© Tracey Lindeman/CBCMontreal Public Health says a rise in HIV diagnoses can be explained by a catch-up in testing and new arrivals from countries where the infection is endemic.
There were about 310 new diagnoses of HIV in 2022, compared to 141 in 2021. Before the COVID-19 pandemic hit, Montreal Public Health recorded about 200 new HIV diagnoses per year.
The jump is partially explained by an increase in testing, said Julian Gitelman, the lead physician for the sexually transmitted and blood-borne infections team at Montreal Public Health.
Alexandre Dumont Blais, the executive director of RÉZO, a non-profit organization that specializes in gay and bisexual men's health, agrees with Gitelman's findings.
"During the pandemic we observed at RÉZO that it was somewhat complicated to get an HIV test or STI test in general because ... of COVID restrictions," he said.
"So I think we can make the link between lack of tests during the pandemic and now."
Gitelman says one of the groups that has seen an increase in diagnoses is men who have sex with other men, but the largest increase was seen in heterosexual people coming from countries where HIV is endemic. This also explains the rise of HIV cases among women.
PrEP and prevention
Gitelman says the key to reach the UNAIDS (Joint United Nations Programme on HIV/AIDS) target of zero new diagnoses is prevention.
"If you're a gay or bisexual man you should talk to your doctor if a medication called PrEP is right for you. It's a medication you can take if you're HIV-negative and it's really been effective at preventing infections when you're exposed to HIV," he said.
PrEP, or pre-exposure prophylaxis, is covered by RAMQ but the deductible is about $100 per month, said Gitelman. It can be prescribed by any family doctor and many health clinics in Montreal's Gay Village and university health centres can provide it. People can check if they're eligible for the medication at Maprep.org.
However, Blais pointed out that it can be harder for women to access PrEP.
Testing and treatment are other important tools to manage HIV, as most sexually transmitted infections can be asymptomatic, said Gitelman.
"The only way to know if you have one is to be tested," he said.
"We want to ensure that everyone with HIV can access treatment because people living with HIV who are taking medications will live a long, healthy life and can't transmit the virus to others."
Montreal Public Health will be working closely with immigration clinics to give people necessary resources due to the change in demographics affected by HIV, said Gitelman.
He says there needs to be less stigma around HIV so people can feel comfortable opening up to medical professionals.
"Stigma is really powerful. It's not just HIV that's stigmatized, but people with minority sexual orientations experience stigma, people who are new arrivals experience stigma, people who are not white experience stigma," he said.
"It really does impact this issue."
Community organizations need funding
The Table des organismes communautaires montréalais de lutte contre le sida (TOMS) — a group representing 30 community organizations in the city — says more help is needed for those working on the ground to prevent HIV.
Olivier Gauvin, a co-ordinator with TOMS, says the numbers surprised him. Although he was aware there was less HIV testing being done during the pandemic, the yearly numbers of new diagnoses were fairly stable before COVID-19.
"Seeing this new increase makes me wonder who aren't we reaching and why aren't we reaching them?" he said.
Gauvin says it's been frustrating trying to get government funding for their organizations.
TOMS left the Montréal sans sida initiative over its "increasing disengagement" last February.
"The government says it's in the fight against HIV with us, but the way they can help is by providing community organizations with the means to actually do this work," said Gauvin.
Comment: This is particularly notable because, also this year, Singapore saw a 10% spike in new HIV infections, the UK reported a rise of gonorrhea cases, and the US has seen record numbers of syphilis cases.
This also follows nearly 2 years of rolling lockdowns, where it's likely that there was actually a decline in sexual encounters.
Whilst increased testing may be a factor, as well as mass migration (at least in the case of the US and UK), it's also known that the experimental covid injections can significantly compromise the immunity of the recipient, and one wonders just how much that is contributing to the 'partial' explanations given above.
See also: Lethal Sex -The Rise of Sexually Transmitted Diseases in the Age of Postmodernist Liberalism