BC-CfE research finds HIV cases were averted through the implementation of Treatment as Prevention¨, needle distribution programs and opioid agonist therapy.
VANCOUVER, March 31, 2017 /CNW/ – A study by the BC Centre for Excellence in HIV/AIDS (BC-CfE), published in the top-ranking medical journal The Lancet HIV, has found harm reduction and access to HIV antiretroviral therapy (ART) averted an estimated 3,204 incident HIV cases in British Columbia between 1996 and 2013. Both evidence-based public health interventions had significant, independent effects on the spread of HIV and the control of the epidemic.
To identify the relative impact of ART and harm reduction, which have both been scaled up in BC since 1996, the authors modeled multiple hypothetical scenarios. Assuming harm reduction services were not scaled up beyond 1996 levels, ART alone is estimated to account for 44% (1,409) of the averted HIV cases across the province. The impact of universal access to ART is likely underestimated, as the study only considered its impact on transmission through needle sharing with its efficacy in reducing HIV transmission set conservatively at 50%.
Assuming ART had no effect at all on HIV transmission through needle sharing, harm reduction services alone-defined in this study as needle distribution and opioid agonist therapy (OAT)-are estimated to account for 77% (2,473) of the averted HIV cases.
“Both harm reduction and access to HIV treatment are keys to curbing the transmission of HIV,” said Dr. Bohdan Nosyk, Research Scientist with the BC-CfE and an author on the paper. “As a treatment for addiction, opioid agonist therapy provides benefits in terms of reduction in disease transmission and improvement in quality of life. Our research has linked the treatment to increases in workplace productivity and decreases in crime costs-making a further economic case for its implementation as part of a harm reduction effort.”
Access to harm reduction and ART also significantly increases an individual’s quality of life years (QALY). OAT, a first-line treatment for opioid addiction that reduces cravings and withdrawal associated with opioid addiction, is linked to substantially greater QALY gains than needle distribution programs.