HIV is still on the rise in Montreal: more than 300 new cases have been recorded this year. The cost of medicines and stigma still represent major obstacles to limiting the transmission of the disease, warns Public Health.
Published at 5:00 a.m.
A public health challenge
HIV remains a significant public health challenge in the metropolis. In total, 329 new cases of HIV were identified in 2023, compared to 311 the previous year, according to a report from the Regional Public Health Directorate (DRSP) of Montreal published this Friday. “This is higher than what we had before the pandemic, with 190 cases in 2019,” says the medical manager, sexually transmitted and blood-borne infections (STBBI) sector at the Montreal DRSP, Dr.r Julian Gitelman. The increase can be partly explained by the catching up of screenings not carried out during the pandemic due to limited capacities.
Treatment to block transmission
Currently, too few people diagnosed with HIV obtain antiretroviral treatment (ART), according to Public Health. These treatments, when started early, block the progression of the disease and limit the risk of transmission. However, in Quebec, only 82% of people living with HIV follow these treatments. This is insufficient, according to the Dr Gitelman. The target of the Joint United Nations Program on HIV/AIDS is more like 95%.
A preventive tool that is still underused
Medicine is also available for people who do not have HIV but may be exposed to the virus. The treatment, called pre-exposure prophylaxis or PrEP, stops the virus from reproducing and taking up residence in immune cells. It can be taken continuously (one daily tablet) or on demand (before and after sexual intercourse). However, its adoption remains insufficient, according to Public Health: only 48.5% of gay, bisexual men and other men who have sex with men for whom treatment is recommended reported using it between 2021 and 2023. PrEP can be prescribed by a family doctor or an authorized health professional in establishments such as the Actuel clinic, the Latin Quarter urban medical clinic or the Licorne clinic.
Groups more at risk
In the past year, men who have sex with men and newcomers represented the majority of new HIV cases in Montreal. Knowing that most people wishing to immigrate to the metropolis must take an HIV screening test, “this can partly explain the number of cases observed in this population”, says the Dr Gitelman. In total, 157 new arrivals were diagnosed with HIV out of more than 100,000 people who immigrated to Quebec during this period.
Beware of stigma
Stigmatization of people living with HIV remains a significant challenge. “It is partly the stigma that prevents people from getting tested, because they do not want to tell their doctor that they are gay and at risk for HIV,” laments the Dr Gitelman. The doctor encourages people at risk to seek information from their healthcare professional.
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