HIV in Canada, Surveillance Report to December 31, 2024: Executive summary

On this page

• Overview
• Key findings
• Contact us for full report
• Endnotes

Overview

The HIV in Canada, Surveillance Report to December 31, 2024, was prepared by the Public Health Agency of Canada (PHAC). It presents and describes national epidemiological trends on Human Immunodeficiency Virus (HIV) diagnoses in Canada by geographic region, age at diagnosis, sex, race and/or ethnicity, and exposure category between 2015 and 2024. This surveillance report presents information on first-time diagnoses from all thirteen provinces and territories (PT), and provides evidence for the planning, evaluation, and implementation of HIV testing, prevention, treatment and education. In addition to first time diagnoses, the report presents previously diagnosed cases by province and territory for 2020 to 2024.

The COVID-19 (SARS-CoV2 / Coronavirus Disease 2019) pandemic had impacts, both known and unknown, on access to HIV testing, prevention, and care services as well as on surveillance activities in Canada. For this reason, data for 2020-2021 should be interpreted with caution. Due to surveillance data being refined by PT over time as data are periodically reviewed and updated, surveillance data for previous years may also be updated by provinces and territories along with the current year's dataset. As such, historical data presented in this report may not exactly match historical data presented in previous national reports.

Key findings

Key findings include:

• In 2024, 2,288 first-time diagnoses (newly diagnosed cases, i.e., no evidence of a previous positive test) of HIV were reported in Canada. This is a decrease of 3.3% compared to 2023 (2,367 new HIV diagnoses in 2023). While this is a decrease in the number of first-time diagnoses from 2023, the number remains higher than pre-pandemic years.
• Data provided by Immigration, Refugees and Citizenship Canada (IRCC) demonstrated that a smaller number of migrants (immigrants, refugees and temporary residents) tested positive for HIV in total during an IME in Canada or abroad in 2024 compared with 2023 (3,167 in 2024 and 3,193 in 2023). While the number of migrants who tested positive for HIV during an IME in Canada increased from 2023 to 2024, the number who tested positive for HIV during an IME abroad decreased. In 2024 the total number of migrants who tested positive for HIV in Canada was 1,699, representing 0.34% of all IMEs in Canada, a higher percentage than pre-pandemic levels (0.24% in 2019) but lower than 2023 when 0.37% of migrants undergoing an IME in Canada tested positive.
• The national first-time HIV diagnosis rate was 5.5 per 100,000 population in 2024. While this was a decrease from 5.9 per 100,000 population in 2023, the rate remained above the relatively stable pre-COVID-19 pandemic rates (e.g. 4.6 per 100,000 in 2019).
• Data received by PHAC from the Provinces and Territories has the sex of cases classified by the mutually exclusive categories of male, female, transgender, or not provided. In some instances, sex and gender may be erroneously conflated in these data. Therefore, data for cases reported as male or female may or may not include transgender people, and reporting may not necessarily align with the gender identity of individuals. The National HIV Surveillance Program is actively working on improving data collection and reporting to better represent gender-diverse communities.
• The national first-time HIV diagnosis rate was 7.2 per 100,000 population in males (male sex) and 3.8 per 100,000 population in females (female sex) in 2024; a decrease from the rate reported in males while the rate in females remained constant in 2023 (which were 7.9 and 3.8 HIV diagnoses per 100,000 population, respectively).
• Recent trends in the HIV diagnosis rate among males show a continued decline in rates between 2015 to 2020 from 7.6 per 100,000 to 4.9 per 100,000 before increasing to 7.9 per 100,000 in 2023 and decreasing to 7.2 per 100,000 in 2024. Among females, the trend shows an increase from 2.2 per 100,000 in 2015 to 2.7 per 100,000 females in 2019 before decreasing to 2.0 per 100,000 in 2020 and increasing to 3.8 per 100,000 in 2024. While the 2024 rate in males was within pre-COVID-19 pandemic levels, the rate in females was above pre-COVID-19 pandemic levels.
• When broken down into age groups, the HIV diagnosis rates were highest in the 25-to-29-year age group (12.5 per 100,000 population) and the 30-to-39-year age group (12.9 per 100,000 population) in 2024.
• HIV diagnosis rates were observed to be approximately two times greater in males than in females in all age groups, with the exceptions of the <15 years and the 15-to-19-year age group (HIV diagnosis rates were similar among sexes).
• While the overall national first-time HIV diagnosis rate decreased from 2023 to 2024, HIV diagnosis rates increased in Manitoba, the Territories, and British Columbia and remained constant in Quebec. While a decrease was observed in the Atlantic region as a whole, not all Atlantic provinces saw a decrease.
• The highest first-time HIV diagnosis rate across the provinces and territories was in Manitoba, with 19.5 per 100,000 population, followed by Saskatchewan with 18.6 per 100,000 population. The lowest diagnosis rate was in the Atlantic region with 1.7 per 100,000 population.
• Similar to 2023, the largest proportion of adult HIV diagnoses was attributed to heterosexual contact (38.3%) in 2024. According to reported exposure category, male-to-male sexual contact continues to account for the largest proportion of diagnoses in males, at 49.9% of diagnoses.
• Heterosexual contact continues to account for the largest proportion of diagnoses in females, at 58.1% of diagnoses. Injection drug use also remains a significant factor among cases in both males and females, accounting for 16.9% of all first-time diagnoses in 2024.
• Proportion of diagnoses attributable to different exposure categories also varied by age group. In the 20-to-24-year age group, male-to-male sexual contact accounted for the largest proportion of diagnoses (43.6%). By contrast, among 40-to-59-year-olds, heterosexual contact accounted for the largest proportion of diagnoses (46.7%).
• Race-based data is essential for identifying and understanding disparities in access to HIV care stemming from historic and ongoing colonialism, racism, and systemic and structural inequities in Canada. Although some provinces collect data on the Indigenous identity and race and/or ethnicity of people newly diagnosed with HIV, the data collection method used may differ from that used by the federal system. As a result, the reporting of race and/or ethnicity data varies significantly across jurisdictions and is not always shared with PHAC. Overall, race and/or ethnicity data were reported for only 38.1% of first-time diagnoses in 2024, representing a continuation of a decreasing trend in race and/or ethnicity data completion since 2015 where 55.3% had race and/or ethnicity data available. No race and/or ethnicity data were reported from Manitoba, Nova Scotia, Saskatchewan, and Quebec for 2024.
• Among the 871 cases of new HIV diagnoses for whom race and/or ethnicity was reported, 31.6% of cases were reported as Black people, 25.4% were reported as white people, and 7.1% were reported as Indigenous Peoples (6.1% First Nations, 0.3% Inuit, and 0.7% Métis). Given race and/or ethnicity data are not missing randomly, these proportions are unlikely to be representative of all first-time diagnoses and should be interpreted with caution. In collaboration with community members, the National HIV Surveillance Program has established a Black Expert Working Group for National HIV Surveillance and a First Nations, Inuit, and Métis Working Group for National HIV and Syphilis Surveillance to provide advice and co-develop strategies to improve the completeness, interpretation, and contextualization of Indigenous identity and race and/or ethnicity data.
• While the number of first-time diagnoses increased between 2020 to 2024 for most provinces/territories, the trends in the number of previously diagnosed cases varied. Likewise, the proportions of reported HIV diagnoses attributed to previously diagnosed cases also varied by province and territory.
• Of the 258 infants reported to be potentially perinatally exposed to HIV in 2024, 96.9% were born to people who had received antiretroviral therapy (ART). There was one infant confirmed to have acquired HIV perinatally that was born to a person who did not receive any ART.
• In 2024, there were 84 cases of acquired immunodeficiency syndrome (AIDS) reported, a continued decrease since 2015. However, findings should be interpreted with caution, as AIDS data were only submitted by four provinces in 2024 (New Brunswick, Ontario, Saskatchewan, and Northwest Territories) and, where this information was available, cases are likely underreported.
• In 2024, there were 128 deaths attributed to HIV (HIV-related death rate of 0.4 per 100,000 population among people living in Canada aged 15 years and older). HIV-related deaths are likely underreported.

Figure 1: Text description

Year of diagnosis	Overall first-time diagnoses	Overall rate per 100,000	Males rate per 100,000	Females rate per 100,000
2015	1,752	4.9	7.6	2.2
2016	1,846	5.1	7.9	2.4
2017	1,802	4.9	7.7	2.1
2018	1,815	4.9	7.2	2.6
2019	1,726	4.6	6.5	2.7
2020	1,313	3.5	4.9	2.0
2021	1,445	3.8	5.4	2.1
2022	1,780	4.6	6.1	3.0
2023	2,367	5.9	7.9	3.8
2024	2,288	5.5	7.2	3.8

Figure 2: Text description

Province	First-time HIV diagnosis rate (per 100,000 population) in 2024	First-time HIV diagnosis (per 100,000 population) in 2023	Increase or decrease in HIV diagnosis rate (2024 compared to 2023)
Alberta	4.3	5.4	Decrease
Atlantic Region	1.7	2.4	Decrease
British Columbia	3.0	2.8	Increase
Manitoba	19.5	19.3	Increase
Ontario	5.4	5.9	Decrease
Quebec	5.1	5.1	No change
Saskatchewan	18.6	19.3	Decrease
Territories	4.6	2.2	Increase

Contact us for full report

To request a full copy of the HIV in Canada, Surveillance Report to December 31, 2024, please contact the HIV Surveillance Team at hass@phac-aspc.gc.ca.