HIV/AIDS in Vancouver, British Columbia: A Growing Epidemic

The prevalence of HIV in Vancouver, British Columbia was subject to two distinct periods of rapidincrease. The first occurred in the 1980s due to high incidence among men who have sex with men(MSM), and the second occurred in the 1990s due to high incidence among injection drug users(IDU). The purpose of this study was to estimate and model the trends in HIV prevalence inVancouver from 1980 to 2006. HIV prevalence data were entered into the UNAIDS/WHOEstimation and Projection Package (EPP) where prevalence trends were estimated by fitting anepidemiological model to the data. Epidemic curves were fit for IDU, MSM, street-based female sextrade workers (FSW), and the general population. Using EPP, these curves were then aggregatedto produce a model of Vancouver's overall HIV prevalence. Of the 505 000 people over the age of15 that reside in Vancouver, 6108 (ranging from 4979 to 7237) were living with HIV in the year2006, giving an overall prevalence of 1.21 percent (ranging from 0.99 to 1.43 percent). Thesubgroups of IDU and MSM account for the greatest proportion of HIV infections. Our modelestimates that the prevalence of HIV in Vancouver is greater than one percent, roughly 6 timeshigher than Canada's national prevalence. These results suggest that HIV infection is having arelatively large impact in Vancouver and that evidence-based prevention and harm reductionstrategies should be expanded.