Page 6: HIV and AIDS in Canada: Surveillance Report to December 31, 2014 - Introduction

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Introduction

The HIV and AIDS in Canada: Surveillance Report to December 31, 2014 presents an overview of the status of HIV and AIDS in Canada based on case reports of HIV and AIDS submitted to the Public Health Agency of Canada (PHAC) by all provinces and territories. This surveillance report also presents data received from Citizenship and Immigration Canada (CIC) and the Canadian Perinatal HIV Surveillance Program (CPHSP). The annual publication of HIV and AIDS in Canada is part of PHAC's mandate to collect, analyze and report on surveillance data at the national level.

This report describes the epidemiology of HIV and AIDS in Canada by identifying trends by geographic location, sex, age group, exposure category (See Appendix 2) and race/ethnicity. It replaces all previously published reports in this series because it reflects the most recent data. Further analysis of the HIV and AIDS surveillance data is available in the HIV/AIDS Epi Updates series^{Footnote 1}.

Surveillance data are critical for understanding the ways in which HIV and AIDS affect a given population. However, the data tend to understate the magnitude of the HIV epidemic. Surveillance data do not represent the total number of people infected with HIV (prevalence) or the number of people newly infected each year (incidence). Surveillance data can tell us only about people who have been diagnosed with HIV or AIDS. Furthermore, because HIV is a chronic infection with a long latency period, many individuals who are newly infected in a given year may not receive a diagnosis until much later. As well, surveillance data are subject to delays in reporting, under-reporting and to changing patterns in HIV testing behaviours.

Since surveillance data describe only the diagnosed portion of the epidemic, statistical modelling and additional sources of information are used to produce estimates that describe the overall HIV epidemic in Canada, including people with diagnosed and undiagnosed HIV infection. Estimates allow for an improved analysis of the epidemic and guide the work undertaken by PHAC and other federal departments under the Federal Initiative to Address HIV/AIDS in Canada. In 2015, PHAC published estimates of incidence and prevalence to the end of 2014, which showed that approximately 75,500 (range: 63,400 to 87,600) people were living with HIV (including AIDS), 21% of whom were unaware of their infection because of a lack of testing or diagnosis^{Footnote 2}. The estimated number of new HIV infections in 2014 was 2,570 (range: 1,940 to 3,200).

Note to reader

There are changes to provincial and territorial surveillance systems that affect the interpretation of the national data set:

• Alberta: Starting in 2010, the surveillance database in Alberta has included a new exposure category called "Citizenship and Immigration Canada/Out of Country (CIC/OOC)" which represents people who acquired HIV infection outside of Canada. 2013 was the first year that data received from Alberta included the CIC/OOC exposure category. This exposure classification was retrospectively applied to cases diagnosed from 2010 to the present. For cases diagnosed outside of Canada before 2010, the original exposure category reported did not change. Within the national data set, the CIC/OOC category is captured in the "Other" exposure category.

This report also contains three new tables that present provincial/territorial data broken down by age group and by sex, as well as a new layout for the exposure category by race/ethnicity table. There are also two additional sex-based rate tables.

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