Prevention in Focus

Fall 2016 

Essential resources

Some key recent Canadian and international HIV and hepatitis C resources.

CATIE resources

Oral pre-exposure prophylaxis (PrEP)

This fact sheet focuses on the use of Truvada as oral PrEP. It includes a summary of PrEP research and reflects the recent approval of Truvada as PrEP in Canada. 

CATIE statement on the use of condoms to prevent the sexual transmission of HIV

This updated statement recognizes the consistent and correct use of internal and external condoms as highly effective strategies to reduce the risk of sexual transmission of HIV. The statement provides recommendations for service providers on how they might improve the uptake and use of condoms among their clients, and reviews the evidence on the effectiveness of condoms to prevent the sexual transmission of HIV.

CATIE statement on the use of PrEP to prevent the sexual transmission of HIV

This updated statement recognizes the consistent and correct use of daily Truvada as pre-exposure prophylaxis (PrEP) as a highly effective and safe strategy to reduce the risk of sexual transmission of HIV. The statement provides recommendations for service providers on how they might better integrate PrEP into their practice, and reviews the evidence on the effectiveness of daily PrEP to prevent the sexual transmission of HIV.

CATIE statement on the use of ART and an undetectable viral load to prevent the sexual transmission of HIV

This updated statement recognizes the consistent and correct use of antiretroviral treatment (ART) by people living with HIV to maintain an undetectable viral load as a highly effective strategy to reduce the risk of sexual transmission of HIV. The statement provides recommendations for service providers on how they might better integrate ART for prevention into their practice, and reviews the evidence on the effectiveness of ART and an undetectable viral load to prevent the sexual transmission of HIV.

Windows of Opportunity: Integrated Hepatitis C Programming Approaches for Priority Populations

This report summarizes the findings from the National Deliberative Dialogue on Integrated Hepatitis C Programming and Services, hosted by CATIE in 2015, to explore frontline hepatitis C continuum of care models (prevention, testing, treatment and support) for priority populations and to identify promising directions in hepatitis C programming, policy and knowledge exchange.

Sexually transmitted infection fact sheets

CATIE has developed a series of fact sheets in partnership with the Sex Information and Education Council of Canada (SIECCAN), which give information on how sexually transmitted infections are transmitted, who is at risk, symptoms, complications, testing and diagnosis, notification of partners, treatment and prevention.

New fact sheets:

Updated fact sheets:

CATIE News

Strategies for improving the hepatitis C care continuum for people who inject drugs

Researchers in the U.S. conducted a systematic review of interventions to improve access to hepatitis C care for people who inject drugs. The researchers grouped and reviewed the interventions based on the following stages across the hepatitis C care continuum: diagnosis or case finding; linkage to care; pre-therapeutic evaluation or treatment initiation; and treatment adherence.

They found that the programs studied were effective at finding new cases of people with hepatitis C compared to the usual care but they required structural support, such as financial resources.

High acceptance for rapid hepatitis C testing

Researchers in Wisconsin surveyed several hundred people who used a syringe and needle exchange program in urban and rural areas in that state about their attitudes toward rapid HCV testing. Of the participants who did not have a history of HCV infection and who responded to the survey, 85% were willing to undergo rapid HCV testing if it were made available. The results from the Wisconsin study underscore a high rate of acceptance of HCV rapid testing.

Researchers use social media to increase HIV testing among men

Researchers in North Carolina have deployed a program called “CyBER/testing,” which they describe as “an intervention designed to promote HIV testing among men who have sex with men and transgender persons who use social media designed for social and sexual networking.” They found that implementation of CyBER/testing led to a marked increase in HIV testing.

The deployment of PEP in a Montreal clinic

Montreal’s Clinique médicale l’Actuel receives between 40 and 50 requests for post-exposure prophylaxis (PEP) each month. In analyzing their database of several thousand PEP users, they found that a regimen that included the fixed-dose combination of tenofovir + FTC (Truvada) was well tolerated and that patients reported that they generally adhered well to PEP regimens. Likely cases of HIV infection due to PEP failure were very rare—less than 1%.

A case of HIV transmission on PrEP and its implications

A review of key details about a case of HIV transmission in a man who was taking pre-exposure prophylaxis (PrEP) in the form of daily Truvada, which was presented at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI).

Truvada approved for HIV prevention in Canada

On February 26th 2016 Health Canada approved the use of Truvada taken every day to reduce the risk of sexual transmission of HIV. Health Canada based its approval on data from clinical trials in men who have sex with men as well as in heterosexual couples where one partner was HIV-positive. In these studies, Truvada was taken once daily every day together as part of a suite of prevention measures. In this context Truvada was highly effective in reducing the risk of HIV infection.

Canadian resources

Hepatitis C in Canada and the importance of risk-based screening

This article from the Public Health Agency of Canada highlights risk factors associated with the acquisition of HCV so that healthcare providers can screen, where appropriate, and detect chronic hepatitis C.

AMMI Canada position statement: The use of early antiretroviral therapy in HIV-infected persons

This position statement from the Association of Medical Microbiology and Infectious Disease Canada encourages initiation of HIV treatment as soon as someone is diagnosed with HIV, regardless of CD4 count.

Protecting lives, preventing HIV: A research think tank on the use of pre-exposure prophylaxis (PrEP) in Canada

In March 2016, more than 40 participants met to discuss the research needed to support the implementation and use of pre-exposure prophylaxis (PrEP) in Canada. Their objective was to discuss the possibilities of a national PrEP research initiative and its potential to contribute to equitable, evidence-based implementations of PrEP across Canada. Participants identified five key areas of potential PrEP research, as well as a range of next steps.

On Point: Recommendations for Prison-Based Needle and Syringe Programs in Canada

This report from Ryerson University, Canadian HIV/AIDS Legal Network and Prisoners with HIV/AIDS Support Action Network (PASAN) provides recommendations for implementing prison-based needle and syringe programs (PNSPs) to help prevent the spread of HIV and hepatitis C virus in Canadian federal prisons. The report concludes with six recommendations on how PNSPs can and should be implemented in Canadian prisons without delay.

Hepatitis C reinfection after successful treatment

The Ontario HIV Treatment Network (OHTN) Rapid Response Service offers quick access to research evidence to help inform decision making, service delivery and advocacy. This publication asks “What is the risk of hepatitis C reinfection after successful treatment?” and provides key take-home messages for service providers.

Impact of successful hepatitis C treatment on quality of life

This OHTN Rapid Response Service publication asks “Does successful hepatitis C treatment improve quality of life?” It also provides key take-home messages for service providers.

The Cruising Counts Guide

This guide from the Gay Men’s Sexual Health Alliance of Ontario (GMSH) is designed for workers in Ontario who provide online sexual health outreach services to gay, bisexual and other men who have sex with men). This updated program guide captures recommendations, best practices and processes currently being used by different online outreach programs across Ontario.

Tuberculosis in Canada 2014: Pre-release

This report from the Public health agency of Canada provides a brief, initial overview of the preliminary number of reported new active and re-treatment TB cases and corresponding incidence rates in Canada for the most recent reporting year. The data presented were extracted from the Canadian Tuberculosis Reporting System on October 30, 2015.

Pistes d’action novatrices en matière de substances psychoactives « illicites » [Innovative interventions for “illicit” psychoactive substances]

The Institut national de santé publique in Quebec (INSPQ) conducted a review and synthesis of the literature on drug intervention programs. These interventions were chosen either because they do not exist in Quebec or only as pilot or small scale projects, or because they have been implemented across Canada, the United States, countries of the European Union, or Australia. The aim of the review was to explore ways to enhance the positive effects and mitigate the negative effects of the current control system for "illegal" substances in Quebec. (French only)

International resources

Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection – Recommendations for a public health approach - Second edition

These World Health Organization (WHO) guidelines provide guidance on the diagnosis of HIV infection, the use of antiretroviral drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care.

Guidelines for the screening, care and treatment of persons with chronic hepatitis C infection: Updated version, April 2016

These World Health Organization (WHO) guidelines provide evidence-based recommendations on screening for, and the care and treatment of, persons with chronic hepatitis C virus infection. They are primarily intended to provide a framework for the development or strengthening of hepatitis C treatment programs.

Viral hepatitis, 2016–2021(Draft global health sector strategies)

The first global health sector strategy on viral hepatitis, developed by the World Health Organization (WHO).

Updated guidelines for antiretroviral post-exposure prophylaxis after sexual, injection drug use, or other non-occupational exposure to HIV—United States, 2016

Updated guidelines from the U.S. Department of Health and Human Services on non-occupational post-exposure prophylaxis (nPEP).