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HIV infection among men who have sex with men in Ontario: Analysis by race/ethnicity

HIV infection among men who have sex with men in Ontario: Analysis by race/ethnicity. Robert S. Remis, Maraki Fikre Merid Ontario HIV Epidemiologic Monitoring Unit University of Toronto Ethno-racial MSM Research Forum November 15, 2004. Background.

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HIV infection among men who have sex with men in Ontario: Analysis by race/ethnicity

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  1. HIV infection among men who have sex with men in Ontario: Analysis by race/ethnicity Robert S. Remis, Maraki Fikre Merid Ontario HIV Epidemiologic Monitoring Unit University of Toronto Ethno-racial MSM Research Forum November 15, 2004

  2. Background • MSM seriously affected by HIV epidemic since the beginning (~1978) • Many developments have influenced epidemiologic trends: Education, information and prevention Identification of HIV (1984) HIV test developed (October 1985) Antiretroviral drugs (1987) HAART (1996)

  3. Objectives • To examine trends reported AIDS cases and HIV diagnoses among MSM in Ontario by race/ethnicity

  4. Methods: Data sources • AIDS cases in Ontario diagnosed from 1981to 2003 and reported to April 2004 from Public Health Branch, MOHLTC • HIV diagnoses reported to Toronto and Ottawa public health units,1983-2004

  5. Methods: Data analysis • AIDS: Number and proportion of reported AIDS cases among MSM by race/ethnicity, health region and year of AIDS diagnosis, 1981-2003 • HIV diagnoses: Number and proportion of HIV diagnoses among MSM by race/ethnicity and year of HIV diagnosis in Toronto and Ottawa PHU, 1983-2004

  6. Reported AIDS cases by exposure category and race/ethnicity, Ontario, 1981-2003 * Proportion known = 61.8%

  7. Reported AIDS cases among MSM by race/ethnicity, Ontario 1981-2003

  8. Reported AIDS cases among MSM by race/ethnicity and health region, Ontario, 1981-2003 (1/2)

  9. Reported AIDS cases among MSM by race/ethnicity and health region, Ontario, 1981-2003 (2/2)

  10. Proportion white among annual reported AIDS cases among MSM, 1981-2003

  11. Annual reported AIDS cases among MSM for selected race/ethnicities,1981-2003

  12. Annual reported AIDS cases among white MSM, Toronto,1981-2003

  13. Annual reported AIDS cases among MSM, Toronto for selected race/ethnicities,1981-2003

  14. Annual reported AIDS cases among MSM in Ottawa by race/ethnicity,1981-2003

  15. Annual reported AIDS cases among MSM in Central East Other by race/ethnicity, 1981-2003

  16. HIV infections among MSM, Toronto and Ottawa public health units,1983-2004 * Proportion known = 59.5%

  17. Annual HIV infections among white MSM reported to Toronto,1983-2004

  18. Annual HIV infections among MSM reported to Toronto by race/ethnicity,1983-2004

  19. Annual HIV infections among MSM reported to Ottawa by race/ethnicity,1983-2004

  20. Summary of findings • AIDS cases • Observed decrease of cases among whites over time and increase in recent years, especially since among Blacks, Latin Americans and Asians • Trends observed in Toronto for whites and Latin Americans and Central East Other for increase among Asians

  21. Summary of findings • HIV diagnoses • Toronto: similar trends as for AIDS cases with decreasing proportion among Whites and increasing among Latin Americans, Asian and Blacks • Ottawa: decrease among whites but others not clear

  22. Limitations • Racial/ethnicity data available for only for about 60% of HIV diagnoses and AIDS cases • Trends possibly different in those without information • Bias likely in direction of over-estimating non-white race/ethnicity

  23. Limitations • AIDS cases subject to underreporting and delayed reporting • Not likely to introduce bias in proportions over time • HIV diagnoses requires decision to undergo HIV testing • May underestimate non-white race/ethnicity

  24. Conclusions • HIV infection among MSM of non-white race/ethnicity growing • Especially important in Toronto (AIDS 10%) and Central East other (AIDS 21%) • Increasing substantially in Toronto in most recent years • AIDS 30-40% since 1999 • HIV 20-30% since 1997

  25. Acknowledgements • Ontario Ministry of Health and Long-Term Care • Frank McGee, coordinator, AIDS Bureau • Lorraine Schiedel, Public Health Division • HIV Laboratory, Central Public Health Laboratory • Carol Swantee, diagnostic data • Keyi Wu, programming • Toronto Public Health • Jo-Anne Ackery • Ottawa Public Health • Orhan Hassan

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