On-site supervised injection services improve access to HIV treatment and health care

published on March 13, 2014

New study finds supervised injection services at Dr. Peter Centre Residence engage patients in care,
improve overall health outcomes, and reduce drug-related harms

Vancouver, B.C. [March 13, 2014]: Supervised injection service integrated into the Dr. Peter Centre (DPC) Residence can improve health care access and outcomes among people living with HIV, according to a new study from the BC Centre for Excellence in HIV/AIDS (BC-CfE).

The DPC Residence is a 24-suite palliative and supportive care program offering 24-hour specialized nursing care within the DPC. Results published in the Journal of the International AIDS Society found that the integration of harm reduction approaches, including supervised injection service, into the DPC Residence led to improved access to palliative and supportive care services and increased adherence to HIV treatment, leading to gains in individual health and life expectancy. In addition, residents reported that these harm reduction approaches reduced drug-related harms, such as injection-related infections and overdose.

“Drug users encounter significant barriers to accessing in-patient health care services,” said Dr. Will Small, senior author of the study and researcher at the BC-CfE. “These findings demonstrate harm reduction approaches can not only reduce drug-related harms, but also improve access and adherence to life-saving treatment and care. We should explore introducing harm reduction approaches within other similar settings.”

The expansion of HIV testing and provision of highly active antiretroviral therapy (HAART) under the BC-CfE-pioneered Treatment as Prevention strategy has led to significant gains in life expectancy among people living with HIV. However, evidence has shown that injection drug users living with HIV often experience suboptimal HIV treatment adherence. While this population subsequently experiences a high burden of illness, they are often unable to access needed palliative and supportive care services due to anti-drug policies and stigma associated with drug use.

Investigators interviewed 13 DPC residents between November 2010 and August 2011 to assess the impact of the supervised injection service on access to and engagement in care. Study participants reported that this harm reduction approach created an environment where care is readily accessed, expressing that they were comfortable discussing their drug use and health needs with staff.

“The Dr. Peter Residence 24-hour specialized nursing care integrates a harm reduction approach that includes supervised injection service so that vulnerable individuals living with HIV, whose lives are severely impacted by addiction, mental illness, and unstable housing, have access to the care they desperately need,” said Maxine Davis, executive director of the Dr. Peter AIDS Foundation. “Significantly, this care is provided within an environment of acceptance and support—whether for a short stay, long term, or end of life care.”

“Supervised injection also helps these vulnerable people build a more open, trusting relationship with nursing staff which can increase the likelihood that clients will take advantage of counselling and addiction treatment,” said Dr. Patricia Daly, Vice-President of Public Health & Chief Medical Health Officer, Vancouver Coastal Health. “As many as 63 per cent of the Dr. Peter Centre’s supervised injection clients have received addiction counselling and one-third have been referred to withdrawal management or longer-term treatment programs.”

In February, the Dr. Peter AIDS Foundation and Vancouver Coastal Health submitted an application to Health Canada for an exemption from federal drug laws to allow the Dr. Peter Centre to continue providing supervised injection services for their clients admitted for care.

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About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians living with HIV.

About the University of British Columbia
The University of British Columbia (UBC) is one of North America’s largest public research and teaching institutions, and one of only two Canadian institutions consistently ranked among the world’s 40 best universities. Surrounded by the beauty of the Canadian West, it is a place that inspires bold, new ways of thinking that have helped make it a national leader in areas as diverse as community service learning, sustainability and research commercialization. UBC offers more than 55,000 students a range of innovative programs and attracts $550 million per year in research funding from government, non-profit organizations and industry through 7,000 grants.

About the Dr. Peter AIDS Foundation
The Dr. Peter AIDS Foundation operates the Dr. Peter Centre, which provides support to some of British Columbia’s most vulnerable citizens who face poverty, homelessness, and mental health and addiction issues, in addition to HIV/AIDS. The Centre uses an integrated model to engage individuals in their health care with a specific goal of improved adherence to HIV treatment and overall improved health.

Media contact:

Kevin Hollett
BC-CfE
Phone: 604-682-2344 ext. 66536
Mobile: 778-848-3420
Email: khollett@cfenet.ubc.ca

Kathryn Sutton
Dr. Peter AIDS Foundation
Phone: 604-608-1874 ext. 2304
Mobile: 604-723-7411
Email: ksutton@drpeter.org

BC Centre for Excellence in HIV/AIDS

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On-site supervised injection services improve access to HIV treatment and health care

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