The epidemiology of HIV in Canada

This fact sheet provides a snapshot of the HIV epidemic in Canada. It is one of a series of fact sheets on the epidemiology of HIV and hepatitis C in Canada.

All epidemiological information is approximate, based on the best available data. The data contained in this fact sheet comes from the HIV/AIDS Epi Updates Chapter 1: Estimates of HIV prevalence and incidence in Canada, 2011 and the Summary: Estimates of HIV prevalence and incidence in Canada, 2011, published by the Public Health Agency of Canada (PHAC). More information can be found in the section “Where do these numbers come from?” at the end of the fact sheet.

The number of people living with HIV in Canada (prevalence) is increasing.1

According to 2011 national HIV estimates:

  • An estimated 71,300 Canadians were living with HIV at the end of 2011.
  • This represents an increase of 7,300 people (11%) since 2008.
  • HIV prevalence increased during the 1980s, slowed down in the mid 1990s, but began to rise again in the late 1990s. This increase is a result of both new HIV infections and fewer deaths due to effective treatment options.

One quarter of people living with HIV in Canada are unaware that they have HIV.2

According to 2011 national HIV estimates:

  • An estimated 17,980 people living with HIV remained undiagnosed in 2011.
  • This represents 25% of the estimated number of people living with HIV.
  • The percentage of people who were unaware of their HIV-positive status varied by exposure category: people exposed through heterosexual sex were most likely to be unaware of their HIV infection (34%), followed by people exposed through injection drug use (24%), and finally men exposed through male-to-male sex (20%).

Almost 25,000 people living with HIV have died since the beginning of the epidemic.2

According to national HIV estimates, 24,300 people with HIV had died due to an HIV-related illness or other cause by the end of 2011.

The HIV epidemic in Canada is concentrated in specific populations (prevalence).1

According to 2011 national HIV estimates, people living with HIV include an estimated:

  • 35,490 gay men and other men who have sex with men (MSM). This represents 50% of all people living with HIV in Canada. The estimate includes 33,330 men whose HIV status was attributed to men having sex with men and 2,160 men whose HIV status could be attributed to either men having sex with men or injection drug use (MSM-IDU).
  • 14,200 people who used injection drugs (IDU). This represents 20% of all people living with HIV in Canada. The estimate includes 12,040 people whose HIV status was attributed to injection drug use and 2,160 men whose HIV status could be attributed to either men having sex with men or injection drug use (please note that these 2,160 men are the same as those noted in the bullet point above).
  • 23,170 people whose HIV status was attributed to heterosexual sex. This represents 33% of all people living with HIV in Canada. Of these, 10,640 people (15% of all people living with HIV) were from a country where HIV is endemic (primarily countries in sub-Saharan Africa and the Caribbean).
  • 600 people whose HIV status could not be attributed to sex or injection drug use. This includes people who likely contracted HIV through blood transfusions or clotting factors, transmission from mother to child, or needle-stick injuries in the workplace. This represents less than 1% of all people living with HIV in Canada.
  • 6,380 Aboriginal people. This represents 9% of all people living with HIV in Canada.
  • 16,600 females. This represents 23% of all people living with HIV in Canada.

The populations most impacted by HIV vary from region to region (prevalence).1

According to 2011 national HIV estimates:

  • The HIV epidemic is concentrated mainly in men who have sex with men in British Columbia (45.5% of people living with HIV), Ontario (56.0%), the Atlantic Provinces (54.2%) and Quebec (54.3%). These estimates includes men whose HIV status was attributed to men having sex with men and men whose HIV status could be attributed to either men having sex with men or injection drug use (MSM-IDU).
  • The HIV epidemic is concentrated mainly in people who use or have used injection drugs in Saskatchewan (71.4% of people living with HIV).
  • The HIV epidemic is concentrated mainly in people who engage in heterosexual sex in Alberta (42.8% of people living with HIV) and Manitoba (56.7%). These estimates include people whose HIV status was attributed to any type of heterosexual sex including those who were born in an HIV endemic country.

An infographic is available which graphically displays HIV prevalence by region.

An estimated 213 people are living with HIV for every 100,000 people in Canada. This varies considerably by region (prevalence).1,3

Using 2011 national HIV estimates and 2011 national census data:

  • The HIV prevalence rate is 213.0 per 100,000 people living in Canada.
  • Regions with higher HIV prevalence rates than the national rate include British Columbia (265.9 per 100,000), Quebec (244.2 per 100,000) and Ontario (233.4 per 100,000).
  • Regions with lower HIV prevalence rates than the national rate include Saskatchewan (203.2 per 100,000), Manitoba (173.8 per 100,000), Alberta (137.2 per 100,000), and Atlantic Canada (42.5 per 100,000).

An infographic is available which graphically displays HIV prevalence by region.

The number of new HIV infections in Canada has remained stable in the past several years but is not insignificant (incidence).1

According to 2011 national HIV estimates:

  • An estimated 3,175 people became infected with HIV in Canada in 2011.
  • This is comparable to or slightly lower than the estimated 3,335 new infections in 2008.

The number of new HIV infections (incidence) may be decreasing among people who inject drugs, females and Aboriginal people.1

According to 2011 national HIV estimates:

  • An estimated 435 new HIV infections (14% of new infections) were attributed to injection drug use compared to an estimated 565 new infections (17% of new infections) in 2008.
  • An estimated 755 new HIV infections (24%) occurred in females compared to an estimated 865 new infections (26%) in 2008.
  • An estimated 390 new HIV infections (12%) occurred in Aboriginal people compared to an estimated 420 new infections (13%) in 2008.

The number of new HIV infections (incidence) may be stable or decreasing slightly among MSM, MSM-IDU and people exposed to HIV through heterosexual sex.1

According to 2011 national HIV estimates:

  • An estimated 1,480 new HIV infections (47% of new infections) were attributed to men having sex with men compared to an estimated 1,470 new infections (44%) in 2008.
  • An estimated 80 new HIV infections (3%) were attributed to men whose HIV status could be attributed to either men having sex with men or injection drug use (MSM-IDU) compared to an estimated 90 new infections (3%) in 2008.
  • An estimated 535 new HIV infections were attributed to heterosexual sex in people from a country where HIV is endemic in 2011 (17%) compared to an estimated 540 new infections (16%) in 2008.
  • An estimated 645 new HIV infections were attributed to heterosexual sex in people born in a country where HIV is not endemic, including Canada, in 2011 (20% of new infections) compared to an estimated 670 new infections (20%) in 2008.

The populations most impacted by new HIV infections vary from region to region (incidence).1

According to 2011 national HIV estimates:

  • New HIV infections are concentrated mainly in men who have sex with men in British Columbia (57.4% of people living with HIV), Ontario (51.8%), the Atlantic Provinces (68.6%) and Quebec (58.5%). These estimates include men whose HIV status was attributed to men having sex with men and men whose HIV status could be attributed to either men having sex with men or injection drug use (MSM-IDU).
  • New HIV infections are concentrated mainly in people who use or have used injection drugs in Saskatchewan (76.1% of people living with HIV).
  • New HIV infections are concentrated mainly in people who engage or have engaged in heterosexual sex in Alberta (44.8% of people living with HIV) and Manitoba (61.7%). These estimates include people whose HIV status was attributed to any type of heterosexual sex including those who were born in an HIV endemic country.

An infographic is available which graphically displays HIV incidence by region.

An estimated 10 people for every 100,000 people were newly infected with HIV in Canada in 2011. This varies considerably by region (incidence).1,3

Using 2011 national HIV estimates and 2011 national census data:

  • The HIV incidence rate is 9.5 per 100,000 people living in Canada.
  • Regions with incidence rates comparable to the national rate include Manitoba (9.5 per 100,000) and Quebec (9.6 per 100,000).
  • Regions with higher HIV incidence rates than the national rate include Saskatchewan (22.3 per 100,000) and Ontario (10.9 per 100,000).
  • Regions with lower HIV incidence rates than the national rate include British Columbia (8.6 per 100,000), Alberta (6.9 per 100,000), and Atlantic Canada (1.5 per 100,000).

An infographic is available which graphically displays HIV incidence by region.

Certain populations have higher rates of new HIV infections (incidence).1

According to 2011 national estimates:

  • Aboriginal populations have incidence rates 3.6 times higher than people of other ethnicities.
  • People from HIV-endemic countries (living in Canada) have incidence rates 9.2 times higher than people of other ethnicities (living in Canada).
  • Men who have sex with men have incidence rates 71 times higher than other men.
  • People who inject drugs have incidence rates 46 times higher than people who do not inject drugs.
  • Males have incidence rates 3.3 times higher than females.

An infographic is available which graphically displays HIV incidence for certain populations.

Key definitions

HIV prevalence—The number of people who are living with HIV at a point in time. Prevalence tells us how many people have HIV.

HIV incidence—The number of new HIV infections in a defined period of time (usually one year). Incidence tells us how many people are getting HIV.

Where do these numbers come from?

All epidemiological information is approximate, based on the best available data. The data contained in this fact sheet comes from the 2011 HIV prevalence and incidence estimates published by the Public Health Agency of Canada (PHAC).

National estimates of HIV prevalence and incidence

National HIV estimates are produced by PHAC and published every three years. Estimates of HIV prevalence and incidence are produced by PHAC using statistical methods which take into account some of the limitations of surveillance data (number of HIV diagnoses reported to PHAC) and also account for the number of people living with HIV who do not yet know they have it. Statistical modelling, using surveillance data and additional sources of information, allows PHAC to produce HIV estimates among those diagnosed and undiagnosed. The most recent estimates available are for 2011. The next set of estimates will be available in 2015 and will pertain to the year 2014.

Calculation of prevalence and incidence rates

HIV prevalence and incidence rates were calculated using the 2011 national estimates and data obtained from the 2011 national census data.

Acknowledgements

We would like to thank the Surveillance and Epidemiology Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada for their helpful comments and expert review of CATIE epidemiology fact sheets.

References

Author(s): Challacombe L

Published: 2015

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