Dr. Brent Roussin, Manitoba's chief public health officer, speaks at the provincial legislative building in Winnipeg in 2020.David Lipnowski/The Canadian Press
Manitoba has declared a public health emergency after a sharp increase in HIV transmissions in the province, with several regions now facing some of the highest rates in Canada.
Brent Roussin, the province’s Chief Public Health Officer, said Thursday that the recent rise in HIV rates is largely owing to injection drug use and unprotected heterosexual sex.
Rates per capita are higher in northern communities and the southwest Prairie Mountain Health region, though the largest number of cases have been diagnosed in the Winnipeg area. Indigenous individuals represent the most disproportionately affected population, Dr. Roussin said.
New cases of HIV in Manitoba rose to 328 in 2025 from a total of 90 in 2019. In 2024, the province reported 19.5 cases per 100,000 people, compared with the national rate of 5.5.
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While year-to-date figures have not yet been finalized, Dr. Roussin said the first quarter of 2026 is on par with the “deeply concerning rise” of about 120 new HIV cases during the same period last year.
“This is significant, it’s concerning, and it requires a co-ordinated action across governments, communities and health systems,” he told reporters at the Manitoba Legislature, adding that the province has never before declared a health emergency for HIV.
A global scourge in the 1980s and 1990s, when it caused hundreds of thousands of deaths before modern treatments became available, HIV/AIDS has been considered a mostly manageable public health concern in the past two decades. Still, transmissions remain high in vulnerable populations, and many parts of the world have reported a resurgence of the disease.
Dr. Roussin said the recent rise of HIV in Manitoba is associated with the converging crises of homelessness, substance use and socioeconomic inequality, which have worsened in the past few years.
He said Indigenous individuals are most affected because it “relates back to all the factors that come from the ongoing effects of colonization.”
Declaring the health emergency allows the province to tap into more resources to combat the disease’s spread, such as support from the federal government, Dr. Roussin said.
“We want to increase awareness, increase access to prevention, testing and harm reduction,” he added, noting that the province is working to provide appropriate messaging to affected communities.
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Health officials tracking the rise of infections have found that HIV risk factors in Manitoba differ from national trends, Dr. Roussin said. Women account for more than 50 per cent of cases in the province; the national average is 32 per cent.
Most newly diagnosed women in the province are under 40, increasing the risk of perinatal cases. Perinatal HIV, often called mother-to-child transmission, occurs when the disease is passed on during pregnancy, labour, delivery or breastfeeding. At least one such case was diagnosed in Manitoba in 2025, following one the previous year, the province noted in a bulletin.
Karine LeBlanc, a senior spokesperson for Health Canada, said in an e-mail that the federal government provided $360,000 to Manitoba and deployed a field epidemiologist for Prairie Mountain Health during an HIV outbreak in early 2025. For the 2026-27 fiscal year, Ottawa has provided $288,000 to the province for other HIV outbreaks, she said.
Ms. LeBlanc said federal health officials will continue to meet regularly with their Manitoba counterparts, as the province is leading the emergency response.
The Assembly of Manitoba Chiefs, which represents 63 First Nations in the province, said a temporary government response will not provide meaningful long-term changes.
“This crisis did not happen overnight,” Grand Chief Kyra Wilson said in a statement, calling it a “public health disaster” that First Nations have been warning about for years.
She said the province must work to support access to HIV care. “No one should be turned away from care because they use substances, live in a remote community, do not have transportation, lack a health card, are unhoused or have experienced racism in the health system. An emergency response that does not remove these barriers immediately is not an emergency response at all.”
Although HIV is now treatable with antiretroviral therapy, and researchers are getting increasingly close to a cure, Dr. Roussin said there is still a stigma attached to the disease.
HIV treatments and preventative medicine – such as pre-exposure prophylaxis pills and injections, commonly referred to as PrEP – are severely underutilized in Manitoba, he said.
“This emergency, it’s not about creating fear,” he said. “It’s about acknowledging the reality that individuals and communities are facing right now and to address that with a level of urgency.”