International workshop highlights B.C.’s pioneering role in the fight against HIV/AIDS

B.C. leads in the implementation of Treatment as Prevention to significantly decrease death, disease progression, and new HIV diagnoses in the province

Hundreds of leading international HIV scientists from around the world congregated in Vancouver last month to hear the latest research on HIV prevention at the 2nd International HIV Treatment as Prevention Workshop.

HIV researchers and clinicians from Zimbabwe, Kenya, Europe, and Argentina rubbed elbows with representatives from international organizations including the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization (WHO), the International AIDS Society (IAS), President’s Emergency Plan For AIDS Relief (PEPFAR), and the National Institutes of Health (NIH) during the four-day workshop from April 22-25.

In his presentation, Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS (BC-CfE), told attendees that in British Columbia, progression to AIDS and death, as well as new HIV diagnoses, have decreased significantly as a result of the province’s innovative Treatment as Prevention strategy.

“The consistent decrease in AIDS-related morbidity and mortality, coupled with the consistent decrease in new HIV diagnoses in B.C., reinforces the effectiveness of Treatment as Prevention,” said Dr. Montaner, co-chair of the workshop.

He noted new province-wide HIV diagnoses fell again in 2011, to 289 from 301 in 2010, from approximately 900 cases per year in the early 1990s.

Treatment as Prevention involves widespread HIV testing and treatment to medically eligible people who are found to be HIV positive. In recognition of the overwhelming evidence that Treatment as Prevention works, the focus of the discussion at the BC-CfE-led workshop was not on the efficacy of the strategy, but rather on how to best put it into action.

“The United States government has embraced treatment as a powerful [and] essential tool in prevention and the achievement of an AIDS-free generation,” Ambassador Eric Goosby, United States Global AIDS Coordinator, told the audience in his keynote address. “Today, we are privileged to sit at the intersection where the worlds of science and implementation combine to produce significant public health impact.”

Workshop attendees debated the most cost-effective ways to implement Treatment as Prevention. However, they all agreed that, as the only province in Canada to implement the strategy and see a consistent decline in new HIV cases, B.C. provides a successful model for other Canadian cities and countries across the world.

“By developing ground-breaking policies such as Treatment as Prevention, B.C. is making significant inroads against HIV and AIDS and providing best practices to implement in Canada and the rest of the world,” said Elly Katabira, president of the IAS and co-chair of the workshop. “We look forward to the day when the battle against HIV and AIDS is finally won.”

In B.C., the Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) pilot project is based on BC-CfE’s HIV Treatment as Prevention strategy. In 2010, the B.C. government invested $48 million over four years in the BC-CfE-led STOP HIV/AIDS pilot to expand HIV testing and treatment in Vancouver’s inner city and Prince George.

Treatment as Prevention has been endorsed by U.S. President Barack Obama and Secretary of State Hillary Clinton as an effective strategy in the fight against HIV/AIDS. They have added their names to a growing list of supporters that includes UNAIDS, WHO, the Clinton Foundation, and the Stephen Lewis Foundation.