Swan Valley’s spike in HIV cases triggers outbreak-like response from Manitoba health officials

The number of new HIV cases in Manitoba’s Swan Valley region has soared, prompting health officials to implement an outbreak-like response to control the situation.

Since October of last year, more than 40 new HIV diagnoses have been reported in Swan Valley, according to Dr. Brent Roussin, the chief provincial public health officer.

The Swan Valley area, which consists of several communities including Swan River, Minitonas and Benito, makes up the northernmost section of the Prairie Mountain Health Authority (PMHA). 

The new cases in Swan Valley were among 41 new cases recorded in the entirety of PMHA in 2024. The health authority in western Manitoba tallied 19 new HIV cases in 2023 and only six new cases in 2022, provincial reports say.

The recent increase in Swan Valley is “many more than what we’ve seen in the past,” Roussin said in an interview.

Contact tracing reveals cases

He said public health authorities established an “outbreak kind of response” by increasing access to testing, asking close contacts of new diagnoses to get tested and providing treatment. 

Contact tracing led public health to find some of the more than 40 HIV diagnoses, Roussin said.

The province’s top doctor acknowledged Manitoba has experienced year-over-year increases in new HIV diagnoses — the 280 new cases in 2023 is a 40 per cent increase compared with the previous year — but what’s happening in Swan Valley stands out, he said.

“We’ve noticed increasing transmission and, from what we’ve seen in this region and what we see in Manitoba, the majority of the transmission is related to injection drug use.”

This differs from the rest of Canada, where statistics show sexual contact is the source of most HIV diagnoses.

Roussin wouldn’t specifiy where the new HIV cases are located in the Swan Valley, saying he would let the communities speak for themselves.

A provincial spokesperson said other agencies are involved in PMHA’s response.

A request for comment from the federal government was referred to Indigenous Services Canada, which wouldn’t say in an email whether First Nation communities were part of the spike in cases, citing privacy concerns. 

Requests for a response from some First Nation leaders in Swan Valley weren’t returned.

Swan River Mayor Lance Jacobson said he knew cases of sexually transmitted and blood-borne illness in the region have grown in recent years, but he wasn’t aware of the new spike in HIV diagnoses. He doesn’t know whether any cases were reported in his town of 4,000 people.

However, Jacobson said, the increase, mostly connected to injection drug use, shows the province’s approach of distributing clean needles to increase safety isn’t working. More than 500,000 sharps were distributed in the town and neighbouring area over a recent one-year span, he said previously.

“I think that the province needs to take another look at this … and look at the money that’s being spent,” Jacobson said. “This is supposed to be a program that was put in place to help [reduce] the costs of health care.” 

Last year, town council passed a resolution calling for an end to the distribution of syringes, and for work on figuring out a cleanup.

Discarded sharps

Prairie Mountain Health responded by sending out teams to clean up sharps and encourage residents to call a hotline to report discarded needles.

Julie Lajoie, an assistant professor at the University of Manitoba who runs a lab studying infectious diseases including HIV, disagreed that harm-reduction approaches should be blamed in this case.

“If somebody takes drugs, they will take it with a clean or dirty needle. Offering a clean needle won’t increase the amount of people who are using drugs,” she said.

Safe needles are one part of the solution, she said, but so is distributing free condoms, making preventive drug PrEP available for those at higher risk, and enhancing mental health supports.

“We forget everything else that is needed to fix the HIV problem that we have in the Prairies,” she said.

The opening of supervised injection sites, which she also recommends, would have the effect of removing a needle after its first use.

Defending needle distribution

Roussin also defended handing out clean needles.

Harm reduction “also has that component of compassion and destigmatization,” he said. “That’s why it’s certainly part of our response.”

Once numbers are finalized, Roussin said, he expects the total number of new HIV diagnoses in 2024 to be similar to the 280 cases recorded in 2023.

Manitoba escaped another significant climb in diagnoses, he said, “but seeing the rate of transmission, seeing the change in the epidemiology with the injection drug use transmission, we certainly could be seeing increasing numbers in 2025.”

In 2023, the most recent year in available data, Manitoba tallied the second-highest infection rate in the country at 19.3 people per 100,000.