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HIV in Canada: 2009 to 2014.

Background
Between 1996 and 2008, the number of newly reported HIV cases in Canada fluctuated between approximately 2,100 and 2,700 cases per year.


Objective
To describe the recent trends in new diagnoses of HIV in Canada between 2009 and 2014 by age group, sex, exposure category, race/ethnicity, and region, as well as the number of perinatally HIV-exposed infants.


Methods
HIV data were compiled from two databases. The National HIV/AIDS Surveillance System is a passive surveillance system that gathers non-nominal data on a voluntary basis from all the provinces and territories of all cases that meet the national case definition, and includes data on age group, sex, race/ethnicity, country of birth, and exposure categories. The Canadian Perinatal HIV Surveillance Program is a sentinel-based surveillance system; non-nominal data is obtained through a national confidential survey completed by participating physicians.


Results
Since 2009 the number of new HIV cases has slowly but steadily declined from 2,391 cases in 2009 to 2,044 in 2014, which is the lowest number of annual HIV cases seen in the last two decades. The largest proportion (32%) of new HIV cases continues to be diagnosed among those 30 to 39 years of age, but the proportion of cases diagnosed among those 50 years of age or over has increased from 15% in 2009 to slightly over 20% in 2014. Approximately 75% of newly diagnosed cases are males and 25% females. In males, the most common exposure category (60%) was men who have sex with men. In females, the most common exposure category (66%) was heterosexual contact followed by injection drug use (27%). Race/ethnicity varied by sex. In males, over 50% were White, 14% were Aboriginal and 13% Black. In females, 35% were Black, 35% were Aboriginal and 22% were White. There were regional variations in HIV rates across Canada. Between 2009 and 2014, the number of perinatally HIV-exposed infants varied between 200 and 249 but the percentage of perinatal treatment increased from 87% in 2009 to 97% in 2014.


Conclusion
The annual number of reported HIV cases in Canada has been declining in recent years. The proportion of HIV-positive mothers receiving treatment has increased and the number of confirmed HIV-infected infants has decreased.