Seek And Treat For Optimal Prevention Of HIV/AIDS® (STOP HIV/AIDS® )
Seek And Treat For Optimal Prevention Of HIV/AIDS® (STOP HIV/AIDS® ), a program conceptualized by the BC-CfE, aims to expand access to HIV testing, care and treatment for all BC residents, particularly for vulnerable populations experiencing difficulties in accessing traditional services. STOP HIV/AIDS® began as a pilot project to expand HIV testing, treatment, and support services to medically eligible individuals in British Columbia. Hon. Kevin Falcon, former Minister of Health Services, announced the program on February 4, 2010. The initial four-year pilot phase was supported by a $48-million funding commitment by the Government of British Columbia to Vancouver Coastal Health, Northern Health, the Provincial Health Services Authority, Providence Health Care, and the BC Centre for Excellence in HIV/AIDS. As of April 1, 2013, STOP HIV/AIDS® was expanded to include all British Columbians. Expansion was carried out by the province’s health authorities with support and leadership from the BC-CfE, which pioneered the concept of Treatment as Prevention®. The BC-CfE continues to monitor and evaluate the progress of the program. Through health authorities across BC, the STOP® program involves collaboration among nurses, health care professionals, social workers and others in order to provide for the broad spectrum of needs of their clients living with HIV. In 2012, based on the success of STOP pilot programs initially launched in Prince George and Vancouver, the BC provincial government announced $19.9 million in funding towards STOP®’s expansion to all provincial health authorities. Members of STOP® outreach teams across the province serve vulnerable populations, many of whom have suffered trauma and lack trust in traditional health care systems. Many clients are simultaneously facing addiction and homelessness problems, while dealing with access to HIV treatment and care. Outreach Nurses with the different STOP® programs work with several clients at time.
Why STOP?
The BC-CfE has found a compelling body of research from around the world that, taken together, shows that expanded HAART access could play an important role in reducing the transmission of HIV in a regional population and at the same time reduce HIV/AIDS-related morbidity and mortality. This hypothetical construct motivated the BC-CfE to redevelop its research agenda under the theme of “Expanding HAART to Curb the Growth of the HIV Epidemic”. While continuing to promote traditional HIV prevention strategies, the BC-CfE proposes to expand HAART access to decrease HIV/AIDS-related mortality in BC, and, secondarily, to evaluate the impact of such expansion on the number of new infections (HIV incidence) in BC over 5 years. The latter will be evaluated as part of an internationally innovative research program to Seek And Treat For Optimal Prevention Of HIV/AIDS® (STOP HIV/AIDS® ), which has now received a US$ 2.5 million Avant Garde Award from the US National Institute of Drug Abuse of the National Institutes of Health. In order to facilitate this evolution of the STOP HIV/AIDS® initiative, the BC-CfE, with the support of the provincial government, has initiated a concerted effort to increase HAART coverage among those in medical need based on the most recent (2008) guidelines within BC, with the special emphasis on engaging hard-to-reach individuals in Vancouver’s DTES and the Northern Health Authority. The Vancouver Coastal Health Authority developed a plan in which the number of HAART-eligible HIV positive individuals taking treatment would be increased by 50%. This approach was endorsed following a process of broad consultations with stakeholders, including community groups, physicians, health officials, social service agencies and addiction specialists. The implementation of the STOP HIV/AIDS® Research Program requires close collaboration between governmental, community and academic partners in areas such as HIV testing, physician education, drug delivery, counseling and outcomes assessment.
Seek and Treat
The Seek and Treat pilot program is an initiative of the STOP HIV/AIDS® Program (Seek And Treat For Optimal Prevention Of HIV/AIDS® ). Conceived at the B.C. Centre for Excellence in HIV/AIDS, Seek and Treat will expand access to HIV/AIDS medications among hard-to-reach and vulnerable populations in Vancouver’s Downtown East Side and Prince George.
On February 4, 2010, the B.C. provincial government committed $48 million to this four-year project, implemented by Northern Health, Vancouver Coastal Health, and Providence Health Care with support from the Provincial Health Services Authority. By providing life saving highly active antiretroviral therapy (HAART) to more medically eligible individuals living with HIV, the virus’ ability spread will be significantly reduced.
For British Columbians who know they have HIV/AIDS and are connected to the health-care system, accessing HAART is relatively straightforward and can have extremely positive outcomes. However, there is a large segment of the at-risk population who are not connected to the health system, and Seek and Treat aims to go out, diagnose, support and provide treatment to these individuals.
Mathematical modeling suggested that implementing the pilot project in the Downtown East Side and Prince George could avert as many as 173 HIV infections in the first five years, which represents approximately $65 million in avoided lifetime HIV treatment costs.
Aims
All of the Aims for the STOP HIV/AIDS® Research Program represent a natural extension of work already being done by the BC-CfE.
Primary Aims
- Aim 1: To enhance HIV case finding in BC
- Aim 2: To increase the number of HIV-positive people accessing care
- Aim 3: To increase the number of HIV-positive people on HAART, consistent with the 2008 Therapeutic Guidelines
- Aim 4: To monitor HIV/AIDS related morbidity and mortality and HIV incidence in BC
Secondary Aims
- Aim 5: To monitor drug adherence, resistance, and adverse events
- Aim 6: To expand health care capacity to support HAART
- Aim 7: To monitor population impact, resource utilization and cost-effectiveness associated with expansion of HAART access
- Aim 8: To model the potential impacts of further HAART expansion in BC