Surveillance Report to December 31, 2008

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Surveillance and Risk Assessment Division
Centre for Infectious Disease Prevention and Control
Public Health Agency of Canada

Acknowledgements: National level HIV and AIDS surveillance is possible as a result of all provinces and territories participating in, and setting directions for, HIV and AIDS surveillance. Accordingly, the Public Health Agency of Canada acknowledges the provincial/territorial HIV/AIDS coordinators, laboratories, health care providers and reporting physicians for providing the non-nominal confidential data that enable this report to be published. Without their close collaboration and participation in HIV and AIDS surveillance, the publication of this report would not have been possible. A complete listing of these contributors is available in Appendix 5.

N.B. This document must be cited as the source for any information extracted and used from it.

Suggested citation: Public Health Agency of Canada. HIV and AIDS in Canada. Surveillance Report to December 31, 2008. Surveillance and Risk Assessment Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, 2009.

Information to the readers of HIV and AIDS in Canada

On behalf of the HIV/AIDS Surveillance Section, we would like to present you with a report entitled HIV and AIDS in Canada: Surveillance Report to December 31, 2008. This report is part of an annual series providing a review of available HIV and AIDS surveillance data in Canada. A summary of mid-year data, to June 30th, will be available at the end of each year, on the Public Health Agency of Canada's website in a few key tables.

The HIV/AIDS Surveillance Section is part of the Surveillance and Risk Assessment Division, which is located in the Public Health Agency of Canada's Centre for Communicable Diseases and Infection Control. This Section is responsible for the data collection and management, analysis and report production related to this HIV and AIDS in Canada report series. In addition, we continue to improve data quality, define and set surveillance standards, as well as support the use of these data to influence programmatic and policy action.

The main findings of the surveillance data are outlined in the section entitled At a Glance, and this is followed by a series of tables summarizing the underlying data. Technical notes and data limitations are available in the Appendices. Explanatory details specific to provincial or territorial surveillance data issues are located at the beginning of each section. For a further description of HIV and AIDS surveillance data HIV/AIDS Epi Updates reports are available.

The publication of this report would not be possible without the submission of HIV and AIDS surveillance data from all provinces and territories. Their ongoing contribution to national HIV and AIDS surveillance is gratefully acknowledged and is further listed in Appendix 5.

David Boulos Manager HIV/AIDS Surveillance Section	Kristina Lalonde A/Senior Research Analyst HIV/AIDS Surveillance Section

Table of Contents

• At a Glance
• HIV Surveillance
• Immigration
• Canadian Perinatal HIV Surveillance Program
• AIDS Surveillance
• Interpretation

Tables

Section I

HIV in Canada: Positive HIV test reports to December 31, 2008 and Reported to PHAC up to February 13, 2009

• 1. Number of positive HIV test reports by year of test (all ages)
• 2. Cumulative number of positive HIV test reports occurring in adults and children by gender between November 1, 1985, and December 31, 2008
• 3. Number of positive HIV test reports among adults (≥ 15 years) by year of test and gender
• 4.   a) Number of positive HIV test reports by age group and year of test
•       b) Number of positive HIV test reports among males by age group and year of test
•       c) Number of positive HIV test reports among females by age group and year of test
• 5.   a) Number and percentage distribution of positive HIV test reports among adults (≥ 15 years) by exposure category and year of test
•       b) Number and percentage distribution of positive HIV test reports among adult males (≥ 15 years) by exposure category and year of test
•       c) Number and percentage distribution of positive HIV test reports among adult females (≥ 15 years) by exposure category and year of test
•       d) Number and percentage distribution of positive HIV test reports among children (< 15 years) by exposure category and year of test
•       e) Number of positive HIV test reports by exposure category and age group between January 1, 2008 and December 31, 2008.
• 6.   a) Number of positive HIV test reports by province/territory and gender between November 1, 1985, and December 31, 2008 (all ages)
•       b) Number of positive HIV test reports by province/territory and year of test (all ages)
•       c) Rate of positive HIV test reports among adults (≥ 15 years) (per 100,000 population) by province/territory and year of test
• 7. Number of positive HIV test reports by exposure category and province/territory between January 1, 2008, and December 31, 2008 (all ages).
• 8. Number of positive HIV test reports by year of test and ethnic status for those provinces/territories that submitted ethnicity data between 1998 and December 31, 2008 (all ages)

Section II

Report of the Canadian Perinatal HIV Surveillance Program, 1984-2008

• 9. Number of Canadian perinatally HIV-exposed infants by maternal exposure category and year of infant birth, 1984-200.
• 10. Number of Canadian perinatally HIV-exposed infants by year of birth, current status and use of antiretroviral therapy (ART) for prophylaxis, 1984-2008
• 11. Cumulative number of Canadian perinatally HIV-exposed infants by geographic region and status at last report, 1984-2008
• 12. Cumulative number of Canadian perinatally HIV-exposed infants by ethnic status and current status, 1984-2008

Section III

AIDS in Canada: AIDS Surveillance to December 31, 2008 and Reported to PHAC up to February 13, 2009

• 13. Number of reported AIDS cases by year of diagnosis (all ages)
• 14. Cumulative number of reported AIDS cases occurring in adults and children by gender between 1979 and December 31, 2008
• 15. Number of reported AIDS cases among adults (≥ 15 years) by year of diagnosis and gender
• 16. a) Number of reported AIDS cases by age group and year of diagnosis
•       b) Number of reported AIDS cases among males by age group and year of diagnosis
•       c) Number of reported AIDS cases among females by age group and year of diagnosis
• 17. a) Number and percentage distribution of reported AIDS cases among adults (≥ 15 years) by exposure category and year of diagnosis
•       b) Number and percentage distribution of reported AIDS cases among adult males (≥ 15 years) by exposure category and year of diagnosis
•       c) Number and percentage distribution of reported AIDS cases among adult females (≥ 15 years) by exposure category and year of diagnosis
•       d) Number and percentage distribution of reported AIDS cases among children (< 15 years) by exposure category and year of diagnosis
•       e) Number of reported AIDS cases among adults (≥ 15 years) by exposure category and age group between 1979 and December 31, 2008
•       f) Number of reported AIDS cases among children (< 15 years) by exposure category and age group between 1979 and December 31, 2008
• 18. a) Number of reported AIDS cases by province/territory and gender between 1979 and December 31, 2008 (all ages)
•       b) Number of reported AIDS cases by province/territory and year of diagnosis (all ages)
•       c) Number of reported AIDS cases among males by province/territory and year of diagnosis (all ages)
•       d) Number of reported AIDS cases among females by province/territory and year of diagnosis (all ages)
• 19. Number and percentage distribution of reported AIDS cases by province/territory and exposure category to December 31, 2008 (all ages)
• 20. Number of reported AIDS cases by year of diagnosis and ethnic status (all ages)

Section IV

A) Mortality due to HIV/AIDS in Canada: Surveillance to December 31, 2008, and Reported to PHAC up to February 13, 2009

• 21. Reported deaths among reported AIDS cases by year of death (all ages)
• 22. Cumulative number of reported deaths among reported AIDS cases occurring in adults and children by age of death and gender between 1979 and December 31, 2008
• 23. Reported deaths among reported AIDS cases among adults (≥ 15 years) and children by year of death
• 24. Reported deaths among reported AIDS cases among adults (≥ 15 years) by year of death and gender
• 25. a) Reported deaths among reported AIDS cases and percentage distribution of adults (≥ 15 years) by exposure category and year of death
•       b) Reported deaths among reported AIDS cases and percentage distribution of adult males (≥ 15 years) by exposure category and year of death
•       c) Reported deaths among reported AIDS cases and percentage distribution of adult females (≥ 15 years) by exposure category and year of death

B) Mortality due to HIV/AIDS in Canada: Vital Statistics from 1987 to December 31, 2005

• 26. Number of deaths attributed to HIV infection by year of death (all ages)
• 27. Number of deaths attributed to HIV infection by age of death and gender from 1987 to December 31, 2005
• 28. Deaths attributed to HIV infection among adults (≥ 15 years) and children by year of death
• 29. Deaths attributed to HIV infection among adults (≥ 15 years) by year of death and gender

Section V

Appendices

• Appendix 1. Technical Notes
• Appendix 2. Data Limitations
• Appendix 3. Terminology
• Appendix 4. HIV Endemic Countries List
• Appendix 5. Data Sources

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At a Glance

HIV/AIDS Surveillance to December 31, 2008

The following report outlines HIV and AIDS surveillance data and provides a description of persons who have been diagnosed with HIV and AIDS in Canada. Surveillance data understate the magnitude of the HIV epidemic and consequently do not represent the total number of people infected with HIV (prevalence) or the number newly infected each year (incidence). Some of the reasons for this include the fact that surveillance data are subject to delays in reporting, underreporting and changing patterns in HIV testing behaviours (who comes forward for testing). In addition, surveillance data can only tell us about persons who have been tested and diagnosed with HIV or AIDS and not those who remain untested and undiagnosed. Furthermore, because HIV is a chronic infection with a long latent period, many persons who are newly infected in a given year may not be diagnosed until later years.

The Public Health Agency of Canada (PHAC) produced estimates of HIV prevalence to the end of 2005 and HIV incidence in 2005. These estimates were created using a combination of methods, incorporating data from a wide variety of sources, including HIV test reports, AIDS case reports, population-based surveys, targeted epidemiologic studies and census data. It was estimated that at the end of 2005 there were approximately 58,000 (48,000-68,000) people in Canada living with HIV (including those living with AIDS), of whom approximately 27% were undiagnosed. The number of people in Canada newly infected with HIV in 2005 was estimated to be 2,300 - 4,500. Estimates of HIV prevalence and incidence are produced by PHAC every three years. The next HIV estimates for 2008 will be published in 2009.

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