Key Points

  1. In Toronto there is a particularly high burden of HIV, with an incidence of newly diagnosed cases twice the provincial average.
  2. Diagnosis of HIV is the only gateway for getting needed care and treatment.
  3. TPH recommends healthcare providers be aware of their patient’s HIV status.
  4. To assess the role for routine testing, Toronto Public Health recommends piloting routine HIV testing in acute care centres in high prevalence areas and in high-risk settings such as addictions clinics and STI clinics, with the goal of identifying cases of HIV earlier to reduce transmission and increase uptake of treatment.

  • Routine offers of testing in high prevalence or high-risk settings and outreach to high-risk groups can improve HIV detection and treatment uptake.
  • The Public Health Agency of Canada (PHAC) recommends HIV testing be considered as part of a routine clinical periodic care.
  • The US Centers for Disease Control and Prevention (CDC) endorses routine voluntary HIV testing for all persons aged 13-64 irrespective of risk factors.
  • The United States Preventive Services Task Force gives a Grade ‘A’ (high net benefit) recommendation for routine screening of HIV for adolescents and adults between 15-65 years of age regardless of risk factors.

  • Diagnosis of HIV is the only gateway for getting needed care and treatment.
  • Antiretroviral treatment dramatically decreases morbidity and mortality while decreasing transmission. New data from the START Trial indicates that there is significant benefit to initiating treatment immediately upon diagnosis.
  • Left untreated, a person diagnosed with HIV can expect to live approximately 12 years; however with treatment, they can expect to live a near-normal lifespan.
  • HIV treatment can effectively reduce transmission risk by up to 90% through reductions in viral load. People who know they are HIV positive are also more likely to take measures to reduce their transmission risk to others.

  • In Toronto, an estimated 15-25% of HIV-infected persons are unaware of their diagnosis.
  • Approximately one-third of cases are identified when immunodeficiency has developed and 10% are diagnosed late in their HIV course when they have AIDS.
  • Toronto has a particularly high burden of HIV, with an incidence of newly diagnosed cases twice the provincial average.
  • Groups at high risk of HIV include men who have sex with men, injection drug users, Aboriginal persons, and persons who emigrate from regions with high rates of HIV.