In late April the Canadian Association for HIV Research (CAHR) held its annual conference. With more than 1,000 members, CAHR is the leading organization of HIV/AIDS researchers in Canada.
The theme for this year’s virtual conference was “Striving Towards Equity and Flourishing in the HIV Response”. In choosing the theme, organizers of the conference compared the decades-long fight for equitable distribution of antiretroviral therapy (ART) to the distribution of COVID-19 vaccines, and the massive disparities seen between high and low-income countries in both.
CAHR organizers emphasized how the work to address social and health disparities in HIV care within Canada, and around the world, must continue. BC-CfE researchers also highlighted this need, and their research showcased how ensuring equity, awareness of the social determinants of health, and adhering to the principles of human rights got us to where we are today – with 27.5 million able to access ART in 2020 and a 50 percent reduction in new HIV infections globally since 1997.
Here are some of the notable CAHR presentations by BC-CfE researchers:
Improvements in ART Initiation Over Time After Diagnosis Among Indigenous People Living with HIV (PLWH) in British Columbia, Canada
BC-CfE Research Coordinator Nicole Dawydiuk presented data from the STOP HIV/AIDS¨ Program Evaluation (SHAPE) Study on antiretroviral therapy (ART) initiation among Indigenous PLWH in BC. The study notes access disparities and disproportionate rates of HIV among Indigenous Peoples, along with delayed initiation and uptake of ART, and how these inequities can be contextualized in the historical and ongoing impacts of colonization, marginalization, and dispossession in Canada.
The BC-CfE’s Treatment as Prevention¨ strategy (TasP¨) relies on early identification and early treatment of HIV, and is a key factor behind the success our province has seen in reducing HIV case rates. By adhering to TasP¨, and by working to reduce the widespread and systemic racism against Indigenous people within BC’s health-care system, there has been significant improvements seen in ART initiation among IPLWH in BC. Dawydiuk ended her CAHR presentation by mentioning an upcoming BC-CfE study which will hold sharing circles to better characterize the unique barriers and facilitators to HIV care engagement among key populations and Indigenous Peoples.
Trends in Illicit Drug Use Among Patients Recently Treated for Hepatitis C in British Columbia, Canada
BC-CfE Research Coordinator Lauren Harrison presented on data from the Per-SVR (preservation of sustained virologic response) study and how trends of illicit drug use affect those treated for hepatitis C (HCV). The data trends show illicit drug use, particularly fentanyl, increased among study participants during the COVID-19 pandemic, which illustrates a need to further tailor harm reduction services.
Understanding and responding to trends in drug use is necessary to meet the needs of under-served clients who may be uniquely impacted by both the overdose crisis and infectious diseases, such as HIV and HCV.
Investigation of genetic integrity and longevity among HIV proviruses persisting during long-term ART
BC-CfE Research Scientist and PhD student Natalie Kinloch spoke at CAHR 2022 on genetic integrity and longevity of HIV proviruses in long-term ART. The research she presented found the majority of proviruses that persist in the HIV viral reservoir were archived closer to ART initiation.
This work shows the persistent viral reservoir of each individual is unique and diverse and how the search for an HIV cure needs to account for this finding.
Humoral responses to one, two and three COVID-19 vaccine doses in people living with HIV receiving suppressive antiretroviral therapy (ART): a longitudinal study
Dr. Hope LaPointe, a BC-CfE Research Coordinator, presented the collaborative work of the BC-CfE Laboratory on COVID-19 vaccine response. The work, done in partnership with SFU, Providence Health Care, AIDS Vancouver, Genome BC, Michael Smith Health Research BC, the BCCDC, and the COVID Immunity Task Force, found strong humoral immune response to second and third COVID-19 immunizations among PLWH on ART with a healthy CD4 count.
The results underscore the immune benefits of third COVID-19 doses in light of Omicron waves.
Wise Women Journeys: Streams of Knowledge and Rivers of Change, Tides of the Coast Salish Sea Bringing our Indigenous Healthcare Teachings
BC-CfE Peer Indigenous Research Associate Valerie Nicholson and Research Coordinator Niloufar Aran presented at CAHR on Indigenizing HIV Research.
The two presented on the importance for care providers to take time to learn about colonization and intergenerational trauma, and to respect/support the inclusion of traditional ways of knowing/healing in someone’s healthcare journey.
Access To Care And Impacts On HIV Treatment Interruptions During The COVID-19 Pandemic Among People Living With HIV In British Columbia, Canada
Dr. David M. Moore is a Public Health Physician and Research Scientist at the BC-CfE.
At CAHR, he presented research from the SHAPE Study on the impact of COVID-19 on access to HIV care and treatment interruption. The SHAPE research found treatment interruptions weren’t more likely during COVID than before the pandemic, and many SHAPE participants reported accessing virtual health services.
Examining the impacts of the COVID-19 pandemic on syndemic conditions and related effects on PrEP use among gay, bisexual and other men who have sex with men in Vancouver, Canada.
Momentum is a sexual health study for men in the Greater Vancouver Area. Dr. Jordan Sang presented at CAHR on Pre-Exposure Prophylaxis (PrEP) use by participants in the Momentum Study during the COVID-19 pandemic. Survey participants had increased PrEP interruptions, partially due to COVID-19 in BC. However, encouraging data shared in the CAHR presentation indicated that those at most risk of HIV were less likely to interrupt treatment.
Increasing trends of depressive symptoms, which were associated with greater odds of PrEP interruption, suggest a need for additional mental health services and targeted follow-up. However, Momentum data trends show decreasing use of alcohol, polysubstance use, and levels of intimate partner violence.