HIV spike among BC drug users linked to COVID-19 lockdown, research says

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A new study says limited access to HIV services during British Columbia’s early COVID-19 lockdowns was associated with a “sharp rise” in HIV transmission among some drug users.

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The study by University of British Columbia researchers says that while reduced social interaction during the March-May 2020 lockdown helped reduce HIV transmission, it may not have “outweighed” the increase caused by caused the restricted access to services.

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The study, published in the Lancet Regional Health, found fewer people started HIV antiretroviral therapy or had viral load testing under lockdown, while visits to overdose prevention services and safe use sites also fell.

The total number of new HIV diagnoses in BC continues a decade-long decline.

But dr Jeffrey Joy, lead author of the report released on Friday, said he had seen a “surprising” rise in transmission among some drug users during the lockdown.

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Joy said transmission rates for such people had been fairly stable for about a decade previously.

“That’s because treatment and prevention services penetrate these populations really well,” he said in an interview.

BC has been a world leader in epidemic surveillance, which means the findings are likely applicable 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 publish it is because (because) it’s probably happening everywhere, but other places aren’t monitoring their HIV epidemic the same way we are.”

Rachel Miller, a co-author of the report, said public health officials need to consider innovative solutions so that actions “taken to address one health crisis do not inadvertently aggravate another”.

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“These services are the frontline defenses in the fight against HIV/AIDS. Many of them have faced disruptions, closures, capacity limitations and other challenges,” Miller said in a release.

“Maintaining access and engagement in HIV services is absolutely essential to prevent disease control regression and unnecessary damage.”

The Department of Health did not immediately respond to requests for comment.

The researchers said the increase among “select groups” could be due to a combination of factors, including residential instability and reduced trust, which raises the barriers for many people who typically receive HIV services.

British Columbia is expected to become the first province in Canada to decriminalize possession of small amounts of hard drugs in January after being granted a temporary federal exemption in May.

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Joy said this decision will make a difference, alongside measures such as safe supplies and needle replacements, to prevent similar problems in the future.

“The takeaway message here is that in times of public health crises and emergencies or other crises, we need to do more, not less, support for these truly vulnerable populations,” he said.

“We have to at least give them continuity and access to their services that they depend on. Otherwise it will only lead to problems that can have long-term consequences.”

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