Manitoba Declares HIV Emergency Amidst Soaring Rates

Manitoba has declared a public health emergency as its HIV rates significantly outpace the national average. Provincial chief public health officer Dr. Brent Roussin announced the emergency on Thursday, noting a rate of 19.5 cases per 100,000 people in 2024, substantially higher than Canada's 5.5 rate.

The surge in cases is attributed to multiple factors, including injection drug use, homelessness, mental health challenges, and rising rates of other sexually transmitted and bloodborne infections. The number of new HIV cases reported in 2025 reached 328, more than doubling the 142 cases from 2021 and tripling the 90 cases from 2019.

This public health emergency declaration provides the province with expanded options for both traditional and non-traditional HIV testing. It also serves as a critical tool for raising awareness and urgency among partners and the public. Addressing issues related to injection drug use is identified as a crucial component of the response strategy.

Indigenous leadership and community organizations have been key in sounding the alarm, prompting the declaration. While acknowledging their significant work, Dr. Roussin emphasized that the escalating numbers necessitate further action. The emergency is framed not as a cause for fear, but as an acknowledgment of current realities requiring urgent attention.

In 2024, approximately 70 percent of HIV transmissions in Manitoba were linked to injection drug use, with heterosexual transmission being another major factor. Notably, over half of the province's cases involve female patients, a figure significantly higher than the Canadian average of 32 percent. Many newly diagnosed female patients are under 40, increasing the risk of perinatal transmission.

Manitoba aims to boost the use of pre-exposure prophylaxis (PrEP), a drug that significantly reduces HIV risk. However, current uptake among women and individuals who inject drugs remains low. The highest HIV rates are observed in the Northern Regional Health Authority and the Prairie Mountain Health region, though the Winnipeg health region reports the largest overall number of cases.

Indigenous populations are disproportionately affected, a situation linked to the ongoing effects of colonization. Addressing the complex issues driving HIV transmission requires a coordinated effort across governments, communities, and health systems, involving collaboration with Indigenous leadership, community organizations, and federal partners.