CTN 244: STOP HIV & AIDS in IDU

About The Study

This study expanded antiretroviral therapy (ART) coverage among injection drug users (IDUs) in the Downtown East Side of Vancouver, BC. From 2010 to 2016, researchers studied if expanded ART among IDUs led to a reduction in the number of new HIV infections and a decrease in adverse HIV/AIDS health outcomes among the target population.

The study enrolled adults living with HIV who inject drugs who are medically eligible for ART (based on current guidelines), but are not accessing therapy or are unaware of their HIV infection status.

Background

We know that ART can directly prevent HIV transmission by rendering the virus undetectable and significantly decreasing the risk of transmission. This was a novel approach to reducing new HIV infections when this study was launched. Knowledge gained from this study assisted in the development of a public health policy for the expansion of ART, as well as to enhance the effectiveness of traditional prevention efforts aimed to reduce HIV incidence.

Results

As hypothesized, expansion of ART resulted in substantial improvements in the proportions of people diagnosed, on ART, and virologically suppressed. Changes in the types of ART available resulted in a decrease in drug interactions and non-recommended drug combinations. People in this cohort were frequently co-prescribed opioids and benzodiazepines. This research provides valuable information, both locally and in other jurisdictions, about the benefits of expanding ART access, the complex medical needs of some people living with HIV, and the cascade of care.