Progress in Canada on the 90-90-90 HIV Targets

Canada supports the global targets established by the Joint United Nations Programme on HIV/AIDS and the World Health Organization, including the 90-90-90 targets that by 2020, 90% of all people living with HIV know their status, 90% of those diagnosed receive antiretroviral treatment, and 90% of those on treatment achieve viral suppression.

This document summarizes national estimates of progress on these targets and highlights information on recent work done in two provinces and federal departments.

National Estimates

An estimated 65,000 people were living with HIV in Canada at the end of 2014. Of those, approximately 80% knew their status, 76% of those diagnosed were on treatment, and 89% of people on treatment had achieved viral suppression, which means that the amount of the virus in their blood has been reduced to very low, often undetectable, levels.

Canada's estimates of progress on the 90-90-90 targets^{Footnote 1} are similar to those reported by other high-income countries. Updated national estimates will be published in summer 2018.

NOTE: Comparisons of Federal and Provincial 90-90-90 measures should be interpreted with caution, as definitions, methods, and data completeness vary between jurisdictions.

Estimates in Federal Correctional Facilities

All inmates in federal correctional facilities are offered a health assessment on admission and, in 2016, 96% of newly admitted inmates accepted a voluntary HIV test to know their status. Inmates are also referred for, or can request, HIV testing anytime during incarceration. As of April 2017, among the 170 inmates diagnosed with HIV, 94% were on treatment, and 91% of those on treatment (with known viral load results) had suppressed viral loads.

Estimates for selected First Nations populations

Data from more than 30 First Nations communities in Western Canada showed that at the end of 2016, there were 138 individuals diagnosed with HIV. Among these, 76% were on treatment, and 85% of those had achieved viral suppression.

Ontario

HIV/AIDS estimates for the second and third 90s have been published by the Province of Ontario based on 2015 data, along with historical trends, from a population-based cohort using a centralized public health laboratory database^{Footnote 3}. Steady progress has been made annually since 2011 on the proportion of people on treatment and who have suppressed viral loads.

Figure 4 - Text Equivalent

Figure 4. Estimated number of persons diagnosed with HIV, and percentage on treatment and with suppressed viral load, Ontario, 2011-2015

Year	Estimated number of persons diagnosed with HIV	Percentage diagnosed on treatment	Percentage on treatment with a suppressed viral load
2011	14,699	73	91
2012	14,999	75	91
2013	15,436	78	92
2014	15,694	79	94
2015	16,110	81	94

These measures have been further broken down by different factors including age group. Figure 5 shows that the proportion of individuals on treatment is higher among older age groups compared to younger age groups.

Figure 5 - Text Equivalent

Figure 5. Estimated number of persons diagnosed with HIV, and percentage on treatment and with suppressed viral load, by age group, Ontario, 2015

Age group	Estimated number of persons diagnosed with HIV	Percentage diagnosed on treatment	Percentage on treatment with a suppressed viral load
<25	469	68	84
25-34	2,009	70	90
35-44	3,529	78	93
45-54	5,737	84	84
55+	4,329	86	97

British Columbia

British Columbia (BC) publishes estimates of its progress against the second and third 90s quarterly using population based methodology with a wide range of linked health care databases^{Footnote 4}. Similar to Ontario, over time there has been an increase in the percentage of people on treatment and with suppressed viral load. BC's data also show that higher proportions of HIV+ males are on treatment and have achieved viral suppression compared to females.

Figure 6 - Text Equivalent

Figure 6. Estimated number of persons diagnosed with HIV, and percentage on treatment and with suppressed viral load, by sex, British Columbia, 2016

Sex	Estimated number of persons diagnosed with HIV	Percentage diagnosed on treatment	Percentage on treatment with a suppressed viral load
Male	8,403	72	82
Female	1,844	67	71

A higher proportion of the men who have sex with men (MSM) group have achieved viral suppression compared to the non-MSM group, and a lower proportion of people who inject drugs (PWID) have achieved viral suppression compared to the non-PWID group.

Figure 7 - Text Equivalent

Figure 7. Estimated number of persons diagnosed with HIV, and percentage on treatment and with suppressed viral load, by exposure category, British Columbia, 2016

By exposure category	Estimated number of persons diagnosed with HIV	Percentage diagnosed on treatment	Percentage on treatment with a suppressed viral load
Men who have sec with men (MSM)	3,478	84	85
Non-MSM	2,873	82	71
People who inject drugs (PWID)	2,532	84	71
Non-PWID	4,730	84	84