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OBJECTIVE: Regular HIV testing and early detection leads to timely treatment. Appropriate treatment and care can prevent disease progression in the individual and prevent onwards transmission within the community. This review describes HIV testing coverage in populations disproportionately affected by HIV and in the general population in Canada. METHODS: A search of published and grey literature on HIV testing uptake in Canada was conducted. Studies reporting quantitative data on testing practices (ever tested, recent testing, and regular testing), published in either English or French from 2008-2012, were included. Studies that involved testing for immigration or prenatal purposes, and post-intervention studies, were excluded. Included studies were assessed using a modified version of the Public Health Agency of Canada's Descriptive Study Critical Appraisal Tool. Pooled prevalence for percent ever tested was calculated for subpopulations and heterogeneity was estimated using the [I.sup.2] statistic. SYNTHESIS: A total of 26 studies were included in the review. The highest rates of ever having been tested were among people who inject drugs (90.6%) and inmates (90.4%); followed by men who have sex with men (83.0%); Aboriginal peoples (55.5%); and the general population (32.8%). Limited information was available on regular and recent testing. CONCLUSION: HIV testing can reduce the number of undiagnosed cases in Canada. Future research should focus on testing coverage in certain populations, and on the extent to which populations engage in regular testing. KEY WORDS: HIV; Canada; testing; prevention OBJECTIF: Des tests reguliers de depistage et une detection precoce du VIH entrainent un traitement en temps opportun. Des traitements et des soins appropries peuvent eviter la progression de la maladie chez un individu et prevenir la retransmission du virus au sein d'une collectivite. Le present examen decrit la couverture de depistage du VIH au sein des populations disproportionnellement touchees par le VIH et au sein de la population generale du Canada. METHODES: Une recherche a ete menee a l'echelle de la litterature grise et des documents publies sur la prise de tests de depistage du VIH au Canada. Des etudes signalant des donnees quantitatives sur des pratiques de depistage (sujets ayant deja passe un test, sujets testes recemment et sujets procedant a des tests reguliers), publiees en anglais ou en francais de 2008 a 2012, ont ete incluses dans la recherche. Les etudes portant sur le depistage prenatal ou aupres des immigrants et les etudes menees apres les interventions, elles, ont ete exclues. Les etudes incluses ont ete evaluees a l'aide d'une version modifiee de l'outil d'evaluation critique pour les etudes descriptives de l'Agence de la sante publique du Canada. La prevalence groupee pour le pourcentage de gens ayant deja passe un test de depistage a ete calculee pour les souspopulations, et l'heterogeneite a ete estimee a l'aide de la statistique [I.sup.2]. SYNTHESE: Au total, 26 etudes ont ete incluses dans l'examen. Les utilisateurs de drogues injectables (90,6 %) et les detenus (90,4 %) avaient les taux les plus eleves de tests de depistage. Ces groupes etaient suivis des hommes ayant des relations sexuelles avec d'autres hommes (83 %), des Autochtones (55,5 %) et de la population generale (32,8 %). Les renseignements accessibles sur les tests reguliers et les tests recents etaient limites. CONCLUSION: Les tests de depistage du VIH peuvent reduire le nombre de cas non diagnostiques au Canada. Les prochaines recherches devraient insister sur la couverture du depistage au sein de certaines populations et sur la mesure dans laquelle les populations procedent a des tests reguliers. MOTS CLES: VIH; Canada; depistage; prevention, In Canada, an estimated 71,300 people were living with human immunodeficiency virus (HIV) at the end of 2011. Approximately 25% (14,500-21,500) of prevalent cases were unaware of their HIV infection. [...]

Background: The Tracks survey of people who inject drugs (PWID) collected data in 14 sentinel sites across Canada (2017-2019). These findings describe the prevalence of human immunodeficiency virus (HIV), hepatitis C and associated risk behaviours among Indigenous participants.Methods: Information regarding socio-demographics, social determinants of health, use of prevention services and testing, drug use, risk behaviours, and HIV and hepatitis C testing, care and treatment was collected through interviewer-administered questionnaires. Biological samples were tested for HIV, hepatitis C antibodies and hepatitis C ribonucleic acid (RNA). Descriptive statistics were calculated and reviewed by an Indigenous-led advisory group using the Two-Eyed Seeing approach.Results: Of the 2,383 participants, 997 were Indigenous (82.9% First Nations, 14.9% Métis, 2.2% Inuit). Over half (54.5%) were cisgender male and the average age was 38.9 years. A large proportion (84.0%) reported their mental health as "fair to excellent". High proportions experienced stigma and discrimination (90.2%) and physical, sexual and/or emotional abuse in childhood (87.5%) or with a sexual partner (78.6%). Use of a needle/syringe distribution program (90.5%) and testing for HIV (87.9%) and hepatitis C (87.8%) were high. Prevalence of HIV was 15.4% (78.2% were aware of infection status) and 36.4% were hepatitis C RNA-positive (49.4% were aware of infection status).Conclusion: High rates of HIV and hepatitis C were identified. Challenges in access to and maintenance of HIV and hepatitis C care and treatment were noted. This information informs harm reduction strategies, including the need to scale-up awareness of prophylaxis in a culturally relevant manner. [ABSTRACT FROM AUTHOR]

We describe the epidemiology of COVID-19 at the start of Canada's epidemic from January 1 to March 12, 2020, before governments at all levels implemented aggressive community based public health measures. During this time, 153 laboratory-confirmed cases were reported in Canada. Due to delays inherent in the diagnosis and reporting process, these cases represented a small subset of the 1,360 confirmed cases subsequently reported, whose symptom onset occurred on or before March 12. More than half (57.8%) of these 1,360 cases had a history of international travel or were linked to a case that had travelled, most commonly from countries where few cases had been reported at that time. Community transmission, marked by cases that could not be traced back to another case, was first noted on February 20 and increased steadily thereafter. This descriptive analysis indicates that COVID-19 was spreading internationally and in Canada more broadly than was initially detected by surveillance systems from January to mid-March 2020. To limit the impact of future waves, an expanded surveillance system is now being implemented with multiple data streams to provide a more complete picture of the epidemic, including early signals of cases and clusters. Improved access to laboratory testing and expanded contact tracing are critical elements to detect and isolate cases early, including those with mild symptoms. [ABSTRACT FROM AUTHOR]

Background: The Tracks survey of people who inject drugs (PWID) collected data in 14 sentinel sites across Canada (2017-2019).Objective: To describe the prevalence of human immunodeficiency virus (HIV) and hepatitis C and associated risk behaviours and to examine trends over time.Methods: Information regarding socio-demographics, social determinants of health, use of prevention services and testing, drug use, risk behaviours, and HIV and hepatitis C testing, care and treatment was collected through interviewer-administered questionnaires. Biological samples were tested for HIV, hepatitis C antibodies and hepatitis C ribonucleic acid (RNA). Descriptive statistics were calculated and trends over time were assessed.Results: Of the 2,383 participants, 65.6% were cisgender male, 42.2% were Indigenous, 48.0% completed some high school or less, 62.6% lived in unstable housing and 75.7% had ever been incarcerated. Average age was 40.1 years. The majority experienced stigma and discrimination (88.7%) and physical, sexual and/or emotional abuse in childhood (85.0%) or with a sexual partner (75.9%). The majority reported use of a needle/syringe distribution program (90.1%) and tested for HIV (90.5%) and hepatitis C (90.9%).Among participants who had ever had sex, the majority (59.2%) reported inconsistent condom use during vaginal and/or anal sex with a casual sex partner. Prevalence of HIV was 10.3% (82.9% were aware of infection status) and many (36.9%) were hepatitis C RNA-positive (50.1% were aware of infection status).Most surveillance indicators remained relatively stable from Phase 1 to Phase 4. Changes were found in substances used, and improvements were noted related to HIV and hepatitis C prevalence and care cascade indicators.Conclusion: Many PWID in Canada were living in unstable housing and experienced high levels of stigma and discrimination. Prevalence of HIV and hepatitis C was high in some areas. These findings contribute to the evidence base used to inform targeted prevention and control measures. [ABSTRACT FROM AUTHOR]

Background: Canada experienced two distinct waves of pandemic (H1N1) influenza during the 2009 pandemic, one in the spring and the second in early fall 2009. We compared the incidence of hospital admissions and severe outcomes (admission to intensive care unit [ICU] and death) during the two waves., Methods: We reviewed data on all laboratory-confirmed cases of pandemic (H1N1) influenza that resulted in hospital admission, ICU admission or death reported to the Public Health Agency of Canada by all provinces and territories from Apr. 18, 2009, to Apr. 3, 2010., Results: A total of 8678 hospital admissions (including 1473 ICU admissions) and 428 deaths related to pandemic (H1N1) influenza were reported during the pandemic and post-peak period. There were 4.8 times more hospital admissions, 4.0 times more ICU admissions and 4.6 times more deaths in the second pandemic wave than in the first wave. ICU admissions and deaths as a proportion of hospital admissions declined in the second wave; there was a 16% proportional decline in ICU admissions and a 6% proportional decline in deaths compared with the first wave. Compared with patients admitted to hospital in the first wave, those admitted in the second wave were older (median age 30 v. 23 years) and more had underlying conditions (59.7% v. 47.5%). Pregnant women and Aboriginal people accounted for proportionally fewer patients who were admitted to hospital or who died in the second wave than in the first., Interpretation: The epidemiologic features of the first and second waves of the 2009 pandemic differed. The second wave was substantially larger and, although the patients admitted to hospital were older and more of them had underlying conditions, a smaller proportion had a severe outcome.