The Queensland HIV Treatment as Prevention (TasP) Roadshow took place over the last week of July and first week of August 2016.
The Roadshow, supported by the Queensland Aboriginal and Islander Health Council (QAIHC) and the HIV Foundation Queensland, engaged with health professionals working in Aboriginal and Torres Strait Islander and mainstream services across north – eastern Queensland.
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JF: Tell me about the Roadshow
ID: The Roadshow is travelling throughout north – east Queensland talking about our concept of Treatment as Prevention (TasP) which was introduced by the British Columbia (BC) Centre for Excellence in HIV and AIDS in 2006. We’ve had a great deal of success with it in BC, in terms of driving down the rates of new cases of HIV. We’ve virtually eliminated AIDS, which is, of course different than HIV.
JF: Is this both in the Aboriginal and mainstream populations?
ID: Both, but let me be clear we have not done as good a job in getting our Indigenous populations into care and treatment so that’s an area we are committed to working on more diligently. The good thing is that our provincial and federal government is very supportive and have made a commitment to working with the Indigenous population on HIV. The virus is an issue not just in British Columbia but there is a significant increase in HIV in our Indigenous population in our prairie provinces, particularly Saskatchewan, as well so we definitely have more work to do there.
JF: Break down Treatment as Prevention for me
So TasP means reaching out, engaging individuals (those who have been diagnosed and those who are at risk of contracting the condition) earlier into care and treatment. The key is getting people into testing, treatment and management early. Sustained treatment, that’s absolutely critical. If you’re not being treated, the virus will replicate, your viral load will go up, your immune system will drop and you’ll become ill. Also, when you put good treatment in place you’re making spread of virus less likely.
The Treatment of Prevention strategy was introduced by us in 2006 and has been adopted in other countries including by the Queensland Government who signed an MOU with us in 2014.
We still have more work to do though, as BC is the only Canadian province that has adopted this Strategy.
JF: Good treatments are available now – are they considered affordable?
RB: Currently the lifetime cost of treating someone with HIV ranges from US $250,000 to US $500,000 (2006 figures).
Our Treatment as Prevention Strategy we have reduced new HIV cases in BC from 700 per year to less than 300 – which has provided savings of around $50 m per year. We have also managed to nearly eliminate AIDS and there’s an important distinctions between AIDS and HIV – AIDS is the result of being infected with HIV for many years without treatment while HIV is an infection we can now treat and control the virus and prevent it from becoming AIDS.
In addition, people with AIDS can also be treated and become healthy and contribute to society like anyone else.
Our Government has made the investment because, as our Director says, you make a decision now and pay it off or you mortgage your province and pay it off over many years. If we don’t do anything the infections will continue.
JF: What are your key messages for Aboriginal and Torres Strait Islander populations when it comes to prevention, testing, treatment?
RB: It’s no different than other parts of the world including BC, we experience the same issues in terms of marginalisation, low education, low income, drug use, mental health issues and so on. The key element, the message that we are giving to people is know your HIV status.
We know that when people know their HIV status they will immediately change their behaviour and there are studies in the US that show that 58 per cent of people who have been diagnosed immediately change their behaviour to lower risk behaviour.
Also, most people care about others so if you know that you are infected with HIV or you become aware you are HIV positive, you are going to try and prevent the transmission of the virus towards your loved ones.