REPORT NOTES DROP IN HIV TRANSMISSION IN BRITISH COLUMBIA

Drug Cocktail Slows Reproduction of Virus

Harm reduction strategies, support programs and better medications are
contributing to the continuing decrease in HIV transmission among
B.C.'s intravenous drug users, according to a report recently released
by the Ministry of Health.

The report cited the Highly Active Anti-retroviral Therapy (HAART) as
one likely contributor to the lower transmission rates.

HAART is a drug cocktail which slows the reproduction of the virus in
patients and lowering their viral load to "undetectable" levels.
Someone with an undetectable viral load is significantly less likely
to transmit the virus to another person through body fluids. The
report says that early diagnosis of HIV and quick uptake of HAART in
intravenous drug users is helping to reduce the spread of the virus
among users.

The report also lists harm reduction programs such as clean needle
exchanges and Vancouver's supervised injection facilities at Insite
and The Dr. Peter Aids Foundation as a reason for the slower spread of
HIV among drug users.

"There is a high correlation between individuals using the injection
service and those people getting daily help with their medication,"
said Maxine Davis, executive director of the Dr. Peter Aids
Foundation. The facility offers supervised injection to its registered
patients on top of other health care services such as nutritious
meals, art and music therapy, showers, laundry services and nursing
care.

The combination of supervised injection and other services creates
that success, Davis said. People who use injections facilities are
more likely to receive ongoing help with their HIV medications--a
necessity for good health, she said.

Davis agreed HAART is playing a significant role in reducing the
spread of HIV. She said transmission in B.C. is down almost 60 per
cent since the 1996 advent of new HIV treatment. "We're way ahead of
any other province," Davis said.

However the report notes changes in drug use trends may also be
contributing to the lower rate of HIV infection. According to the
report, crack cocaine smoking in the Downtown Eastside is on the rise,
lowering drugs used by injection and consequently reducing the spread
of HIV among drug users.

But despite the changes in drug habits, provincial health officer Dr.
Perry Kendall called harm reduction services a success. "The recent
decline in new HIV cases is encouraging, especially since a
significant decrease has been seen amongst vulnerable populations like
those who use injectable drugs," he said in a release. "This decrease
is more proof that Highly Active Anti-retroviral Therapy and other
harm reduction services are working and should be expanded."

The report concluded with recommendations to continue lowering
transmission among injection drug users.

"B.C. is a world leader in the development of evidence based,
effective interventions to prevent HIV among injection and
non-injection drug users; this evidence base needs to be expanded and
effective interventions need to be scaled up provincially," said the
report.

It recommends expanded access to HAART and harm reduction programs. It
also calls for the continuation of needle exchange programs where
dirty needles don't have to be handed over to receive clean ones.

Davis said transmission rates in countries in Asia and Eastern Europe
still soar due to injection drug use. She called for more support of
harm-reduction strategies, which require an acceptance of risky behaviour.

"Until countries, including our own, have the courage to implement
services that are scientifically upheld, the epidemic will continue to
be out of control unnecessarily," she said.