New HIV cases drop among those who use injection drugs

News Release – Ministry of Health, Office of the Provincial Health Officer

VICTORIA – New cases of HIV among people who use drugs by injection (IDU) in B.C. continue to decline. According to a new report released today by the provincial health officer, it is crucial that harm reduction measures are sustained and expanded for this decline to continue.

According to the report, entitled Decreasing HIV Infections Among People Who Use Drugs by Injection in BC, there are a number of factors that might contribute to the decrease in new HIV cases seen among injection drug users. The uptake and expansion of Highly Active Anti-retroviral Therapy (HAART) – the current gold standard in HIV treatment –likely has been a major factor in reducing the number of HIV incidences in this population.

HAART has the ability to change the way people live with HIV by improving their quality of life and reducing transmission rates. Participation in harm reduction programs has been associated with a decrease risk for HIV and Hepatitis C Virus (HCV). Transmission of this disease has also likely been affected by changes in drug use (type of drugs and routes used) or changes in the population.

 

The launch in February 2010 of the Seek and Treat to Optimally Prevent HIV/AIDS (STOP AIDS) pilot program, with $48 million in provincial funding over four years, aims to better connect at-risk populations in Prince George and inner-city Vancouver with appropriate testing and treatment services. The pilot program is supported by government and led by Dr. Julio Montaner and his team at the BC Centre for Excellence in HIV/AIDS.

The latest research from the BC Centre for Excellence shows that the number of people living with HIV in B.C., who were receiving HAART, increased by 547 per cent from 1996 to 2009. During that same time period, new HIV diagnoses fell by 52 per cent.

The made-in-B.C. approach has most recently been adopted by China to implement a countrywide HIV prevention and treatment program, which utilizes HAART.

Current efforts to prevent the spread of HIV among people who inject drugs need to be sustained and expanded. The report makes several recommendations, including the expansion of HAART and further support for the STOP AIDS project, the expansion of point-of-care testing programs for HIV and HCV and exploring new approaches to get more people tested. Also, continuing to expand harm reduction services and programs, especially in correctional facilities and to IDU, is needed.

Other recommendations include supporting programs and projects that address determinants of health, the improvement of data and monitoring systems and fair access to services.

Quotes:

Dr. Perry Kendall, provincial health officer, British Columbia:

“The recent decline in new HIV cases is encouraging, especially since a significant decrease has been seen amongst vulnerable populations like those who use injectable drugs. This decrease is more proof that Highly Active Anti-retroviral Therapy and other harm reduction services are working and should be expanded.”

Dr. Julio Montaner, director, BC Centre for Excellence in HIV/AIDS:

“HAART has been tremendously successful, extending the lives of thousands of British Columbians. More recently, our research has shown that the expansion of the HAART program has been a major factor in reducing HIV incidence in the province, particularly among those who use drugs by injection. As a result, several jurisdictions, including San Francisco, New York, Washington DC, in the USA and China are moving forward to embrace the use of HIV treatment and prevention as pioneered by the BC-CfE.”

Quick Facts:

  • This report summarizes findings and recommendations of a 2009 expert working group, which reviewed HIV numbers in IDU.
  • Their research concluded that in 2000, there were 137 new cases of HIV in the IDU population. In 2009, this number dropped to 64.
  • The number of new positive HIV tests in 2008-09 appears to be at a lower level than prior to 2008.
  • The decrease of new positive HIV tests was found in all ethnic groups and in both males and females around the province in all health authorities. Those between the ages of 20-39 saw the most apparent decrease.
  • Data on Hepatitis C (HCV) infections provides a good indicator for potential risk of HIV transmission among IDU.
  • More people are being tested for HCV in British Columbia. In 1998, 64,000 individuals were tested. In 2009, the number of people tested for HCV rose to over 120,000.
  • While the number of people getting tested for HCV has increased, the number of new reported cases is down from 4,353 in 2000 to 2,444 in 2009.

Learn More:

The report can be viewed online at: http://www.health.gov.bc.ca/library/publications/year/2011/decreasing-HIV-in-IDU-population.pdf