Manitoba has seen a sharp increase in HIV rates over the past four years — and the doctors who have been tracking the data say the situation is likely to get worse.
The Manitoba HIV Program unveiled its 2018-2021 report findings Thursday — World AIDS Day and Indigenous Awareness Week — by highlighting an overrepresentation of Indigenous people living with HIV, and more women being diagnosed.
"This is the best data we've ever put together. I think it tells us a lot about a population at risk," Manitoba HIV Program director Dr. Ken Kasper said during a media briefing Wednesday at Winnipeg's Nine Circles Community Health Centre.
The number of people newly diagnosed with HIV and living in the province increased from 111 in 2018 to 169 in 2021, an increase of 52 per cent.
Kasper and his team are still collecting data for 2022, but he expects those numbers to go way up. He estimates Manitoba will see more than 200 new diagnoses of HIV this year.
"The goal in Canada in 2023 was to have 500 new people diagnosed," he said. "The way things are going in Manitoba in 2022, we'll have over 200 of those 500 cases. And clearly, they are not going to meet their targets."
The rate of new HIV transmissions in 2020 was 4.0 per 100,000 people, according to the Public Health Agency of Canada. Manitoba sits three times above the national average, coming it at 12.2 per 100,000 people.
Kasper estimates that rate will be even higher in 2022, potentially four to five times higher than the rest of the country.
The "burden of HIV," according to Kasper, is in the Winnipeg Regional Health Authority, with more than 65 per cent of people diagnosed with the virus in Manitoba last year.
The number of new HIV diagnoses in the Prairie Mountain Health Regional Health Authority dropped the past few years, but Kasper expects that number will rise in 2022.
The growing proportion of females acquiring HIV is also troublesome, with half of the new diagnoses being female.
This is way up compared to the national average in 2020, which saw one in three females make up the total number of new HIV diagnoses.
The average age of a female contracting HIV also dropped from 39 in 2018 to 32 in 2021, according to the report.
It also dropped for males, albeit slightly from 38.5 years old to 36.5 years old.
And for the first time, the program's report examined sexual orientation, with six in 10 self-identifying as heterosexual, and two in 10 identifying as gay, bisexual or men who have sex with men.
Kasper identified heterosexual sex as one of two major risk factors the program's patients are self-reporting, with injection use the other major risk.
Social determinants of health contribute to rising rates
Dr. Lauren MacKenzie, associate director of the Manitoba HIV Program, pointed to social determinants such as homelessness, substance abuse and mental health conditions, as key factors in the acquisition of HIV.
The report found nearly 50 per cent of females and 25 per cent of males experienced homelessness. Nearly two-thirds of females and more than one-third of males self-reported injection drug use.
HIV acquisition is even more of an alarming issue among Indigenous people, with 73.4 per cent of people referred to the Manitoba HIV Program in 2021 self-identifying as Indigenous.
That number rose sharply from just over 50 per cent in 2018.
"We can't lead this effort to identify solutions on our own and we really need the input of our Indigenous partners to guide us to help find these solutions," MacKenzie said.
The program plans to break down Indigenous numbers into Métis, Inuit and First Nations in the future.
MacKenzie also highlighted the challenge of ensuring people who are diagnosed stay associated with the program and seek treatment.
Of the 517 people diagnosed with HIV and referred to the program from 2018 to 2021, 501 of them were linked to HIV care. However, by the end of the reporting period, 93 people were either linked to or did not remain engaged in treatment. This accounts for nearly 20 per cent of all people diagnosed with HIV in the province in that span.
Dr. Marcia Anderson, executive director of Indigenous Academic Affairs for the Indigenous Institute of Health and
Healing, says the current state of Indigenous health, including HIV diagnosis, is rooted in previous government policies such as forced assimilation of Indigenous peoples.
"The system is producing the results that it was designed to produce and that is not any less true in the data that we are seeing today," Anderson said.
Strengthening Indigenous leadership on the issues and supporting a provincial Indigenous-led HIV strategy is key, according to the Manitoba HIV Program.
Anderson believes First Nation leadership is prepared to act.
"First Nations leadership and broader Indigenous leadership will work with the HIV program," she said. "[They] will work with all levels of government on these calls to action," she said.
The program also issued two broad calls to action: maximizing treatment as prevention and supporting primary care capacity.
New data says more Manitobans getting HIV, with higher proportions of women, Indigenous people - CBC.ca
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