Canada: One-Third of British Columbia Residents Who Died of HIV Causes Didn't Get Treatment

One-third of British Columbia residents who died of HIV-related causes did not access life-saving treatment, according to a new study by researchers at the B.C. Centre for Excellence in HIV/AIDS.

People who did not get treatment -- although drugs are free -- were most likely First Nations, female, poor and/or living in Vancouver's drug-infested Downtown Eastside. An earlier center study said aboriginal injection drug users in Canada's poorest postal code contract HIV at twice the rate of non-aboriginals.

The study called for culturally sensitive interventions to improve access to antiretroviral drugs among HIV-positive aboriginals. The British Columbia Persons With AIDS Society said the report underlines the government's need to increase its ARV budget. "Provincial government inaction in the face of irrefutable evidence is tantamount to criminal negligence," said Glen Bradford, the group's chair.

Epidemiologist Mark Tyndall of the center said no one has been denied state-of-the-art treatment, although the drugs cost up to $14,000 (US$10,607) annually per person. Epidemiologist Dr. Evan Wood, the study's lead author, said he is alarmed that two-thirds of HIV-infected British Columbians discontinue ARV treatment shortly after starting it.

The authors used information from the B.C. Health Ministry's Vital Statistics Agency to evaluate 1,239 HIV-related deaths from January 1995-December 2001.

Woods said he hopes HIV testing and referral at Vancouver's safe injection site will help reduce deaths. He said the center is initiating programs with the Vancouver Coastal Health Authority to improve access to physicians and ARVs in Downtown Eastside.

British Columbia currently spends about $37 million (US$28 million) a year on HIV drug therapy for 3,000 people, including 400 IDUs, according to Brian Hogg, drug treatment manager at the center.

The study, "Prevalence and Correlates of Untreated Human Immunodeficiency Virus Type 1 Infection Among Persons Who Have Died in the Era of Modern Antiretroviral Therapy," is published in the Journal of Infectious Diseases (2003;188(8):1164-1170).

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