Abstract
Introduction: British Columbia has made significant progress in the treatment and prevention of HIV since 1996, when Highly Active Antiretroviral Therapy (HAART) became available. However, we currently lack a historical summary of HIV prevention and care interventions implemented in the province since the introduction of HAART and how they have shaped the HIV epidemic. Guided by a socio-ecological framework, we present a historical review of biomedical and health services, community and structural interventions implemented in British Columbia from 1996-2015 to prevent HIV transmission or otherwise enhance the cascade of HIV care. Methods: We constructed a historical timeline of HIV interventions implemented in BC between 1996 and 2015 by reviewing publicly available reports, guidelines and other documents from provincial health agencies, community organizations and AIDS service organizations, and by conducting searches of peer-reviewed literature through PubMed and Ovid MEDLINE. We collected further programmatic information by administering a data collection form to representatives from BC's regional health authorities and an umbrella agency representing 45 AIDS Service organizations. Using linked population-level health administrative data, we identified key phases of the HIV epidemic in British Columbia, as characterized by distinct changes in HIV incidence, HAART uptake and the provincial HIV response. Results and Discussion: In total, we identified 175 HIV prevention and care interventions implemented in BC from 1996 to 2015. We identify and describe four phases in BC's response to HIV/AIDS: the early HAART phase (1996-1999); the harm reduction and health service scale-up phase (2000-2005); the early Treatment as Prevention phase (2006-2009); and the STOP HIV/AIDS phase (2010-present). In doing so, we provide an overview of British Columbia's universal and centralized HIV treatment system and detail the role of community-based and provincial stakeholders in advancing innovative prevention and harm reduction approaches, as well as "seek, test, treat and retain" strategies. Conclusions: The review provides valuable insight into British Columbia's HIV response, highlights emerging priorities, and may inform future efforts to evaluate the causal impact of interventions.
| Original language | English |
|---|---|
| Article number | 1941 |
| Journal | Journal of the International AIDS Society |
| Volume | 20 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2017 |
| Externally published | Yes |
Bibliographical note
Funding Information:This study was supported by the British Columbia Ministry of Health (BCMoH), which funded the Seek and Treat for Optimal Prevention of HIV & AIDS pilot project, as well as funding from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH) [Grant numbers: DP1DA026182 and R01DA036307].
Funding Information:
Julio SG Montaner has received limited unrestricted funding, paid to his institution, from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, the MAC AIDS FUND, and ViiV Healthcare. P Richard Harrigan has received grants from, served as an ad hoc adviser to, or spoken at various events sponsored by Pfizer, Glaxo-SmithKline, Abbott, Merck, Tobira Therapeutics, Virco, and Quest Diagnostics and served as a consultant for ViiV Health Care, Tobira Therapeutics, Selah Genomics, and Quest Diagnostics, and holds stock in Merck and EKF Diagnostics. Rolando Barrios reports personal fees from Gilead Sciences, personal fees from MSD, outside the submitted work. Outside of the work, authors report grants from CIHR, the Michael Smith Foundation, US National Institutes of Health, National Institute on Drug Abuse, and the British Columbia Ministry of Health. All other authors declare no competing interests.
Publisher Copyright:
© 2017 Olding M et al; licensee International AIDS Society.
ASJC Scopus Subject Areas
- Public Health, Environmental and Occupational Health
- Infectious Diseases
