Updated Ontario HIV testing guidelines aim to diagnose people earlier, link them to care and enable viral suppression

The guidelines will help Ontario meet its 2030 UNAIDS targets by diagnosing infections early and getting people on treatment quickly

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April 11, 2023 [Toronto] — In collaboration with the Ontario Ministry of Health (MoH) and Ontario-based clinicians and testing providers, the Ontario HIV Treatment Network (OHTN) has updated recommendations for providers offering HIV testing in Ontario.  

While advances in testing and treatment mean new HIV infections are declining in Ontario, there were still 485 new HIV diagnoses in 2021, disproportionately concentrated in a small number of populations. These include gay, bisexual, two-spirit, and other men who have sex with men, African, Caribbean and Black communities, Indigenous Communities, people who use drugs, cis and trans women, including those from the communities above, who face systemic and social inequities, and are more likely to be exposed to HIV through a sexual or drug using partner.  

The updated guidelines align with Ontario’s commitment to achieve the 95-95-95 targets set out by UNAIDS that say by 2030, 95 per cent of people living with HIV should be diagnosed, 95 per cent of those should be on treatment, and 95 per cent of those should be virally suppressed. The guidelines will support a broader range of health care providers in identifying people at high risk of infection and providing them with an efficient pathway to testing and prevention services or treatment. 

“The release of these new guidelines is a progressive step toward eliminating new HIV infections in Ontario,” says Dr. Kieran Moore, Ontario’s Chief Medical Officer of Health. “The testing guidelines complement ongoing work across sectors and communities to address factors that increase the risk of HIV infection and impact the lives of people with HIV.” 

Thanks to advances in testing technologies, the updated guidelines indicate that the “testing window”—the time between when a person is exposed to HIV and when a test can confirm a negative or positive result—has gone from three months to six weeks. This means providers can diagnose and get people on treatment sooner and suppress the virus more quickly. A person with a suppressed viral load is considered “undetectable.” A person with undetectable HIV can live a healthy life and cannot transmit the virus on to sexual partners. 

“The guidelines encourage providers to learn the signs and symptoms of both acute and chronic HIV infection, so HIV infections are detected at the earliest possible opportunity, and people with an HIV-positive diagnosis can be linked to care as soon as possible,” explains Jean Bacon, Executive Director of OHTN. “Too many people are still going undiagnosed. The OHTN and its partners updated these guidelines to help providers identify new cases earlier, reduce transmission, ensure better health outcomes, and help Ontario meet its 95-95-95 targets.” 

The guidelines also encourage providers to link people at high risk of HIV and who test negative to prevention and harm-reduction services, including pre-exposure prophylaxis (PrEP)—a daily medication that prevents HIV infection.  

Please visit https://bit.ly/htoguidelines to read the new guidelines and learn more. 


The Ontario Guidelines for Providers Offering HIV Testing were developed by the Ontario HIV Treatment Network (OHTN), in collaboration with the Ministry of Health, Public Health Ontario, Ontario College of Family Physicians and Ontario-based clinicians and testing providers. 

Ontario HIV Treatment Network (OHTN) 

The Ontario HIV Treatment Network is a non-profit network whose mission istoimprove the health and lives of people living with and at risk of HIV by using data and evidence to drive change. The OHTN works to influence decision-making at all levels—personal, clinical, organizational and policy—by working collaboratively with our partners to gather and analyze data and support the use of this data to drive change. 

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