Background on STOP HIV/AIDS
The funding for the STOP HIV/AIDS pilot projects ($48 million over four years) represents the first new HIV/AIDS funding in the province of BC in over 13 years. Dr. Julio Montaner and his colleagues at the BC Centre for Excellence have galvanized tremendous support and political will for this approach to addressing the epidemic in the province, and globally there is tremendous interest as well. In terms of the roll out of the pilot projects in Prince George and Vancouver’s inner city, there is promise that the initiatives will make a difference for people living with HIV/AIDS by promoting testing and access to treatment.
At the same time, PAN maintains that expanded HAART and bio-medical approaches are not enough. In the words of Dr. Montaner himself, expanded HAART must take place “as part of a comprehensive care and support package” (Keynote address "Treatment as Prevention", Opening Plenary, Pacific AIDS Network Conference, February 25th, 2008). This is consistent with extensive research that demonstrates that biomedical approaches and interventions delivered by health professionals, absent a community base, are less successful. HIV/AIDS needs to be addressed in a comprehensive, coordinated and holistic fashion, with a view to broader socio-economic, health and cultural issues.
PAN member organizations, both within and outside of the pilot project areas, want to contribute to the success of the STOP initiative and the goal of promoting access to treatment. Since the HIV/AIDS epidemic first began, in response to emerging and urgent needs, PAN member organizations have provided services and programs that have been flexible, timely, innovative and creative, often with minimal financial resources. PAN members have also brought the lived experiences of persons living with HIV/AIDS (PHAs) and those most at risk “to the table”, calling attention to the prevention, care, treatment and support needs of some of the most marginalized people in our society. There is much we can bring to the table but successful collaboration requires meaningful engagement.
PAN’s Ongoing Work with regard to STOP HIV/AIDS
At PAN’s Fall 2010 conference, delegates to both the PHA Forum, as well as the Executive Director Summit, identified the STOP inititiative as the first priority for the network to be involved with. Delegates charged the PAN Board and staff to work to communicate the current concerns that presently exist regarding STOP to the various stakeholders (the health authorities, the BCCfE, Providence Health and the Ministry of Health Services). There was also a recognition that many of some of these concerns stemmed from a lack of information about the initiative. Optimistically, there was also a desire for PAN to work to create opportunities for authentic feedback and engagement from community organizations to these stakeholders in order to advance the laudable goals of STOP HIV/AIDS.
PAN Board and staff work to find opportunities:
- to respectfully communicate concerns of our member organizations and allies with regards to the STOP initiative to key stakeholders and decision-makers,
- to foster collaboration with public health within the ambit of the STOP pilot projects and beyond,
- to underscore the ongoing commitment, successes and challenges of the community-based response in advancing the health and wellness of PHAs and those most at risk.
Some opportunities realized to date include:
Since June 2010 PAN’s Executive Director Jennifer Evin Jones ([email protected]) has sat on the Provincial Health Services Authority’s STOP HIV/AIDS Planning Committee, and her community colleagues on that committee also include Winston Thompson and Sandy Lambert from Renewing Our Response. For more information on the PHSA Planning Committee, please click here.
PAN Program Coordinator Heidi Standeven ([email protected]) joined the STOP HIV/AIDS Testing Strategies Subcommittee in October 2010. For more information on the Testing Strategies Subcommittee, please click here.
PAN’s Executive Director Jennifer Evin Jones, along with Darren Lauscher (mailto:[email protected]), Vice-Chair of the PAN Board of Directors, joined the STOP HIV/AIDS Community Engagement Working Group (CEWG) in November 2010. The CEWG reports to the STOP-HIV Leadership Committee. The CEWG will advocate for community ideas and concerns to be included in the planning and decision-making processes, so that services take into account the diverse values and needs of the communities we serve. For more information on the CEWG, please click here.
Darren Lauscher is also an active participant and contributor to the STOP HIV/AIDS Structured Learning Collaborative. The intention of the collaborative is to engage physician teams from across the health authorities in improved health care delivery for people living with HIV/AIDS in three key areas: retention in HIV care; strengthening care partnerships (including with community based organizations; and improved HIV care. For more information on the Structured Learning Collaborative, please click here.
About STOP HIV/AIDS – from the BC Centre for Excellence (BCCfE Webite)
Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) will expand access to HIV/AIDS medications among hard-to-reach and vulnerable populations in Vancouver’s Downtown East Side and Prince George.
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 has in fact already 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. It is anticipated that the STOP HIV/AIDS Research Program will eventually be expanded to other areas of BC, under close monitoring and evaluation by the BC-CfE.
Aims of STOP HIV/AIDS
All of the Aims for the STOP HIV/AIDS Research Program represent a natural extension of work already being done by the BC-CfE.
- 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
- 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
PLEASE NOTE: All of the above information was taken from the BC Centre for Excellence in HIV/AIDS website:
To view video from the STOP HIV/AIDS press conference, held on February 4, 2010, where the $48 million project was announced, please visit this link: http://www.youtube.com/user/bccfe
To visit the STOP HIV/AIDS website please click this link: www.stophivaids.ca
Documents for download related to STOP HIV/AIDS:
To download the Spring/Summer 2011 issue of the STOP HIV/AIDS update please CLICK HERE.
To download the Fall 2010 issue of the STOP HIV/AIDS bulletin please CLICK HERE.
To download a copy of the first issue of the STOP HIV/AIDS bulletin please CLICK HERE.
Pilot Region Information and Updates
The VCH subpage is available here: http://paninbc.ca/network-initiatives/stop-hivaids/vancouver-coastal-health/
The new NH subpage is available here: http://paninbc.ca/network-initiatives/stop-hivaids/northern-health/