New research shows that HIV treatment for illicit drug users improves their social and socioeconomic wellbeing as well as their health.
While the health benefits of antiretroviral therapy (ART) for HIV are well documented, less is known about possible secondary benefits.
Lindsey Richardson, an assistant professor in the Department of Sociology at the University of British Columbia and research scientist with the BC Centre for Excellence in HIV/AIDS (BC-CfE), presented findings from two studies July 22 at the International AIDS Society (IAS) Conference in Vancouver. IAS 2015 is the world's largest scientific conference on HIV and AIDS and is organized this year by the IAS in partnership with the UBC Division of AIDS.
In the first study, people starting HIV treatment for the first time were more likely to transition out of homelessness, start addiction treatment, and begin a romantic relationship. A second study found that adherence to ART - meaning an individual is dispensed their HIV medication at least 95 per cent of the time - increases the probability they will transition out of homelessness and end involvement in activities like sex work, drug dealing or street-based income generation.
"These studies find HIV treatment and care may be able to help reduce inequities by promoting improved health, socio-economic stability and improved quality of life," said Richardson. "This research points to how HIV care and treatment can open doors to improvements in other areas relevant to people's social determinants of health. Both studies reinforce the benefits of early ART initiation and consistent ART treatment, particularly for marginalized and hard-to-reach individuals."
The findings point to additional benefits of HIV treatment that could be further enhanced by housing support, income support and other services. Both studies used data from the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS), an ongoing study of approximately 1,000 individuals living with HIV and AIDS in Vancouver who use illicit drugs. The ACCESS study is funded by the U.S. National Institutes of Health (NIH).
"Treatment as Prevention® (TasP) - providing full and early access to antiretrovirals to those living with HIV - provides a path to ending AIDS in our lifetime that is founded on firm scientific evidence," said Dr. Julio Montaner, director of the BC-CfE and a professor of Medicine at UBC. "Dr. Richardson's groundbreaking research indicates TasP®'s open and accessible approach to health care can have significant social and economic implications."
Treatment as Prevention®
Treatment as Prevention® (TasP®) - pioneered by Director of the BC-CfE Dr. Julio Montaner and first introduced at the 2006 IAS Conference - consists of widespread HIV testing and the immediate and full offer of highly active antiretroviral therapy (HAART) to those who test positive and those who are medically eligible. TasP® has been proven to greatly improve a patient's quality of life and extend longevity by decades, while significantly reducing the likelihood of transmission. British Columbia is the only province to implement TasP® and the only one to see a consistent decline in new HIV cases. Within BC, the implementation of TasP® with support from the provincial government has resulted in significant declines in HIV transmission among injection drug users. In addition, TasP® has led to an 88 per cent decline in new AIDS cases and a 65 per cent drop in new HIV cases since 1994.
About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada's largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul's Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including government, health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians.