{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:22:59Z","timestamp":1791490979797,"version":"4.3.4"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008220","name":"Canadian Foundation for AIDS Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008220","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"canadian institutes of health research","doi-asserted-by":"publisher","award":["176645"],"award-info":[{"award-number":["176645"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002879","name":"canadian hiv trials network, canadian institutes of health research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002879","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Characterization of populations at risk of acquiring HIV is required to inform the public health response to HIV. To identify potential changing needs in HIV prevention and care cascade, we aim to describe how the demographic profiles and exposure categories of newly diagnosed HIV positive individuals attending a large sexual health clinic in Montr\u00e9al (Canada) evolved since the beginning of the antiretroviral therapy era in the mid-1990s.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using diagnosis data from participants of the <jats:italic>Clinique m\u00e9dicale l\u2019Actuel<\/jats:italic> cohort of HIV-positive patients, we examined the distribution of exposure categories (sexual orientation, sexual behaviours, injection drug use, being born in an HIV-endemic country) by gender and year of diagnosis. Time trends in mean age and in the proportion of patients with late (CD4 &lt;350 cells\/\u03bcL) or advanced stage (CD4 &lt;200 cells\/\u03bcL) of HIV infection at diagnosis were assessed through meta-regressions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 2,612 patients diagnosed with HIV between January 1<jats:sup>st<\/jats:sup>, 1995 and December 31<jats:sup>st<\/jats:sup>, 2019 were included. Overall, mean age was 35 years (standard deviation: 10 years) and remained stable over time. The proportion of patients with advanced stage of HIV infection decreased from 16% in 1995 to 4% in 2019. Although men who have sex with men (MSM) consistently accounted for the highest proportion of new diagnoses (77%, 2,022\/2,612 overall), their proportion decreased since 2013. There was also a concomitant decrease in the proportion of people who inject drugs, with none of the newly diagnosed participants reporting injection drug use since 2017, and an important increase in the proportion of patients born in an HIV-endemic country (24%, 7\/29 in 2019), especially among women. Compared to patients from non-endemic countries, those from HIV-endemic countries were characterized by higher proportions of heterosexuals (88% vs 17%) and of women (52% vs 7%), and were twice likely to get diagnosed at an advanced stage of HIV infection (32% vs 15%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In absolute numbers, MSM continue to account for the largest exposure category. However, patients from HIV-endemic countries, who tend to be diagnosed at later stages of HIV infection, constitute an increasing proportion of newly diagnosed individuals. These persons could face distinct barriers to rapid diagnosis. Tailoring HIV testing strategies and other prevention interventions to the specific unmet prevention needs of these individuals is warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0258383","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T03:11:20Z","timestamp":1633662680000},"page":"e0258383","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Characteristics of new HIV diagnoses over 1995\u20132019: A clinic-based study in Montr\u00e9al, Canada"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5043-426X","authenticated-orcid":true,"given":"Katia","family":"Gigu\u00e8re","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maliheh","family":"Vaziri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Olivier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Charest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Szabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9jean","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8363-4388","authenticated-orcid":true,"given":"Mathieu","family":"Maheu-Giroux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"pone.0258383.ref001","article-title":"Global AIDS update 2020\u2014Seizing the moment: Tackling entrenched inequalities to end epidemics","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS)","year":"2020"},{"key":"pone.0258383.ref002","article-title":"HIV in Canada: 2019 Surveillance Highlights: Government of Canada","author":"Public Health Agency of Canada (PHAC)","year":"2019"},{"key":"pone.0258383.ref003","article-title":"Programme de surveillance de l\u2019infection par le virus de l\u2019immunod\u00e9ficience humaine (VIH) au Qu\u00e9bec\u2014Rapport annuel 2019","author":"Institut national de sant\u00e9 publique du Qu\u00e9bec (INSPQ)","year":"2020"},{"issue":"4","key":"pone.0258383.ref004","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S1473-3099(13)70692-3","article-title":"Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial","volume":"14","author":"B Grinsztejn","year":"2014","journal-title":"The Lancet Infectious Diseases"},{"issue":"9","key":"pone.0258383.ref005","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1056\/NEJMoa1600693","article-title":"Antiretroviral therapy for the prevention of HIV-1 transmission","volume":"375","author":"MS Cohen","year":"2016","journal-title":"N Engl J Med"},{"issue":"12","key":"pone.0258383.ref006","doi-asserted-by":"crossref","first-page":"304","DOI":"10.14745\/ccdr.v45i12a01","article-title":"HIV in Canada-Surveillance Report, 2018.","volume":"45","author":"N Haddad","year":"2019","journal-title":"Can Commun Dis Rep."},{"key":"pone.0258383.ref007","article-title":"Optimiser le d\u00e9pistage du virus de l\u2019immunod\u00e9ficience humaine au Qu\u00e9bec \u00e0 l\u2019\u00e8re des nouvelles strat\u00e9gies de pr\u00e9vention","author":"Institut national de sant\u00e9 publique du Qu\u00e9bec (INSPQ)","year":"2019"},{"key":"pone.0258383.ref008","article-title":"Strat\u00e9gie qu\u00e9b\u00e9coise de lutte contre le sida, phase 4\u2014Orientation 1997\u20132002. Gouvernement du Qu\u00e9bec","author":"Minist\u00e8re de la Sant\u00e9 et des Services sociaux","year":"1997"},{"key":"pone.0258383.ref009","article-title":"Le d\u00e9pistage anonyme du VIH: vers des services int\u00e9gr\u00e9s de d\u00e9pistage du VIH, des MTS et des h\u00e9patites virales\u2014Orientations.","author":"Minist\u00e8re de la Sant\u00e9 et des Services sociaux","year":"2001","journal-title":"Gouvernement du Qu\u00e9bec"},{"key":"pone.0258383.ref010","article-title":"Strat\u00e9gie qu\u00e9b\u00e9coise de lutte contre l\u2019infection par le VIH et le SIDA, l\u2019infection par le VHC et les infections transmissibles sexuellement\u2014Orientations 2003\u20132009","author":"Minist\u00e8re de la Sant\u00e9 et des Services sociaux","year":"2004","journal-title":"Gouvernement du Qu\u00e9bec"},{"key":"pone.0258383.ref011","author":"World Health Organization (WHO)","year":"2013","journal-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection"},{"key":"pone.0258383.ref012","article-title":"Avis int\u00e9rimaire sur la prophylaxie pr\u00e9exposition au virus de l\u2019immunod\u00e9ficience humaine","author":"Minist\u00e8re de la Sant\u00e9 et des Services sociaux","year":"2013","journal-title":"Gouvernement du Qu\u00e9bec"},{"issue":"6","key":"pone.0258383.ref013","doi-asserted-by":"crossref","first-page":"e028768","DOI":"10.1136\/bmjopen-2018-028768","article-title":"Cohort profile: l\u2019Actuel Pre-Exposure Prophylaxis (PrEP) Cohort study in Montreal, Canada.","volume":"9","author":"ZR Greenwald","year":"2019","journal-title":"BMJ Open"},{"issue":"4","key":"pone.0258383.ref014","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/QAI.0000000000002472","article-title":"Pre-exposure prophylaxis uptake among men who have sex with men who used nPrEP: a longitudinal analysis of attendees at a large sexual health clinic in Montr\u00e9al (Canada).","volume":"85","author":"Y Xia","year":"2020","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0258383.ref015","unstructured":"Canada\u2019s source for HIV and hepatitis C information. Oral pre-exposure prophylaxis (PrEP) [Available from: https:\/\/www.catie.ca\/en\/fact-sheets\/prevention\/pre-exposure-prophylaxis-prep."},{"key":"pone.0258383.ref016","article-title":"Fast-track citites: ending the HIV epidemic","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS)","year":"2014"},{"issue":"9","key":"pone.0258383.ref017","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1093\/aje\/kwq479","article-title":"Trends in human immunodeficiency virus incidence and risk behavior among injection drug users in Montreal, Canada: a 16-year longitudinal study","volume":"173","author":"J Bruneau","year":"2011","journal-title":"Am J Epidemiol"},{"key":"pone.0258383.ref018","article-title":"Surveillance des maladies infectieuses chez les utilisateurs de drogues par injection\u2014\u00c9pid\u00e9miologie du VIH 1995\u20132017, \u00c9pid\u00e9miologie du VHC 2003\u20132017","author":"Institut national de sant\u00e9 publique du Qu\u00e9bec (INSPQ)","year":"2019"},{"issue":"1","key":"pone.0258383.ref019","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1186\/s12889-019-8052-y","article-title":"Delayed linkage to HIV care among asylum seekers in Quebec, Canada.","volume":"19","author":"N Kronfli","year":"2019","journal-title":"BMC Public Health"},{"key":"pone.0258383.ref020","author":"Centers for Disease Control and Prevention (CDC).","year":"2019"},{"key":"pone.0258383.ref021","article-title":"HIV\/AIDS Epi Updates\u2014Chapter 13: HIV\/AIDS in Canada among people from countries where HIV is endemic","author":"Public Health Agency of Canada","year":"2012"},{"key":"pone.0258383.ref022","article-title":"Agence de la sant\u00e9 et des services sociaux de Montr\u00e9al","author":"A Fall","year":"2014","journal-title":"Surveillance de seconde g\u00e9n\u00e9ration du VIH aupr\u00e8s des communaut\u00e9s montr\u00e9alaises originaires d\u2019Afrique subsaharienne et des Cara\u00efbes anglophones"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0258383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T03:11:43Z","timestamp":1633662703000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0258383"}},"subtitle":[],"editor":[{"given":"Shui Shan","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,10,7]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0258383","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,7]]}}}