Prevention in Focus

Fall 2017 

In case you missed it…

CATIE resources

Undetectable viral load and HIV sexual transmission

Studies have shown that HIV-positive people who are engaged in regular healthcare, are on treatment and have an ongoing undetectable viral load, do not pass HIV to their sexual partners. This client resource explains what an undetectable viral load is, why it is important for both a person’s health and HIV prevention, and how someone can know they have an ongoing undetectable viral load.

Your Guide to HIV Treatment

HIV treatment has changed dramatically. We now know that starting treatment early is better for a person’s long-term health and that maintaining an undetectable viral load can prevent HIV transmission. With proper treatment and care, people with HIV can stay healthy and live a long, full life. This new guide offers up-to-date information on how treatment works and the importance of starting treatment early.

The HIV testing process

This fact sheet outlines the general approach to HIV testing in Canada, although each region may have slightly different approaches to HIV testing.

HIV treatment and an undetectable viral load to prevent HIV transmission

This fact sheet looks at how taking HIV treatment to maintain an undetectable viral load can prevent HIV transmission.

Sexual Transmission of Hepatitis C: Research Update and Implications for Gay Men’s Health Providers

This webinar highlights the latest research on hepatitis C transmission and treatment, with the goal of better equipping public health, healthcare providers and gay men and other men who have sex with men with updated information about the sexual transmission of hepatitis C.

PEP/PrEP Update – A BC Case Study

This webinar gives an update on the situation in British Columbia regarding access and advocacy for PEP and PrEP that should interest clinicians, policy-makers, and community members alike.

CATIE News

New point-of-care hepatitis C antibody test approved in Canada

In January 2017, Health Canada approved the use and sale of a point-of-care antibody test for screening people for exposure to hepatitis C virus (HCV). The test, called the OraQuick HCV rapid antibody works by checking a small drop of blood (taken from a finger prick) for antibodies to HCV. The test is more than 98% accurate at detecting those antibodies. It provides results in 20 minutes.

Canadian women’s experiences receiving a hepatitis C diagnosis

The rate of hepatitis C is on the rise among Canadian women, in particular among women aged 15 to 29 years old. Approximately 60% of new infections in this age group are in women.

Diagnosis is a critical opportunity for connecting people to hepatitis C care. However, some research has found that people often have a poor experience with the hepatitis C testing process. A recent study looked at the experiences of Canadian women who receive a hepatitis C diagnosis and providse recommendations about how to improve hepatitis C testing experiences.

Aussie study finds HIV home-based test kits welcomed by gay and bisexual men

In a randomized clinical trial, researchers in Australia recruited more than 300 HIV-negative men to compare different patterns of HIV testing behaviour. All the men were told to continue to use the sexual health and other clinics that they would visit from time to time for testing for sexually transmitted infections, including HIV, but one group received free HIV self-testing kits while a control group did not.

The researchers found that rates of HIV testing doubled among men who were given the self-test kits. Among those who had not been tested in the past two years and who received the kits, rates of testing rose nearly four-fold. There was no significant change in the testing behaviour of men in the control group.

A nurse-led adherence intervention for HIV works and saves money

A team of researchers in the Netherlands has shown that a nurse-led intervention called AIMS (Adherence Improving self-Management Strategy) has had a measurable and significant effect on improving treatment success rates. A key aspect of AIMS is that it is data driven. It uses specialized pill bottles with covers or caps (called MEMS-Caps) that are capable of capturing information about the date and time the bottles were opened. Participants who received AIMS were significantly more likely to have lower viral loads and less likely to develop virological failure compared to people who did not receive AIMS.

An economic analysis that accompanied the present AIMS study suggests that if AIMS were to be widely implemented, health systems would save millions of dollars while the number of years people with HIV would live in good health would increase.

Research finds that harm reduction and ART helped to reduce the spread of HIV in Vancouver

Researchers at the British Columbia Centre for Excellence in HIV/AIDS along with other researchers in Vancouver have attempted to study the relative impact that HIV treatment (ART), harm reduction or both can have on the spread of HIV. In their study, the harm reduction services consisted of the provision of sterile syringes/needles and the prescription of drugs such as methadone and buprenorphine. The researchers developed computer simulations of the HIV epidemic in B.C. to understand the effect of ART, harm reduction services or both on the province’s HIV epidemic.

The researchers estimated that between 1996 and 2013, 3,204 new cases of HIV infection were prevented due to “the combined effect of the expansion of harm reduction services and ART coverage on HIV transmission via [sharing of syringes/needles].”

New hepatitis C screening guidelines released for Canada

The Canadian Task Force on Preventive Health Care has released recommendations for policy makers and clinicians who are considering which adult populations should be offered screening for HCV infection. The task force has come out against broad-based screening of symptom-free adults who are not at high risk for exposure to HCV.

Canadian resources

HIV/AIDS Strategy to 2026: Focusing Our Efforts – Changing the Course of the Prevention, Engagement and Care Cascade in Ontario

This strategy was developed by the Ontario Advisory Committee on HIV/AIDS (OACHA) in consultation with a broad range of HIV/AIDS stakeholders, including people living with HIV and those from priority populations who are at-risk of HIV, people working in community-based HIV organizations and programs, HIV clinical care services, and public health units.

It includes a report on the state of progress and the remaining challenges in the response to HIV in the province, and a series of recommendations on how to ensure the response to HIV in Ontario can fully capitalize on scientific advancements in HIV prevention, care and treatment.

Providing HIV PrEP: Steps to Patient Engagement - Service Provider Guide

This guide from CTAC is designed for healthcare providers interested in prescribing HIV pre-exposure prophylaxis or PrEP. It provides background on what PrEP is and outlines the process of providing PrEP including how and why patients might be interested in PrEP, how to engage patients in conversation about PrEP, assessments needed before prescribing PrEP, and ongoing care.

Universities Without Walls Pozcast Episode 1 – Undetectable = Untransmittable (U=U)

A person living with HIV who has an undetectable viral load does not transmit the virus to their partners. To discuss this significant advance in science and its impact James Watson talks to two people passionate about the topic and the messaging, Laurie Edmiston, the Executive Director of the Canadian AIDS Treatment Information Exchange (CATIE) and Adrian Betts an HIV positive activist, and the Executive Director of an AIDS service organization in Ontario.

The role of peers in linkage, engagement, and retention in HIV care

This resource from the Ontario HIV Treatment Network (OHTN) addresses the role of peers in linkage, engagement and retention in HIV care.

HIV criminalization in Canada: key trends and patterns

As part of an effort to contribute to an informed public dialogue on the issue, this short report from the Canadian HIV/AIDS Legal Network provides a snapshot of the temporal and demographic patterns of HIV criminalization in Canada from 1989 to 2016. It also updates information on the outcomes of HIV non-disclosure criminal cases.

Know your rights: guide for parents living with HIV

This resource from the Canadian HIV/AIDS Legal Network was produced for parents or prospective parents living with HIV, including women, transgender men and non-binary people. Its aim is to provide practical information and to foster knowledge about some of the main areas of concern that parents living with or affected by HIV may have.

Know your rights: a guide for child and family service providers serving people living with HIV

This guide from the Canadian HIV/AIDS Legal Network was written for child and family service providers who provide support and assistance to people living with or affected by HIV.

Privacy and disclosure for youth living with HIV or Hep C: questions and answers

This guide from the Canadian HIV/AIDS Legal Network is for youth between the ages of 15 and 29 and focuses on some of the factors at play when young people living with HIV or hepatitis C are thinking about telling others about their HIV or hepatitis C status.

Indigenous women, HIV and gender-based violence

This report from the Canadian HIV/AIDS Legal Network synthesizes resources that jointly consider Indigenous women, HIV and gender-based violence and relevant recommendations for law reform.

Indigenous communities: HIV, privacy and confidentiality: questions and answers

This guide from the Canadian Aboriginal AIDS Network (CAAN) and the Canadian HIV/AIDS Legal Network provides answers to common questions on disclosure, privacy and confidentiality in the health-care settings, workplaces, post-secondary institutions and other settings — places where many Indigenous people living with HIV have expressed concerns about their privacy.

Indigenous communities and HIV and HCV in federal prisons: questions and answers

This booklet from the Canadian Aboriginal AIDS Network (CAAN) and the Canadian HIV/AIDS Legal Network is for prisoners who identify as First Nations, Inuit and Métis, and who are imprisoned in a federal prison or healing lodge run by the Correctional Service of Canada.

Harm reduction services for Indigenous people who use drugs: questions and answers

This guide from the Canadian Aboriginal AIDS Network (CAAN) and the Canadian HIV/AIDS Legal Network provides Indigenous people who use drugs with information related to harm reduction services such as needle and syringe programs, safer drug consumption services, opioid substitution therapy (e.g., methadone) and naloxone.

Reducing stigma and discrimination through the protection of privacy and confidentiality

This resource from the Canadian HIV/AIDS Legal Network and the Canadian Public Health Association (CPHA) explains the important role of privacy and confidentiality in reducing stigma and discrimination related to STBBIs, and offers frontline health and social service providers several strategies they can use to deal with issues related to privacy, confidentiality, the criminalization of HIV non-disclosure and stigma reduction.

HIV Pre-Exposure Prophylaxis and Sex Work in Canada 2016

In October 2016, a group of 50 women, men and trans people from across Canada who work with sex workers met in Toronto. The purpose of this national consultation was to give participants the opportunity to educate themselves, explore and grapple as a group with the implications of HIV pre-exposure prophylaxis (PrEP) on the sex industry. This report from the Triple-X Workers' Solidarity Association of British Columbia and University of Toronto summarizes what was discussed during the two-day consultation.

Gay generations: life course and gay men's health: findings from the national Sex Now survey

Sex Now is  a  national  periodic survey  conducted by the Community-Based Research Centre (CBRC) in Vancouver. The theme explored by the 2014/15 edition of the survey was Gay Generations: life course experiences among cohorts composed of the youngest to oldest gay and bisexual men in the survey. The survey provided an unprecedented opportunity to learn more from Canadian men about life course influences on health and prevention, especially the way in which changes in historic patterns of stigma and discrimination are influencing current circumstances related to HIV.

Shared Measures for Community Organizations Addressing HIV and Hepatitis C

This resource from Pacific AIDS Network (PAN) outlines a series of indicators that can be used to measure the contribution community-based HIV/HCV organizations are making across B.C. The common use of these indicators across the sector will improve B.C.’s ability to compare the relative effectiveness of different programs and services to make more informed choices, and improve learning from organizations’ most successful practices.

Hepatitis C in Canada - Infographic Poster

This infographic poster from the Public Health Agency of Canada provides information on the hepatitis C virus infection in Canada. The infographic is based on 2015 data provided by the provinces and territories in Canada as part of the Canadian Notifiable Diseases Surveillance System and selected research findings to complement the surveillance information.

Access to HCV Treatment in Federal Institutions - CTAC Policy Position Paper

This report from CTAC looks at issues and recommendations around access to hepatitis C virus (HCV) treatment in federal institutions and addresses questions like: How has treatment, traditionally, been administered? What are the factors behind such a high HCV prevalence rate? What kind of preventative measures can be taken? How have Correctional Service Canada's (CSC) drug eligibility restrictions changed, and what does this mean for HCV treatment within the institutional setting? 

The report includes information on screening; treatment; harm reduction; social determinants of health (gender, mental health/substance abuse); CSC's new and less restrictive eligibility requirements around fibrosis scores; and, finally, CTAC's recommendations for increasing treatment access.

Recommendations on hepatitis C screening for adults

These recommendations, which apply to the general adult population, were developed by The Canadian Taskforce for Preventative Health Care. The task force does not recommend population-wide screening for older adults; instead they recommend continuing to screen people at higher risk of infection, such as people with a history of injection drug use.

The Canadian Liver Foundation, Action Hepatitis Canada and several Canadian liver experts have criticised the screening recommendations.

Not Just in Pakistan: Hepatitis C is a global disease - URDU booklet for Pakistani newcomers living with Hep C

Not Just in Pakistan: Hepatitis C is a global disease - ENGLISH booklet for Pakistani newcomers living with Hep C

English and Urdu booklets from CTAC with information on hepatitis C epidemiology, treatment, finding a doctor, and drug coverage.

Getting started: Important things to know when you have hepatitis C

This guide from Hepatitis Education Canada and CATIE answers questions about hepatitis C and advice on what to do after being diagnosed with hepatitis C.

Sexual Health at Midlife and Beyond: Information for Sexual Health Educators

This resource from the Sex Information and Education Council of Canada (SIECCAN) provides sexual health information for midlife people or older adults. It was created for people working in sexual health education.

International resources

WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection

This tool from the World Health Organization (WHO) contains modules for a range of stakeholders to support them in the consideration, planning, introduction and implementation of oral PrEP. The modules can be used on their own or in combination.

Global health sector strategy on viral hepatitis 2016–2021

This World Health Organization report is the first global health sector strategy on viral hepatitis, a strategy that contributes to the achievement of the 2030 Agenda for Sustainable Development.

It covers the first six years of the post-2015 health agenda, 2016–2021, building on the Prevention and Control of Viral Hepatitis Infection: Framework for Global Action, and on two resolutions on viral hepatitis adopted by the World Health Assembly in 2010 and in 2014.

IDUIT (Implementing comprehensive HIV and HCV programmes with people who inject drugs: practical guidance for collaborative interventions)

The International Network of People Who Use Drugs (INPUD) has created a tool that contains practical advice on implementing HIV and hepatitis C programs with people who inject drugs. It is based on recommendations in the WHO, United Nations Office of Drugs and Crime, and UNAIDS technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injection drug users.

The tool is designed for use by public-health officials, managers of HIV and harm reduction programs, NGOs – including community and civil-society organizations – and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates.

Models for improving linkage to care for people living with HIV released from jail or prison

This resource from the U.S. National Center for Innovation in HIV Care summarizes effective models and best practices of linkage to care programs for people living with HIV who are leaving jail or prisons and re-entering society. It is based on U.S. project reports, training manuals and resources guides on post-incarceration linkage to care programs in the United States.