By educating healthcare providers, policymakers, and key influencers, the BC-CfE promotes evidence-based policy that can potentially lead to the elimination of HIV and AIDS, as well as other communicable diseases. In no particular order, the following top 5 findings show how BC-CfE researchers contribute to that work.
The decriminalization of sex work could avert 33-46% of HIV infections over the next decade. A BC-CfE study in the Lancet, demonstrated that decriminalization of sex work, as practiced in New Zealand and parts of Australia, could reduce the spread of HIV. Research from the Gender and Sexual Health Initiative (GSHI) at the BC-CfE has consistently shown criminalizing any aspect of sex work – including sex workers, clients and third parties – elevates stigma, harassment, violence and risks for HIV infection.
Supervised injection services, or harm reduction services, can improve health care outcomes. According to a BC-CfE-led study at the Dr. Peter Centre, supervised injection service integrated into the Dr. Peter Centre Residence in Vancouver can improve health care access and outcomes among people living with HIV. In February of 2014, the Dr. Peter AIDS Foundation and Vancouver Coastal Health applied for an exemption from federal drug laws to allow the Dr. Peter Centre to continue providing supervised injection services for its clients.
Criminalization of HIV non-disclosure not supported by evidence. Dr. Julio Montaner, director of the BC-CfE, was among six Canadian medical experts to sign on to a trailblazing statement affirming that sex with a condom or in the presence of a suppressed plasma viral load while on antiretroviral therapy poses a negligible possibility of HIV transmission. The letter was in response to an increasing number of criminal cases of HIV non-disclosure in Canada in the past decade. At present, Canadian law requires both a condom and a suppressed plasma viral load while on antiretroviral therapy to reduce the risk of transmission to a sexual partner, despite evidence showing both together to be unnecessary. Research has consistently shown that criminalization of non-disclosure is not a productive means of curbing the spread of HIV, and can actually hinder prevention efforts.
Among street-involved youth, women are twice as likely to be infected with hepatitis C. These findings are from a survey of the At-Risk Youth Study (ARYS) cohort, 940 street-involved youth recruited from September 2005 to November 2011. Previous BC-CfE research, also based on the ARYS cohort, found generally higher rates of HCV among street-involved youth measured at up to 11 per cent. HCV infection is a leading cause of illness and death worldwide. On a national scale in Canada, men have higher rates of hepatitis C diagnosis than women.
Risk of overdose among people injecting drugs at Insite, was over two times more likely on or immediately after “cheque day.” Researchers at the Urban Health Research Initiative (UHRI) at the BC-CfE observed significantly increased risk of overdose among people injecting drugs at Vancouver Coastal’s supervised injection facility. (It should be noted that no overdose deaths have been recorded at Insite since the facility’s opening in 2003.) Based on these findings, a pilot project was designed for Vancouver’s Downtown Eastside to try distributing welfare and other social assistance cheques in smaller instalments over time.