HIV cases in Alberta are rising, creating a need for broad outreach, experts say

Doctors and frontline workers are closely monitoring HIV rates in Alberta.

An annual report from Alberta Health shows that the number of new HIV cases increased by 73 per cent last year, from 293 in 2022 to 507 in 2023.

The number of reported cases has almost doubled since 2019.

“It’s significant. It’s the opposite direction in which we hope HIV rates and infections are going,” said Dr. Caley Shukalek, a Calgary physician who works in the prevention and treatment of HIV and STDs (sexually transmitted infections). infections).

There are likely a number of factors contributing to this trend, including changing demographics, Shukalek said.

While HIV still affects gays, bisexuals, transgender people and other people who have sex with men, he is seeing increasing numbers of cases in the heterosexual community and among those who use injection drugs, especially in Manitoba and Saskatchewan.

And immigration likely plays a role, too, he said.

Provincially, 54.8 percent of cases identified last year were acquired outside the country, compared to 43 percent in 2022. according to the September 2024 report.

“If we see a greater influx of people into Canada, we may see increases here as well. We also see Canadians traveling abroad and coming back,” Shukalek said.

Sometimes HIV is discovered through testing during the immigration process, he noted.

“Especially refugees who come here who may not have had screening before arrival end up being screened… and new infections are found and then treatment is started,” Shukalek said.

Dr. Ameeta Singh said many of the newcomers she sees in her practice in Edmonton are already being treated, regardless of where they come from.

“Often they are already suppressed with an undetectable viral load,” said Singh, a clinical professor in the department of infectious diseases at the University of Alberta.

“So it’s really just a matter of trying to incorporate them into our system and transition them to sometimes newer medications… and then provide other wrap-around support,” she said.

Thanks to medical advances in recent decades, HIV is treatable and is considered a “chronic manageable disease,” Singh said.

“Being diagnosed with HIV today no longer means being excluded from everything, including immigration.”

Tension on the front line

Frontline agencies are feeling the impact as the number of HIV cases increases.

“We have seen a huge increase in demand for our services over the past year,” says Finn St. Dennis, research and evaluation manager at the Edmonton-based Queer and Trans Health Collective (QTHC).

“Our team is doing our best to keep up. But demand exceeds our capacity.”

Through their work, St. Dennis is seeing newer infections among younger people in the queer and trans community and is concerned that awareness among Albertans in general is declining.

St. Dennis would like to see more provincial and federal government funding for frontline agencies, such as QTHC, which provides support including safer sex services and short-term counseling.

‘Even from an economic point of view [it] It is wise to invest in prevention rather than treatment,” they said.

St. Dennis also believes that more detailed data collection (including, for example, transmission rates among transgender, queer women and non-binary people) could help frontline staff design effective programming.

Katie Ayres with SafeLink Alberta said they too are trying to figure out why the numbers are rising.

The agency works to raise awareness and has launched targeted outreach programs to connect with people from countries or regions where HIV is endemic.

“Sometimes talking about sexual health and sexual activity, condom use and HIV prevention is not culturally appropriate within certain communities.” she said.

According to her, there is a need for a broader reach.

“I think we probably need to diversify HIV education and awareness beyond the traditional populations that we have targeted as health care providers, which is often the queer communities.”

It’s also important to target younger Albertans, she said, pointing to studies showing a decline in condom use among teens and young adults.

And services like supervised consumption sites and needle exchange programs are also critical, she said.

Government response

While this year’s numbers are not yet final, cases are on track to be similar to 2023, according to the Alberta government.

“Alberta, like many other jurisdictions in Canada and around the world, has experienced a rapid increase in STDs, including HIV, over the past decade,” an Alberta Health spokesperson said in an email.

The province pointed to a variety of factors, including “an increase in population, more effective contact tracing, greater availability of HIV testing at community-based organizations and the expansion of rapid point-of-care testing in Alberta.”

The spokesperson said $7 million annually is provided to organizations for the prevention, testing, treatment and other support of sexually transmitted and blood-borne infections.

There are also other programs aimed at syphilis.

Meanwhile, Shukalek worries about the healthcare system’s ability to keep pace, with no signs of a decline.

“Do we have enough health care to provide access to all these patients?” he asked.

“I worry too… if we find so many, how many haven’t we found yet?”