Treating Social Determinants Of Health Can Help End HIV/AIDS

published on October 4, 2016 by Dr. Julio Montaner, in The Huffington Post

Picture this scenario: An individual living with HIV in British Columbia, "Doug" (whose name has been changed for privacy), was being "shuffled around" through care. As a result, he had grown tired and had mostly given up on treating his HIV. Sadly, he had begun telling family and friends that he wouldn't be around much longer. Can you see a solution to a situation like this?

There was an answer for Doug. An outreach worker, with the province of B.C.'s STOP® Program (Seek and Treat for Optimal Prevention of HIV/AIDS), knocked on his door and started to connect him to services to help support his medical adherence.

Doug needed to have a regular health care provider, and the outreach worker set him up with one. Beyond that, he needed the supports to help him stay consistent with care. He was placed in supportive housing, as well as in an integrative care program where he could develop his interests in music. Eventually, Doug (an electrician by trade who plays and builds musical instruments) became healthy, fully adherent to HIV medications and achieved an undetectable viral load.

Stories like Doug's are very personal and individual victories; however, they show the changes that can take place when addressing systemic social and economic barriers. B.C.'s STOP® Program, based on principles of the Treatment as Prevention® (TasP) strategy developed at the B.C. Centre for Excellence in HIV/AIDS (BC-CfE), acknowledges the importance of addressing social and economic inequities -- termed social determinants of health. The STOP® Program aims to expand and offer access to HIV testing, care and treatment for medically eligible B.C. residents, particularly for populations experiencing difficulties in accessing traditional services.

The concept behind STOP® is to immediately offer universal HIV treatment to those diagnosed with the disease. This TasP® approach has led to improved health outcomes and to a consistent drop in new HIV cases in B.C.. Once on sustained and consistent treatment, an individual's viral load declines making it highly unlikely they will transmit the virus. B.C. is the only province to implement TasP® and the only one to see a consistent drop in new HIV cases. Globally, the United Nations has adopted a plan to end AIDS by 2030 that is based on principles of TasP®. Organizations like the Global Fund are on board with this plan to #EndItForGood and make the next generation AIDS-free.

In B.C., through TasP® and STOP® we have seen successes like Doug's. We have seen people living with HIV who use injection drugs, a population some doubted could maintain consistent treatment, achieve improved health and see significant reductions in HIV transmission. (In B.C., through consistent access to HIV treatment, the number of people who inject drugs who achieved an undetectable viral load increased from 30 per cent in 2006 to 71 per cent in 2012.)

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Treatment as Prevention®

Julio Montaner

BC Centre for Excellence in HIV/AIDS

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Treating Social Determinants Of Health Can Help End HIV/AIDS

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