On Wednesday, October 22, the HIV Continuum of Care Collaborative met in Richmond to share triumphs and challenges encountered along the shared pathway towards an HIV and AIDS-free generation in British Columbia. The Collaborative is part of the BC-CfE’s Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) initiative and comes under the umbrella of the innovative Treatment as Prevention (TasP) strategy. It was initially launched as a pilot in 2009 and has since been expanded. The Collaborative aims to apply HIV evidence and experience-based interventions in communities in need across BC.
The meeting in Richmond opened with a look at the ways TasP is obtaining a global reach. Dr. Julio Montaner, Director of the BC-CfE joined the event by video to speak about the exciting news of the UNAIDS using the made-in-BC strategy of TasP as the backbone of their 90-90-90 initiative. Dr. Montaner highlighted UNAIDS’ 90-90-90 solution by 2020 to ensure 90 per cent all people living with HIV will know their HIV status; 90 per cent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90 per cent of all people receiving HIV antiretroviral therapy will have viral suppression. When the three-part strategy is achieved, at least 73 per cent of all people living with HIV worldwide will be virally suppressed. Achieving these targets by 2020 will enable the world to end the AIDS epidemic by 2030.
Dr. Rolando Barrios, Collaborative Medical Director and Assistant Director of the BC-CfE, opened up the discussion by sharing specific examples of how Collaborative participants are working to meet and exceed these goals here in BC. The 90-90-90 solution will be broadly discussed at the November 24th ARV update and the International AIDS Society Conference to be held in Vancouver in July 2015.
In keeping with the “all teach, all learn” philosophy, the meeting provided an opportunity to build further on solutions to close gaps across the HIV continuum of care. Through learning and networking sessions, storyboards and panel discussions, the Collaborative members shared lessons learned and strategies for continued quality improvement. Common challenges addressed included: reaching diverse populations across urban and rural settings; providing continuous and comprehensive care across care transitions; addressing the medical needs of incarcerated populations; and forming lasting and effective partnerships. Panelist Glen Bradford, Manager of Peer Navigation and Prison Outreach with Positive Living Society of BC, highlighted the need to honestly engage with peer navigators to ensure inclusion – and better connect patients to the right care.
A high note of the event was the chance to celebrate key innovations and stories of progress. Positive Wellness North Island, for example, was chosen by Collaborative Planning Group members for successfully re-engaging people previously lost to care, seeing a 20 per cent increase in patient engagement. In a tie with the Fraser Health ST/BBI Regional Team, the St. Paul’s Hospital Pharmacy team was also awarded in the category “Retention, Adherence, and Suppression.” The team successfully shifted resources to provide clinical services for remote patients who received little or no pharmacy support, while at the same time implementing a more convenient antiretroviral refill system for more stable patients. Another success story celebrated was the BC Centre for Disease Control’s (BC CDC) rapid referral pathway, connecting patients to HIV specialist care and support within 48 hours of an acute HIV diagnosis at the BC CDC clinic.
At close of the daylong meeting, members were encouraged to continue to build on the momentum, look for “bright spots” and replicate success, test before implementing, spread best practices, and connect with members of the Collaborative.
The next collaborative meeting will take place in January or February 2015. Confirmed dates will be shared through the STOP HIV/AIDS Listserv¨ and mailing list.