BC-CfE updates its Primary Care Guidelines

September 20, 2021

The BC Centre for Excellence in HIV/AIDS (BC-CfE) created the first edition of its Primary Care Guidelines for the Management of HIV/AIDS in Adults in British Columbia back in 2011. Now, 10 years later, thanks to the diligent work of the Primary Care Guidelines Working Group (a working group appointed by the Committee for Drug Evaluation and Therapy), the most recently updated version of the guidelines is now available for health care providers throughout the province to become more actively involved in the diagnosis and care of people living with HIV (PLWH).

The Primary Care Guidelines play a key role in the BC-CfE’s ongoing commitment to providing the most current information and research regarding the management of HIV. The guidelines were developed by consensus amongst a committee of experts, based on interpretation of current best practices for the primary care of PLWH and related conditions.

An expert committee composed of primary care and infectious disease physicians, a nurse practitioner, a pharmacist, and a person living with HIV prepared the original guidelines in 2011. Since then, the guidelines have been consistently reviewed and revised to ensure the information and advice provided is as current and up-to-date as possible.

This summer saw the most recent review of the guidelines by a working group consisting of family, public health, and infectious disease physicians, and a peer navigator. The working group updated epidemiological information, baseline assessment and investigations, immunization recommendations, as well as issues related to co-morbidities and the health of women and transgender individuals. Specialty topics were reviewed by experts on the matter.

Thankfully, today, HIV infection is no longer a death sentence. Due to effective antiretroviral drug regimens, HIV is now seen as a chronic manageable medical condition. Early diagnosis and initiation of antiretroviral therapy (ART) has dramatically improved the management of HIV infection and has led to substantial reductions in HIV-related morbidity and mortality. Research shows that a 20-year-old living with HIV and receiving ART in the U.S. or Canada can expect to live into their early 70s, a life expectancy approaching that of the general population. In addition, there is now clear evidence that the widespread use of ART prevents HIV transmission. Even after repeated sexual exposures without using condoms, PLWH who are receiving ART and who have maintained a very low plasma HIV viral load do not transmit HIV. This is true for both heterosexual couples and men who have sex with men.

However, in order for ART to be effective to the point where PLWH cannot transmit HIV, individuals must be fully engaged in care, right from an initial assessment to long-term retention in care and virologic suppression. This concept, which stems from the BC-CfE’s strategy of Treatment as Prevention (TasP), is known as the HIV Cascade (or Continuum) of Care. The HIV Cascade of Care is the framework for assessing progress in HIV care and treatment in BC. Following these strategies has led to BC being one of the few jurisdictions in the world which has successfully surpassed the 90-90-90 UNAIDS target for 2020: 90% of people living with HIV (PLWH) in BC being diagnosed, 90% of those diagnosed receiving ART, and 90% of those on ART having an extremely low HIV viral load. As of the latest estimates, BC stands at 92%, 91%, and 94% on each respective benchmark.

Studies suggest that as many as 50% of HIV transmission events may occur from people who are in the acute and very early stages of illness. This means early detection and diagnosis of HIV infection is absolutely critical in preventing further transmission. The BC-CfE’s Primary Care Guidelines for the Management of HIV/AIDS in Adults in British Columbia helps all British Columbians, not just those living with HIV, by providing practical and easily accessible information and resources for primary care providers.

Dr. Silvia Guillemi, Clinical Advisor with the BC-CfE and Primary Care Guideline Working Group member and contributing author, said, “We are proud to release the latest revised version of the BC-CfE’s Primary Care Guidelines for the Management of HIV/AIDS in Adults in British Columbia. The Primary Care Guidelines working group reviewed the most up-to-date data on the primary care of PLWH, and these guidelines were developed with the support of the BC-CfE Clinical Education team. We are thankful for the contributions of experts on special topics like women and transgender health, and to the BC family physicians and nurse practitioners that reviewed and provided feedback for these guidelines.”

Zsept2021_forecast_web.pdfPrinter Friendly

SIGN UP TO RECEIVE THE FORECAST NEWSLETTER BY EMAIL!

Receive the latest news and information on advances in research, treatment and education. Be the first to hear about upcoming events and conferences, and other opportunities to connect with researchers at the BC-CfE.

CLICK TO SIGN UP!

Tags:

Hope to Health Primary Care Clinic

Epidemiology and Population Health

Therapeutic Guidelines Committee

BC Centre for Excellence in HIV/AIDS

Search form

BC-CfE updates its Primary Care Guidelines

Tags:

Search form