1. STOP HIV/AIDS Rolando Barrios, MD, FRCPC Assistant Director BC Centre for Excellence in HIV/AIDS Assistant Medical Director HIV/AIDS Program Providence Health Care Adjunct Professor – School of Population and Public Health, UBC

2. Background: Natural History of HIV is well known. The importance of early HIV diagnosing and its impact on transmission and outcomes. The importance of timely access to care, and support. The role of ARV treatment both at individual and population level. Increase understanding of HIV as a chronic manageable condition requiring greater involvement from patients (self-management)

3. HOW HIV affects BC 1:4 people infected with HIV are unaware of their HIV positive status. They won’t benefit from care and treatment They contribute to ~ 60% of new infections 1:3 people dying from HIV in BC have never accessed ARV treatment. Higher HIV rates among particular groups Higher mortality rates in some geographic areas

4. STOP HIV/AIDS Business case for the need to expand HIV care and treatment was prepared Government decided to implement a Pilot Project in the two most affected areas Vancouver’s inner city Downtown Prince George Funded provided to VCH, NH, PHSA, BCCFE and PHC. Development of strategic goals and a model for monitoring and evaluation was developed

7. Indicators #IndicatorProvincialVancouverNorthern Interior 7HCV & HIV Testing50%62%65% 9Advanced HIV at Diagnosis14%13%<1% 11Acute Infection6%9%6% 14Late ARV initiation29%24%<1% 21DRT before ARV start84% 100% 22Suppressed pVL on ART61%64%57% 23Appropriate ART combination 81% 100% 24Rx refill adherence73%76%46% 25# MDs initiating ARV Rx46331 29ARV regimen change3.723.81%0% STOP HIV/AIDS Pilot Project – Indicators Report (August 2010)

8. LISA Survey VCHNHALISA Unstable housing*37%29%32% Receiving Income Assistance75%85% Food insecure70%86%66% Unemployment78%67% Not satisfied with physician5%14%6% LISA Participants: N= 1000. 2% from NHA and 67% from VCH 26% Women, 81% use HIV-related programs and services regularly *Unstable housing defined as living in a hotel, boarding room, hostel, transition house, prison, hospital or not having a fixed address at the time of the interview Hogg et al. 2009 (Summary statistics of the LISA Project)

9. Questions? Contact: Rolando Barrios: rbarrios@cfenet.ubc.carbarrios@cfenet.ubc.ca