whose HIV status was attributed to injection drug use (IDU) and an additional 2,400 men (3%) whose HIV infection may have been due to either injection drug use or having sex with men (MSM-IDU) because they reported both behaviours at testing.

According to 2014 national HIV estimates, 20% of HIV-positive people whose infection is attributable to injection drug use remain undiagnosed. This represents an estimated 2,312 people.

Eleven percent of people who inject drugs tested in 11 Canadian cities in 2010–2012 were HIV positive. Sixty-eight percent had evidence of a current or past infection with hepatitis C. Among those in this study who self-reported they were HIV positive, 95% reported being under the care of a doctor, with 66% currently taking prescribed drugs for their HIV infection. Of those who are aware of a current hepatitis C infection, 48% are under the care of a doctor for their hepatitis C and 2% are currently taking prescribed drugs for hepatitis C.

Resources

The epidemiology of HIV in people who inject drugs in Canada – CATIE fact sheet

Summary: Estimates of HIV Incidence, Prevalence and Proportion Undiagnosed in Canada, 2014 – Public Health Agency of Canada (PHAC)

HIV/AIDS in Canada – CATIE infographic

People living with HIV in Canada – CATIE infographic

New HIV infections in Canada – CATIE infographic

Where is HIV hitting hardest? – CATIE infographic

HIV in Canada – PHAC infographic

Summary of key findings from I-Track Phase 3 (2010–2012) – Public Health Agency of Canada (PHAC)

I-Track: Enhanced Surveillance of HIV, Hepatitis C and Associated Risk Behaviours Among People Who Inject Drugs in Canada: Phase 2 Report – PHAC

Injection drug use and HIV/AIDS – Canadian HIV/AIDS Legal Network fact sheets

Sources

  1. Public Health Agency of Canada. Summary: Estimates of HIV Incidence, Prevalence and Proportion Undiagnosed in Canada, 2014. Ottawa: Surveillance and Epidemiology Division, Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, PHAC; 2015. Available at: http://www.catie.ca/en/resources/summary-estimates-hiv-incidence-prevalence-and-proportion-undiagnosed-canada-2014
  2. Yang Q, Ogunnaike-Cooke S, Halverson J, et al. Estimated national HIV incidence rates among key sub-populations in Canada, 2014. Presented at 25th Annual Canadian Conference on HIV/AIDS Research (CAHR), 12–15 May 2016, Winnipeg, Canada. Abstract EPH3.5.
  3. Public Health Agency of Canada. Summary of Key Findings from I-Track Phase 3 (2010-2012). Surveillance and Epidemiology Division, Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, 2012. Available at: http://www.catie.ca/en/resources/summary-key-findings-i-track-phase-3-2010-2012