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December 5, 2025

HIV in Manitoba: Rising Rates, Awareness, and How Physicians Can Help

Manitoba continues to face one of the highest and fastest-growing HIV rates in Canada. New figures were released this week coinciding with World AIDS Day and Indigenous AIDS Awareness Week. In 2024, Manitoba had the highest HIV infection rate in Canada (excluding Quebec) with 19.5 per 100,000 people infected, according to the Public Health Agency of Canada. 

In Manitoba, there were 291 newly diagnosed HIV cases (138 males, 153 females) reported in 2024, compared to 283 cases in 2023. This represents a 2.83 per cent increase in the number of new HIV diagnoses, according to the province’s annual surveillance report released Monday. 

Why it’s happening

A growing share of cases involve people facing significant social and structural challenges. ​“There has been a dramatic increase in cases,” said Dr. Joshua Aquin, Medical Officer of Health serving the Winnipeg region. ​“The population it is affecting is people who are facing social and systemic barriers.” Many are presenting late, with complications of advanced HIV. Some people with HIV are lost to care entirely. 

Housing insecurity, racism, stigma, and untreated mental health or substance use challenges compound risk. ​“There is a history of colonization and stigma and racism behind structural inequities that present challenges,” said Dr. Sarah Lesperance, Medical Officer of Health. For many patients, basic survival needs come first. ​“When you are unstably housed, where you are going to sleep or have your next meal are more pressing issues,” added Dr. Aquin. 

Kim Bailey, Director, Prevention Testing and Wellness with Nine Circles agrees disparities are driving the higher rates here in Manitoba. These are compounded by intergenerational trauma resulting from colonialism, residential schools, and racism in Manitoba. ​“There is a lack of urgency around HIV as many believe that it is a thing of the past. While we have the medical tools to eliminate HIV including PreP and HIV treatment, it still rages on. This tells me that the focus for HIV prevention lies in addressing poverty, housing, stigma, addictions, and improved access to care. 

Public awareness: HIV is Here

The WRHA Healthy Sexuality and Harm Reduction team, Nine Circles, and community partners launched HIV is Here, a colourful, community-driven public campaign. 

“We found outdated perceptions of HIV as an untreatable, terminal illness, or as a ​‘gay disease,’” said Dr. Lesperance. ​“People said nobody talks about HIV anymore.” 

The campaign aims to normalize conversation, correct myths, and highlight that HIV is treatable. 

“Harm reduction is a pathway to prevention,” said Dr. Aquin. That includes accessible testing in settings where people feel safe. Testing is available in community agencies, emergency departments, and correctional facilities. ​“People learn about their diagnosis where they can also find support,” he said. 

Street outreach is playing a key role. Andrea Farrell, a public health nurse with Street Connections, said trust takes time: ​“Many don’t understand there are treatments and preventative measures, even though they’re hearing more about rising cases.” 

What physicians can do

  • Offer HIV testing routinely. 
  • Talk about sexual health and well-being. 
  • Manitoba began to offer pre-exposure prophylaxis, commonly known as PrEP, at no cost to any individuals who don’t already have full coverage through their insurance. 
  • Use Manitoba’s HIV treatment guidance to support care in primary practice. 
  • Encourage consistent linkage to care, as sustained treatment prevents transmission. 

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