A new study says reduced access to HIV services during early COVID-19 restrictions in British Columbia was linked to a “surge” in HIV transmission among some drug users.
The study by University of British Columbia researchers says that while reduced social interaction during the March-May 2020 lockdown worked to reduce HIV transmission, it may not have “compensated” for the increase caused by reduced access to services.
The study, published in Lancet Regional Health, found that fewer people started antiretroviral treatment for HIV or had viral load tests under lockdown, while visits to overdose prevention services and safe drinking spaces also fell.
The total number of new HIV diagnoses in BC has continued to decline for decades.
But Dr Jeffrey Joy, the lead author of the report published on Friday, said he had found a “surprise” in transmission among some drug users during the lockdown.
Joy said transmission rates for such people had previously been fairly stable for about a decade.
“This is because there has been very good penetration of treatment and prevention services in these populations,” he said in an interview.
BC has been a world leader in tracking outbreaks, which means the results are likely to apply elsewhere, Joy said.
“We’re uniquely positioned to find these things,” he said. “The reason I thought it was important to do this study and get it out there is (because) it’s probably happening everywhere, but other places aren’t tracking the HIV epidemic the same way we are.”
Rachel Miller, co-author of the report, said health authorities needed to consider innovative solutions so that measures “put in place to address one health crisis do not inadvertently exacerbate another”.
“These services are the first line of defense in the fight against HIV/AIDS. Many of them have faced disruptions, closures, capacity limits and other challenges,” Miller said in a press release.
“Maintaining access to and engagement with HIV services is absolutely essential to prevent backsliding in controlling the epidemic and unnecessary harm.”
The health department did not immediately respond to requests for comment.
The researchers said the rise among “selected groups” could be attributed to a combination of factors, including housing instability and reduced confidence, raising barriers for many people who routinely receive HIV services.
British Columbia is set to become the first province in Canada to decriminalize the possession of small amounts of hard drugs in January after receiving a temporary federal exemption in May.
Joy said this decision, along with measures such as safe supply and safe needle exchange, will make a difference in preventing similar problems in the future.
“The take home message here is, in times of crisis and public health emergencies or other crises, we need to support these really vulnerable populations more, not less,” he said.
“At the very least, we need to give them continuity and access to the services they depend on. Otherwise, it just leads to problems that can have long-term, long-term consequences.”
This report by The Canadian Press was first published on September 24, 2022.
