The 2018 Manitoba HIV Program Report: Findings & Recommendations

Since 2007, the Manitoba HIV Program has been the primary provider of specialized, evidence-informed HIV care and treatment for people living in Manitoba. At the end of 2018, approximately 1400 people living with HIV were receiving care at one of the program’s three clinic sites: Nine Circles Community Health Centre or the Health Sciences Centre in Winnipeg, or the 7th Street Health Access Centre in Brandon.

Each year, the program produces an annual report that looks at the characteristics of individuals who entered into HIV care in the previous year, identifies key areas for improving health outcomes and outlines key accomplishments that show our program is helping Manitobans live well with HIV.

2018 Highlights

HIV rates among Indigenous People reflect long-standing systemic racism in Manitoba’s health care system.

Health care leaders must address barriers faced by Indigenous people that result in avoidable and unfair inequities when accessing care. Systemic racism related to HIV includes: lack of HIV awareness campaigns for Indigenous Manitobans, inequitable access to culturally-safe testing and treatment, and lack of public information available about Pre-Exposure Prophylaxis (PrEP) being available free of charge for people covered under the Non-Insured Health Benefit. The Manitoba HIV Program proudly supports the work of First Nations communities, Tribal Councils and Indigenous-led organizations to help improve health outcomes for HIV positive, Indigenous clients.

Successful testing initiatives contribute to people being diagnosed and connected with care sooner.

In 2018, National HIV/STBBI Testing Day was held in Manitoba for the first time. Sites across the province offered traditional testing services as well as alternative testing technologies like point-of-care testing and dried blood spot testing. HIV testing on that day increased by nearly 150% with many participants being tested for the first time. Initiatives like National Testing Day helped the Manitoba HIV Program achieve a longstanding goal of having less than 15% of all clients present as “very late to care” in 2018 (with CD4 counts below 200).

A harm reduction approach, including better access to harm reduction supplies, is needed to support clients new to care.

In 2018, injection drug use surpassed heterosexual sex as the most-likely mode of HIV transmission in Manitoba. Health care teams employ a variety of harm reduction strategies to help our clients who are injecting drugs achieve positive health outcomes. This includes connecting people to addiction and mental health therapies, prescribing PrEP, and distributing new needles and other safer drug use equipment like sharps containers free of charge.

Access to medication is crucial to preventing HIV transmission in Manitoba.

Manitoba is one of the last provinces that does not provide comprehensive coverage for HIV medication. Current criteria for clients accessing the provincial drug program can result in delay of treatment, treatment interruption, or lack of treatment all together. Ensuring people can access and stay on medication has significant public health benefits: for every HIV transmission prevented due to undetectable viral load as a result of adherence to HIV medication, there is a minimum cost savings of 1.3 million dollars. The Manitoba HIV Program advocates for no-cost HIV treatment for all Manitoba residents who are living with HIV and do not qualify for any other medication cost coverage program.

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Friendly reminder: Data and statistics can perpetuate stigma if used to make general assumptions. HIV doesn’t target specific groups; it’s transmitted one person at a time. Anyone can get HIV, so it’s important that we all practice harm reduction strategies and get tested regularly!