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Alberta Health
Notifiable Sexually Transmitted Infections &
Human Immunodeficiency Virus
2013 Annual Report
Surveillance and Assessment Branch
February 2015
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Alberta Health, Surveillance and AssessmentSTI and HIV 2013 Annual Report February 2015
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Alberta Health, Surveillance and AssessmentSTI and HIV 2013 Annual Report February 2015
Table of Contents
Executive Summary ................................................................................................................. 1
Introduction .............................................................................................................................. 2
Figure 1:
Number of Notifiable STIs and Other Notifiable Diseases reported in Alberta,
2005 to 2013 ....................................................................................................... 2
Chlamydia ................................................................................................................................. 3
Figure 1.1: Number of Chlamydia Cases and Crude Rate (per 100,000) in Alberta by
Gender, 2005 to 2013 ......................................................................................... 3
Figure 1.2: Number of Chlamydia Cases and Age-Specific Rate (per 100,000) by Gender
in Alberta, 2013 (n=15,825) ................................................................................. 4
Figure 1.3: Chlamydia Crude Rate (per 100,000) by Alberta Health Zone, 2013 ................... 5
Figure 1.4: Number of Chlamydia Cases in Alberta by Ethnicity (Self-defined), 2005 to 2013 6
Figure 1.5: Number of Sexual Partners Identified by Newly Diagnosed Chlamydia Cases in
Alberta, 2011 to 2013 .......................................................................................... 7
Gonorrhea ................................................................................................................................ 8
Figure 2.1: Number of Gonorrhea Cases and Crude Rate (per 100,000) in Alberta by
Gender, 2005 to 2013 ......................................................................................... 8
Figure 2.2: Number of Gonorrhea Cases and Age-Specific Rate (per 100,000) by Gender in
Alberta, 2013 (n=1,973) ...................................................................................... 9
Figure 2.3: Gonorrhea Crude Rate (per 100,000) by Alberta Health Zone, 2013 .................10
Figure 2.4: Number of Gonorrhea Cases in Alberta by Ethnicity (Self-defined), 2005 to 2013
..........................................................................................................................11
Figure 2.5: Number of Sexual Partners Identified by Newly Diagnosed Gonorrhea Cases in
Alberta, 2011 to 2013 .........................................................................................12
Infectious Syphilis ..................................................................................................................13
Table 3: Number of Infectious Syphilis Cases by Stage in Alberta, 2005 to 2013 ..................13
Figure 3.1: Number of Reported Infectious Syphilis Cases and Crude Rate (per 100,000) in
Alberta by Gender, 2005 to 2013 .......................................................................14
Figure 3.2: Number of Infectious Syphilis Cases and Age-Specific Rate (per 100,000) by
Gender in Alberta, 2013 (n=120) ........................................................................15
Figure 3.3: Infectious Syphilis Crude Rate (per 100,000) by Alberta Health Zone, 2013 ......16
Figure 3.4: Number of Infectious Syphilis Cases in Alberta by Ethnicity (Self- defined), 2005
to 2013 ...............................................................................................................17
Figure 3.5:
Number of Sexual Partners Identified by Newly Diagnosed Infectious SyphilisCases in Alberta, 2011 and 2013 .......................................................................18
HIV............................................................................................................................................19
Figure 4.1: Number and Crude Rate (per 100,000) of Newly Diagnosed HIV Cases in Alberta
by Gender, 2005 to 2013 ...................................................................................19
Figure 4.2: Number of Newly Diagnosed HIV Cases and Age-Specific Rate (per 100,000) by
Gender in Alberta, 2013 (n=255) ........................................................................20
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Figure 4.3: Newly Diagnosed HIV Crude Rate (per 100,000) by Alberta Health Zone, 2013 21
Figure 4.4: Number of Newly Diagnosed HIV Cases in Alberta by Ethnicity (Self-defined), ..22
2005 to 2013 ......................................................................................................22
Figure 4.5a:Proportion of Newly Diagnosed HIV Cases in Alberta by Risk Exposure Category
among Females, 2005 to 2013 ...........................................................................23
Figure 4.5b:
Proportion of Newly Diagnosed HIV Cases in Alberta by Risk Exposure Categoryamong Males, 2005 to 2013 ...............................................................................24
Figure 4.6: Number of Newly Diagnosed HIV Cases in Alberta by Encountered Risk
Selection and Gender in Alberta, 2010 to 2013 ..................................................25
Figure 4.7: Number of Newly Diagnosed HIV Cases Co-Infected With Hepatitis B and/or
Hepatitis C in Alberta, 2008 to 2013 ...................................................................26
Figure 4.8: Number of Newly Diagnosed HIV Cases Infected with and Timing of Chlamydia,
Gonorrhea, or Infectious Syphilis in Alberta, 2005 to 2013 .................................27
Figure 4.9: Number of Newly Diagnosed HIV Cases and Crude Rate (per 100,000) of First
Nations vs. Non-First Nations in Alberta by Year of Diagnosis, 2005 to 2013 .....28
Figure 4.10:Crude Rate of Newly Diagnosed HIV Cases for First Nations (per 100,000) in
Alberta by Sex and Year of Diagnosis, 2005 to 2013 .........................................29
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Executive Summary
J3'% 1$V(1& V1$%$)&% 1,&$% (< %$F",//B &1,)%8'&&$7 ')
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Introduction
I(1$ &3,) ?>> 6(88")'6,0/$ 7'%$,%$% ') ./0$1&, ,1$ )(&'
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Chlamydia
+3/,8B7', '% &3$ 8(%& 6(88()/B 1$V(1&$7 )(&'?G P,% ,/8(%& &P'6$ ,% 3'#3 ,% &3$ 8,/$ 1,&$ W@S\ 6,%$% V$1 ?>>4>>> 5%9 =S?6,%$% V$1 ?>>4>>> V$1%()%4 1$%V$6&'5$/BX ,)7 1$V1$%$)&$7 H= V$1 6$)& (< ,// 63/,8B7', 6,%$%9
J3$ )"80$1 ,)7 1,&$ (< 6,%$%
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Figure 1.2: Number of Chlamydia Cases and Age-Specific Rate (per 100,000) by Genderin Alberta, 2013(n=15,825)
?G4 \= V$1 6$)& (?G P$1$ ,8()#
+,"6,%',)% WHKeX ?? 6,%$% (< 63/,8B7', P'&3
")_)(P) $&3)'6'&B ') =>?G9
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Gonorrhea
;()(113$, '% &3$ %$6()7 8(%& 6(88()/B 1$V(1&$7 %$F",//B &1,)%8'&&$7 ')?G9 E(&3 =>?= ,)7 =>?G 3,5$ %$$)
')61$,%$% ') 1,&$%
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Figure 2.2: Number of Gonorrhea Cases and Age-Specific Rate (per 100,000) by Gender in Alberta,2013 (n=1,973)
>4>>> 8,/$%X9 I,/$% 3,7 3'#3$1 1,&$% &3,)
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Figure 2.3: Gonorrhea Crude Rate (per 100,000) by Alberta Health Zone, 2013
;()(113$, 1,&$% 7'>4>>> V$1%()%9
R) =>?G4 &3$ #()(113$, 1,&$ ') &3$:78()&() ^()$ P,% &P'6$ 3'#3$1&3,) &3$ 1,&$ ') &3$ +,/#,1B ^()$WH@9> 6,%$% V$1 ?>>4>>> 5%9 G=9G6,%$% V$1 ?>>4>>>4 1$%V$6&'5$/BX9
J3$ :78()&() ^()$ ,)7 &3$M(1&3 ^()$ 3,7 3'#3$1 1,&$% ( 6,%$% V$1 ?>>4>>> V$1%()%9
Cases Rates Cases Rates Cases Rates Cases Rates
North 283 64.3 316 70.6 512 111.5 514 108.4
Edmonton 484 41.3 691 58.1 860 70.4 813 64.0
Central 106 23.6 119 26.3 142 31.0 127 27.1
Calgary 279 20.1 345 24.4 506 34.8 490 32.3
South 30 10.4 25 8.6 42 14.4 29 9.8
ALBERTA 1,182 31.7 1,496 39.5 2,062 53.0 1,973 49.0
2012 2013Health Zone
2010 2011
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Figure 2.4: Number of Gonorrhea Cases in Alberta by Ethnicity (Self-defined), 2005 to 2013
513
807 829687
477 352
548
757 755
139
160 132
153
90
48
112
125 100452
603 616693
636
547
560
794706
50
63 4252
46
39
51
76
90
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
2005
(n=1,181)
2006
(n=1,666)
2007
(1,657)
2008
(n=1,635)
2009
(n=1537)
2010
(n=1,000)
2011
(n=1,294)
2012
(n=1,789)
2013
(n=1,674)
NumberofCases
Caucas ian Black Aboriginal Asian Other
M(&$- J3'% $F6/"7$% g")_)(P)h
.% ') V1$5'("% B$,1%4 &3$ 3'#3$%& V1(V(1&'()% (< #()(113$, 6,%$% P$1$ %$$) ,8()# +,"6,%',)% ,)7
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Figure 2.5: Number of Sexual Partners Identified by Newly Diagnosed Gonorrhea Cases in Alberta,2011 to 2013
" % & ' ( # ) #
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Infectious Syphilis
D)$ (< &3$ (/7$%& %$F",//B &1,)%8'&&$7 ')
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Figure 3.1: Number of Reported Infectious Syphilis Cases and Crude Rate (per 100,000) in Albertaby Gender, 2005 to 2013
2005 2006 2007 2008 2009 2010 2011 2012 2013Female Cases 55 67 73 100 91 56 28 20 24
Male Cses 91 148 174 143 189 122 68 108 96
Female Rate 3.4 4.0 4.2 5.7 5.0 3.0 1.5 1.0 1.2
Male Rate 5.4 8.5 9.7 7.8 10.1 6.4 3.5 5.5 4.7
0
2
4
6
8
10
12
0
50
100
150
200
250
300
Rate(per100,0
00)
NumberofCases
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P,% ,/8(%&
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Alberta Health, Surveillance and AssessmentSTI and HIV 2013 Annual Report February 2015
Figure 3.2: Number of Infectious Syphilis Cases and Age-Specific Rate (per 100,000) by Gender inAlberta, 2013 (n=120)
?G9 J3$ 3'#3$%& ') &( =@ B$,1% ,#$#1("V W?>9H 6,%$% V$1 ?>>4>>> 8,/$%X
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Figure 3.3: Infectious Syphilis Crude Rate (per 100,000) by Alberta Health Zone, 2013
R) =>?G4 &3$ 3'#3$%& 1,&$ (< 7'%$,%$P,% ') +,/#,1B ^()$% WG9\ 6,%$% V$1?>>4>>> V$1%()%Xf &3$ /(P$%& 1,&$P,% ') &3$ +$)&1,/ ^()$ P'&3 >9S6,%$% V$1 ?>>4>>>9
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')?G4 &3$
V1(V(1&'() (< ') &(&,/X
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Figure 3.5: Number of Sexual Partners Identified by Newly Diagnosed Infectious Syphilis Cases inAlberta, 2011 and 2013
" % & ' ( # ) #
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W?\`?=T 6,%$%X ') =>?=4 &3$) &( =G V$16$)& W=\`?=? 6,%$%X ') =>?G9
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Alberta Health, Surveillance and AssessmentSTI and HIV 2013 Annual Report February 2015
HIV
2"8,) '88")(7$>4>>> V$1%()% ')
=>?G4 "V %/'#3&/B >4>>> ') =>?? ,)7 H9= 6,%$% V$1 ?>>4>>> V$1%()% ') =>?=9
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Figure 4.2: Number of Newly Diagnosed HIV Cases and Age-Specific Rate (per 100,000) by Genderin Alberta, 2013 (n=255)
?G P$1$ /$%% &3,) ()$ &( H> B$,1%
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Figure 4.3: Newly Diagnosed HIV Crude Rate (per 100,000) by Alberta Health Zone, 2013
R) =>?G4 &3$ :78()&() ^()$ 3,7&3$ 3'#3$%& 1,&$ (< 2RY P'&3 \9\6,%$% V$1 ?>>4>>> V$1%()%4 >4>>>V$1%()%9 J3$ /(P$%& 1,&$ (< 2RYP,% ') &3$ +$)&1,/ ^()$ P'&3 =9\6,%$% V$1 ?>>4>>> V$1%()%9
R) V1$5'("% B$,1%4 &3$ :78()&(),)7 M(1&3 ]()$% 3,5$ 3,7 &3$3'#3$%& 1,&$% (< 2RY ') &3$V1(5')6$9 J3$ =>?G 2RY 1,&$ ?G P3'/$&3$ 1,&$
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Alberta Health, Surveillance and AssessmentSTI and HIV 2013 Annual Report February 2015
Figure 4.4: Number of Newly Diagnosed HIV Cases in Alberta by Ethnicity (Self-defined),2005 to 2013
77 91
128
98 100 93 102 92 101
34
54
47
7144
4352 82
7441
54
36 42
3933
39
39 45
8
106 6
1416
9
12 14
86
14
99
0
50
100
150
200
250
300
2005(n=165)
2006(n=213)
2007(n=223)
2008(n=224)
2009(n=205)
2010(n=191)
2011(n=216)
2012(n=234)
2013(n=243)
NumberofCases
Caucasian Black Aborig inal Asian Other
M(&$- J3'% $F6/"7$% g")_)(P)h
A'#"1$ @9@ %3(P% &3$ V1(V(1&'() (< )$P/B 7',#)(%$7 2RY 6,%$% P'&3 _)(P) $&3)'6'&B 3,% 63,)#$7
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6,%$% P,% E/,6_9 J3$ V1(V(1&'() (< )$P/B 7',#)(%$7 2RY 6,%$% ') ./0$1&, %$/
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HIV Risk Exposure
!')6$ =>?>4 , )$P 6,&$#(1B ??4 GK V$16$)& ') =>?=4
,)7 &( GS V$1 6$)& ') =>?G9 A'#"1$ @9K0 %3(P% &3,& &3$ +R+`DD+ V1(V(1&'()% ?> ,)7 =>??4 ?H V$16$)& ') =>?= ,)7 ?K V$1 6$)& ') =>?G9
Figure 4.5a: Proportion of Newly Diagnosed HIV Cases in Alberta by Risk Exposure Categoryamong Females, 2005 to 2013
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2005(65)
2006(74)
2007(68)
2008(81)
2009(69)
2010(56)
2011(70)
2012(69)
2013(77)
-&'.&/0()*+,&,
Other/ Unknown
Perinatal
NIR - Other
NIR - Heterosexual
MSM and IDU
MSM
IDU
Heterosexual - Partner at Risk
Heterosexual - Endemic
CIC/Out of Country*
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&( ?= V$16$)& ') =>?G9
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Figure 4.5b: Proportion of Newly Diagnosed HIV Cases in Alberta by Risk Exposure Category amongMales, 2005 to 2013
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2005(109)
2006(146)
2007(158)
2008(151)
2009(149)
2010(148)
2011(155)
2012(173)
2013(177)
-&'.&/0()*+,&,
Other/ Unknown
Perinatal
NIR - Other
NIR - Heterosexual
MSM and IDU
MSM
IDU
Heterosexual - Partner at Risk
Heterosexual - Endemic
CIC/Out of Country*
.% ') V1$5'("% B$,1%4 &3$ 8(%& 6(88() 1'%_ $FV(%"1$ 6,&$#(1B ?G4
K> V$1 6$)& (< 8,/$ 6,%$% 1$V(1&$7 ') I!I9 R[a ,% , 1'%_ K &( , /(P (< )')$ V$1 6$)& ') =>?G9
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Figure 4.6: Number of Newly Diagnosed HIV Cases in Alberta by Encountered Risk Selection andGender in Alberta, 2010 to 2013
F M F M F M F M F M F M2008 2009 2010 2011 2012 2013
Sharing other drug paraphernalia 6 11 4 15 9 16 8 14 5 18 8 21
Sexual partner of intravenous drug user(IDU)
7 9 10 12 10 14 3 12 9 10 10 14
Sexual partner of a person withconfirmed or suspected HIV/AIDS
11 28 19 22 13 32 16 39 18 40 28 48
Sex trade worker 4 2 12 4 10 4 7 0 7 6 6 7
Patron of sex worker 0 5 0 9 0 13 0 13 0 19 0 25
0
20
40
60
80
100
120
"#$%&'()*+,&,
R) =>?G4 @\ 8,/$% P'&3 )$P/B '7$)&'
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Figure 4.7: Number of Newly Diagnosed HIV Cases Co-Infected With Hepatitis B and/or Hepatitis Cin Alberta, 2008 to 2013
&"">
7*:&''9
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10
15
20
25
30
35
40
45
50
NumberofCo-InfectedCases
M j J(&,/ )$P/B 1$V(1&$7 2RY 6,%$%
O3$) $F,8')')# 2$V,&'&'% E ,)7 + 6(U')
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Figure 4.8: Number of Newly Diagnosed HIV Cases Infected with and Timing of Chlamydia,Gonorrhea, or Infectious Syphilis in Alberta, 2005 to 2013
Before Same time After Before Same time After Before Same time After
2005 (N=174) 17 3 10 20 2 11 7 0 2
2006 (N=221) 20 4 12 12 0 7 13 2 1
2007 (N=226) 16 0 20 13 1 19 16 7 5
2008 (N=233) 19 2 18 24 2 35 17 2 4
2009 (N=218) 18 2 20 4 2 18 15 5 3
2010 (N=204) 12 4 28 8 4 24 2 2 6
2011 (N=225) 15 4 21 13 3 34 4 1 8
2012 (N=242) 11 4 30 8 6 18 2 3 4
2013 (N=255) 19 5 37 10 10 30 3 0 3
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Alberta Health, Surveillance and AssessmentSTI and HIV 2013 Annual Report February 2015
HIV among First Nations in Alberta
Figure 4.9: Number of Newly Diagnosed HIV Cases and Crude Rate (per 100,000) of First Nationsvs. Non-First Nations in Alberta by Year of Diagnosis, 2005 to 2013
2005 2006 2007 2008 2009 2010 2011 2012 2013
FN Cases 37 43 33 37 31 29 35 31 38
Non-FN Cases 137 177 193 196 167 175 190 211 217
FN Rate 25.2 28.5 21.7 23.9 19.9 18.5 22.2 19.4 23.4
Non-FN Rate 4.3 5.4 5.7 5.7 4.7 4.9 5.2 5.7 5.6
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28
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Alberta Health, Surveillance and AssessmentSTI and HIV 2013 Annual Report February 2015
Appendix A: HIV Hierarchy
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