Estimated Number Of People Living With Hiv
The Agency estimates that approximately 62,050 people were living with HIV at the end of 2018 . This estimate represents a 3% increase from the estimated 58,291 at the end of 2016 .
The estimated prevalence rate in Canada at the end of 2018 was 167 per 100,000 population .
Figure 10. HIV Prevalence: Estimated number of people living with HIV in Canada
This graph shows estimated number of people living with HIV by year. The vertical axis shows point estimates for number of people living with HIV, along with the associated low estimate and high estimate. The horizontal axis shows the calendar years.
Of the estimated 62,050 people living with HIV in Canada at the end of 2018:
- Nearly half were among gay, bisexual and other men who have sex with men. .
- 14.0% were people who inject drugs, and 33.4% were heterosexuals.
- About one in four PLHIV was female and this proportion has been consistent over the past 6 years.
- One in ten was Indigenous. This proportion remained stable compared to the 2016 estimates.
Figure 11. Proportion of people living with HIV, by key population, Canada, 2018
This pie chart shows the estimated percentage of people living with HIV by key population in 2018.
Stigma And Discrimination Are At The Core Of Heightened Hiv Risk For Trans People
Transgender people are put at increased risk of HIV not because of any inherent quality about being trans, but because of how our society marginalizes transgender people.
- Transgender people face intense stigma, discrimination, social rejection, and exclusion from many areas of life, including health care, education, employment, and housing.
- Transgender people also face high rates of incarceration, mental health issues, and violence.
- Of the 2% of students who identify as transgender, 35% have been bullied at school, and 35% have attempted suicide.
- Transgender people have higher rates of activities that might put them at risk for HIV, though many of these are ways of coping with societal rejection, including sex without condoms, commercial sex work, and drug use.
Another huge problem transgender people face is insensitivity and ignorance to transgender issues in the health field. Doctors who misgender, mistreat, and cast blame on transgender people can traumatize their trans patients. In one survey, 19% of transgender people said they were refused medical care because of their gender identity, while 28% had been harassed in a doctors office. This can lead to poorer health outcomes and limited health care access for transgender peopleand can deter them from seeking health care altogether.
Often, the problems facing transgender people compound and end up heightening risk for HIV acquisition. Transgender people are much more likely to acquire HIV if they:
Hiv Among Transgender People In The Us
There are nearly 1 million transgender adults in the United States, though that number continues to grow as more people come to understand transgender identity.
Here are several key statistics regarding HIV among transgender people in the U.S.:
- Approximately 2,351 transgender people were diagnosed with HIV in the United States between 2009 and 2014.
- Of those, 84% were transgender women, and 15% were transgender men. One percent had a nonbinary identity.
- About half of transgender people43% of transgender women and 54% of transgender menwho received an HIV diagnosis during that period lived in the U.S. South.
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Were More Closely Connected Than You Might Think
The reality is that there are fewer gay and bi guys than there are straight men and women. So when youre meeting a guy for casual sex, the pool of people you have to choose from is smaller. This makes gay and bi guys much more closely connected, sexually, than the rest of the population. It also allows HIV and other STIs to spread quickly among us.
Causes Of Increased Risk
Understanding the stark differences in lifetime HIV risk is not always easy. The common, knee-jerk response might be to conclude, dispassionately, that sexual practices paired with cultural attitudes and behavior are the sole factors that place gay black men at such profoundly high risk.
But the simple fact is that gay black men in the U.S. sit in the epicenter of numerous intersecting vulnerabilities, which together make infection all but inevitable in certain individuals.
From a broader social perspective, it is known that any epidemicbe it HIV or any other communicable diseasetends to strike groups that are stigmatized well in advance of the disease event. This happens because there are generally few systems in place to intervene, either medically and legally, and often little interest to act from those outside the stigmatized population.
We saw this in the early part of the AIDS epidemic in the 1980s, when gay men, just emerging from an era of police abuse and judicial apathy, were hit by a wave of infections with no means to stop it, There was nothing in the way of gay health services or advocacy groups to combat inaction on either the state or federal level.
So, with deaths rising from the hundreds to thousands, the gay community took it upon themselves , to mount their own healthcare services and civil action groups .
It’s a vicious cycle that only further stigmatizes gay black men while fueling the already high new infection rate.
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Hiv Infection Rates In The Us
The CDC reported that in 2009 that male-to-male sex accounted for 61% of all new HIV infections in the U.S. and that those who had a history of recreational drug injection accounted for an additional 3% of new infections. Among the approximately 784,701 people living with an HIV diagnosis, 396,810 were MSM. About 48% of MSM living with an HIV diagnosis were white, 30% were black, and 19% were Hispanic or Latino. Although the majority of MSM are white, non-whites accounted for 54% of new infections HIV related MSM infections in 2008.
In 2010 the CDC reported that MSM represented approximately 4 percent of the male population in the United States but male-to-male sex accounted for 78 percent of new HIV infections among men and 63 percent of all new infections. Men overall accounted for 76% of all adults and adolescents living with HIV infection at the end of 2010 in the United States, and 80% of the estimated 47,500 new HIV infections. 69% of men living with HIV were gay, bisexual, and other men who have sex with men. 39% of new HIV infections in US men were in blacks, 35% were in whites, and 22% were in Hispanics/Latinos. The rate of estimated new HIV infections among black men was 103.6six and a half times that of white men and more than twice the rate among Hispanic/Latino men as of 2010.
What Steps Can Gay And Bisexual Men Take To Prevent Hiv Infection
Gay and bisexual men can take the following steps to reduce their risk of HIV infection:
Choose less risky sexual behaviors.Receptive anal sex is the riskiest type of sex for getting HIV. Insertive anal sex is less risky for getting HIV than receptive anal sex . In general, there is little to no risk of getting or transmitting HIV from oral sex.
Limit your number of sex partners.The more partners you have, the more likely you are to have a partner with poorly controlled HIV or to have a partner with a sexually transmitted disease . Both factors can increase the risk of HIV transmission.
Use condoms correctly every time you have sex.
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List Of Estimated Hiv Infection Rates By Country
Disclaimer: estimated HIV rates can be inaccurate. For example, UNAIDS reported that the HIV rate among MSM in Australia was 18.1%, but the actual rate reported by The Australian Federation of AIDS was 7.3%. This is due to the fact UNAIDS relied on a convenience sample of men who were more at risk to HIV, and thus did not capture an accurate representation of the MSM population.
Where Do These Numbers Come From
Most of the data contained in this fact sheet come from HIV in Canada: 2019 Surveillance Highlights Summary: Estimates of HIV incidence, prevalence and Canadas Progress on Meeting the 90-90-90 HIV target, 2018 and population-specific surveillance data.
Healthcare providers are required to report HIV diagnoses to their local public health authorities, including diagnoses resulting from anonymous tests. Each province and territory then compiles this information and provides it to the Public Health Agency of Canada. This information does not contain names or personal identifiers. Sometimes additional information is also collected and sent to the Public Health Agency of Canada, such as information about a persons age, gender, ethnicity, exposure category and laboratory data such as the date of the HIV test.
National estimates of HIV prevalence and incidence
National HIV estimates are produced by the Public Health Agency of Canada using statistical modelling that takes into account some of the limitations of surveillance data and also accounts for the number of people with HIV who do not yet know they have it and the number of people with HIV who have died.
Canadian Perinatal HIV Surveillance Program
The Canadian Perinatal HIV Surveillance Program collects information on infants born to females with HIV in Canada.
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The Ryan White Hiv/aids Program And Racial And Ethnic Minority Populations
Many federal programs are available to assist people of color who are living with HIV. The Health Resources and Services Administrations Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary medical care, medications, and essential support services for low-income people living with HIV who are uninsured and underserved. More than half the people diagnoses with HIV in the U.S. receive services through RWHAP each year.
The Program serves a diverse population. Of the more than half a million clients served by RWHAP, nearly three-quarters of them are from racial and ethnic minority populations, with 47.1 percent of clients identifying as black/African American and 23.2 percent identifying as Hispanic/Latino.
For information about HIV care outcomes for racial and ethnic clients and other served by the RWHAP program, see these fact sheets:
Us Response To The Global Epidemic
The U.S. President’s Emergency Plan for AIDS Relief is the U.S. Governments response to the global HIV/AIDS epidemic and represents the largest commitment by any nation to address a single disease in history. Through PEPFAR, the U.S. has supported a world safer and more secure from infectious disease threats. It has demonstrably strengthened the global capacity to prevent, detect, and respond to new and existing riskswhich ultimately enhances global health security and protects Americas borders. Among other global results, PEPFAR provided HIV testing services for nearly 50 million people in Fiscal Year 2020 and, as of September 30, 2020, supported lifesaving ART for nearly 18.2 million men, women, and children.
In addition, the National Institutes of Health represents the largest public investment in HIV/AIDS research in the world. NIH is engaged in research around the globe to understand, diagnose, treat, and prevent HIV infection and its many associated conditions, and to find a cure.
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Stigma Discrimination And Violence
Gender norms in many cultures sanction the ill-treatment of men who have sex with men. As a result, a large proportion of men who have sex with men worldwide have reported experiencing violence due to their sexual orientation. This is especially evident in particularly machismo cultures and patriarchal societies.99
In some areas, public officials, police and healthcare workers are committing these offences. The fear of being identified as homosexual deters many men from accessing HIV services, avoiding healthcare check-ups and treatment in order to keep their orientation secret.100101
Evidence is also emerging that, in some settings, a high proportion of men who have sex with men are also experiencing intimate partner violence . A UK study among men who have sex with men involved in a trial for PrEP found around 45% had been a victim of IPV and around 20% had been a perpetrator.102
What Factors Put Men Who Have Sex With Men At Risk Of Hiv
The fact that HIV prevalence among men who have sex with men is so high in many countries means that members of this group have an increased chance of being exposed to the virus. This is mainly due to having unprotected sex.10 However, there are other factors that put men who have sex with men at heightened risk of HIV.
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Hiv And African American Gay And Bisexual Men
Black/African Americana gay, bisexual, and other men who reported male-to-male sexual contact b,c are more affected by HIV than any other group in the United States and dependent areas. d In 2018, Black/African American gay and bisexual men accounted for 26% of the 37,968 new HIV diagnoses and 37% of new diagnoses among all gay and bisexual men. e
Hiv Among Indigenous People
How many Indigenous people are living with HIV in Canada ?
According to national HIV estimates, 6,180 Indigenous people were living with HIV in Canada in 2018. This represents 10.0% of all people with HIV in Canada.
How many new infections are there in Indigenous people in Canada each year?
According to national HIV estimates, 314 new HIV infections in Canada were in Indigenous people in 2018. This represents 14.0% of all new infections. In comparison, Indigenous people made up only 4.9% of the total Canadian population in 2016, making Indigenous people over-represented in new HIV infections in Canada.
How is Canada doing at reaching the global targets of 90-90-90 for Indigenous people who inject drugs?
According to a surveillance study conducted with Indigenous people who inject drugs in Canada between 2017 and 2019:
- 78.2% of Indigenous PWID with HIV were aware of their status in 20172019
- 83.7% of Indigenous PWID diagnosed with HIV were on treatment in 20172019
- 64.4% of Indigenous PWID on HIV treatment reported an undetectable viral load in 20172019
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Mental Health: A Major Issue Affecting Hiv In Lgbtq Communities
LGBTQ people are disproportionately at risk for a variety of mental health issues, including major depression, bipolar disorder, and generalized anxiety disorder. These issues can lead to detrimental outcomes, like drug use, suicideand, of course, HIV.
Poor LGBTQ mental health comes from a myriad of factors. Some are societal, including the stigma and shame associated in some communities with having a queer or transgender identity. Others are interpersonal, like the need to stay in the closet or the fear of being outed. Often, queer and transgender children are told that they are not good at performing their assigned gender, which can lead them to internalize a sense of failure early in their lives.
Most of the research studying LGBTQ people and mental health centers around gay and bisexual men. Researchers tend to consider mental illness and HIV to be a syndemic in gay and bisexual men, meaning they intertwine with one anothereach epidemic perpetuates the other. Depression, trauma, and substance use are all linked to HIV acquisition risk in different ways.
In addition, as with so many other health disparities in the U.S., racism worsens the impact of mental health issues on people living with HIV.
Younger Men Weren’t Around For The Height Of The Hiv/aids Epidemic
Among men who have sex with men, the youngest population saw the largest increase in annual HIV diagnoses by far. But the change in HIV diagnoses varied among older age groups.
“I don’t think it’s really clear why we’re seeing different patterns across different age groups,” Lansky says. “But we do know some of the things that I think in particular are affecting the younger men.”
One explanation commonly voiced by other HIV/AIDS experts and advocates is that younger populations are less likely to know the dangers of the disease, because they weren’t around during the height of the HIV epidemic in the 1980s and early 1990s. During this era, the disease quickly spread throughout the world, and few treatment and prevention options were known. The disease ravaged the gay community in particular, infecting and killing millions.
Older gay and bisexual populations who lived through the height of the HIV epidemic do appear more likely to practice safe sex, based on CDC data for HIV-negative or HIV-unknown men in 20 US cities with a high prevalence of HIV/AIDS. About 60 percent of under-40 gay and bisexual men said they had anal sex without a condom in the past year. Only half of gay and bisexual men 40 and older reported having anal sex without a condom in the same time span.
“I don’t think it’s really clear why we’re seeing different patterns across different age groups”
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