Prevention in Focus

Spring 2015 

Essential resources

90-90-90: An ambitious treatment target to help end the AIDS epidemic

This UNAIDS report lays out ambitious new targets for HIV testing, treatment and suppression of viral load. By 2020:

  • 90% of all people living with HIV will know their status;
  • 90% of all people diagnosed with HIV will be on sustained HIV treatment;
  • 90% of all people on treatment will have viral suppression (undetectable viral load).

If these targets are met, then 73% of people in the world living with HIV will be virally suppressed. Modelling suggests that that if these targets are met, then by 2030 the world will be able to end the AIDS epidemic. The report discusses how these ambitious targets can be achieved.

Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations

This report brings together all the current World Health Organization (WHO) guidelines relevant to the WHO five key populations: men who have sex with men (MSM), people who inject drugs, people in prisons and other closed settings, sex workers and transgender people. The guidelines lay out the steps necessary for countries to increase access to HIV testing, treatment and care for these five populations. Comprehensive HIV packages for the five key populations are outlined in the guidelines, including measures to better manage sexual and reproductive health, mental health and co-infections such as tuberculosis and hepatitis. The guidelines also highlight the need for needle and syringe and opioid substitution therapy programmes and include recommendations for treatment of overdose in the community. Highlighting that rates of HIV infection among MSM remain high almost everywhere and new prevention options are urgently needed, WHO strongly recommends the use of pre-exposure prophylaxis (PrEP) combined with condoms for this population.  

HIV Prevention in Clinical Care Settings: 2014 Recommendations of the International Antiviral Society–USA Panel

These recommendations were developed by an expert volunteer panel of the International Antiviral Society-USA (IAS-USA). They are intended as guidelines for clinicians to implement a combined biomedical-behavioural approach to HIV care and prevention. Recommendations include the use of HIV treatment for all people living with HIV to reduce the risk of transmitting the virus and the use of pre-exposure prophylaxis (PrEP) in people at high risk for HIV infection. The guidelines also highlight the importance of the integration of behavioural and social interventions in the healthcare system to help people living with HIV or who are at high risk for infection to access and remain in high quality HIV care.

HIV, Stigma and Society: Tackling a Complex Epidemic and Renewing HIV Prevention for Gay and Bisexual Men in British Columbia – Provincial Health Officer’s 2010 Annual Report

This report highlights the disproportionate number of new diagnoses among gay and bisexual men in British Columbia and the lack of substantial improvements over the last 10 years compared to other key populations. It discusses how some sub-populations among gay and bisexual men experience additional vulnerability based on age, ethnicity, and geographic location. A series of drivers of the HIV epidemic within this population are examined, including: awareness of HIV status, access to appropriate health care, HIV treatment, systemic challenges to HIV prevention, marginalization, stigma, racism, sexual network patterns, sexually transmitted infections, and sexual behaviour. The report includes 15 recommendations from the advisory groups that were involved in the development of the report and six priority recommendations from the provincial health officer for immediate action to reduce the HIV epidemic among gay and bisexual men in British Columbia.

HIV/AIDS Epi Update – Chapter 1: National HIV Prevalence and Incidence Estimates for 2011

For the first time, the Public Health Agency of Canada (PHAC) has provided new HIV epidemiological data that will help us to better plan and deliver programming. This includes provincial estimates for both HIV prevalence and incidence along with a breakdown of exposure category.

In addition, new estimates of population sizes are available, including men who have sex with men, people who use drugs, Aboriginal people and people from HIV-endemic countries. These new numbers have allowed PHAC to estimate incidence rates for these populations and to compare these rates to other populations.  

Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, 2014

These recommendations were developed by the U.S. Centers for Disease Control and Prevention (CDC) in collaboration with other governmental and non-governmental organizations. They are intended to advance the goals of the 2010 National HIV/AIDS Strategy for the United States: prevent new HIV infections, increase the proportion of persons with HIV who are aware of their infection, prevent HIV-related illness and death, and reduce HIV-related health disparities. The recommendations compile long-standing and new federal recommendations about biomedical, behavioural, and structural interventions that can help reduce the risk of HIV transmission by reducing the infectiousness of people with HIV and their risk of exposing others to HIV. Included is a summary of recent scientific evidence, programmatic experience and expert opinion that support the recommendations.

Hepatitis C surveillance in Canada

This article summarizes the surveillance trends of cases of hepatitis C virus reported to the Canadian Notifiable Disease Surveillance System from 1991 to 2012. Time trends are provided from 1991 to 2012, with a more detailed examination of age and sex patterns from 2005 to 2012.

Estimated prevalence of hepatitis C virus infection in Canada, 2011

This article summarizes the prevalence estimates of hepatitis C virus (HCV) in Canada. The report includes estimates of chronic HCV prevalence for Canada and for specific sub-populations. It is estimated that between 0.64% and 0.71% of the overall Canadian population was living with chronic HCV infection in 2011 and 44% of these individuals were undiagnosed.