BC Centre for Excellence in HIV/AIDS announces the virtual end of the domestic HIV epidemic in British Columbia

published on December 1, 2023

The spread of HIV within the province reaches historically low levels, showing infection events are now “sporadic”

Vancouver, B.C. – December 1st marks World AIDS Day and the start of Indigenous AIDS Awareness Week. Today, the BC Centre for Excellence in HIV/AIDS (BC-CfE) is proud to announce the virtual end of the domestic epidemic of HIV in British Columbia.

Formerly the epicenter of the HIV/AIDS epidemic in Canada, British Columbia is now recording historically low levels of HIV infections the province. The BC-CfE’s progress can be attributed to the made-in-BC Treatment as Prevention (TasP) strategy, and the availability of government-funded HIV medication Pre-exposure Prophylaxis (PrEP) since 2018.

New HIV infections in BC have gone from about 1,000 cases per year during the peak of the epidemic to about 120 per year and have remained stable at that level over the last three years. Negative health effects and early deaths related to HIV have decreased significantly—by an impressive 90%—during the same period of time.

“When the BC-CfE opened its doors in 1992, one person in BC was dying from AIDS almost every day. Following our discovery that HIV treatment also stops HIV transmission, the BC-CfE developed the TasP strategy, which proactively facilitates access to testing, treatment, and support for people living with HIV to halt the progression of the virus and AIDS-related deaths, says Dr. Julio Montaner, Executive Director and Physician-in-Chief of the BC-CfE. “Our experience in BC shows it is possible to stop HIV/AIDS as an epidemic. Policymakers and healthcare leaders across Canada must strengthen their commitment and match the success of the BC TasP campaign nationally.”

A recent BC-CfE genetic analysis of all new people living with HIV (PLWH) diagnosed in BC over several decades, confirmed transmission events within the province have become mostly sporadic. As a result, new clusters of HIV transmission within BC are at an all-time low. Taken together, these results confirm that the BC combined TasP + PrEP strategy has been very successful in stopping the progression to AIDS and premature death among PLWH and decreasing HIV transmission among those at risk.

Two years ago, I joined Dr. Julio Montaner and his team at the BCCfE to declare the end of the AIDS as an epidemic. On the occasion of World AIDS Day, I am pleased to join them in announcing that B.C. nears the end of HIV epidemic. This significant progress is made possible by the strong collaboration of government, communities and organizations such as BC-CfE on HIV and AIDS treatment, prevention and education programs. We must continue to work together and our knowledge and best practices with other jurisdictions so we can end the HIV/AIDS epidemic collectively.
- The Honourable Adrian Dix, BC Minister of Health

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About the British Columbia Centre for Excellence in HIV/AIDS

The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility – nationally and internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. The made-in- BC Treatment as Prevention strategy (TasP) pioneered by BC-CfE, and supported by UNAIDS since 2011, inspired the ambitious global target for HIV treatment - known as the 90-90-90 Target by 2020 and current 95-95-95 Target by 2025 - to end AIDS as a pandemic by 2030. The BC-CfE is applying TasP to therapeutic areas beyond HIV/AIDS, including viral hepatitis and addiction, to promote Targeted Disease Elimination as a means to contribute to healthcare sustainability. The BC-CfE works in close collaboration with key stakeholders, including government, health authorities, health care providers, academics, and the community to decrease the health burden of HIV/AIDS, hepatitis C and addictions across Canada and around the world.

For more information, please contact:
James Prescott
Phone: 1-604-314-1330
Email: james.prescott@edelman.com

BACKGROUNDER: WORLD AIDS DAY

The BC Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility – nationally and internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. Over three decades, the BC-CfE has developed innovative models and strategies to reach BC’s most vulnerable residents and remove gaps in healthcare delivery.

During the AIDS crisis, the BC-CfE lead the charge with the made-in-BC HAART (highly active anti-retroviral therapy) - changing the course of the HIV/AIDS crisis and providing the first treatment to reduce HIV to undetectable levels and reduce risk of transmission. Pioneered by the BC-CfE, the Treatment as Prevention (TasP) strategy of providing immediate, sustained treatment for people with HIV (with effective testing and tracing), further reduced morbidity, mortality and new infections.

Today, the BC-CfE is applying TasP to therapeutic areas beyond HIV/AIDS, including viral hepatitis and opioid use disorder, to achieve Targeted Disease Elimination (TDE™) to contribute to healthcare sustainability. Recently, the BC-CfE launched the evidence-based, research-driven, integrated clinical care facility - the Hope to Health Research and Innovation Centre - a place delivering universal, integrated, accessible healthcare to marginalized British Columbians who are disconnected from care.

Nearing the end of the HIV epidemic in BC
BC-CfE analysis shows that TasP is highly effective in stopping progression to AIDS and premature death among people living with HIV (PLWH), and for no additional cost, TasP is able to prevent HIV transmission, making this a cost-saving strategy. There is global consensus that PLWH are unable to transmit HIV while fully virologically suppressed on antiretroviral therapy, which has led to the community-based U=U (Undetectable = Uninfectious) campaign. Preliminary BC-CfE studies suggest the addition of targeted PrEP on a background of TasP markedly decreased HIV transmission.
Today, the BC-CfE is encouraging policymakers and healthcare leaders across Canada to strengthen their commitment and match the success of the BC TasP campaign nationally in an effort to meet the United Nations 95-95-95 by 2025 Target, as a necessary step to “End AIDS as a Pandemic by 2030”.

About TasP
The made-in-BC Treatment as Prevention strategy (TasP ) pioneered by BC-CfE, and supported by UNAIDS since 2011, inspired an ambitious global target for HIV treatment. The UNAIDS 90-90-90 Target to end AIDS as a pandemic by 2030 is a United Nations Sustainable Development Goal.
BC-CfE analysis shows that TasP is highly effective in stopping progression to AIDS and premature death among people living with HIV (PLWH), and for no additional cost, TasP is able to prevent HIV transmission, making this a cost-saving strategy. Indeed, today, we have reached a global consensus that PLWH are unable to transmit HIV while fully virologically suppressed on antiretroviral therapy, which has led to the community-based U=U (Undetectable = Uninfectious) campaign. Preliminary BC-CfE studies suggest the addition of targeted PrEP on a background of TasP can markedly decrease HIV transmission.

About PrEP

In British Columbia, HIV PrEP is available through the BC Centre for Excellence in HIV/AIDS (BC-CfE) Drug Treatment Program at no cost to qualifying patients deemed clinically at risk of HIV infection. Pre-exposure prophylaxis (PrEP) refers to the use of oral antiretroviral medications by HIV-negative individuals to reduce the risk of acquiring HIV infection. In this context, PrEP refers to ongoing use of antiretrovirals prior to and after potential exposure to HIV. PrEP differs from post-exposure prophylaxis (PEP) where a short course of standard three-drug antiretroviral therapy (ART) is used following a high-risk exposure event. Since 2010, six randomized controlled trials involving men who have sex with men (MSM), heterosexual HIV-serodiscordant couples, and people who inject drugs (PWID) have been published showing that tenofovir disoproxil fumarate(TDF)-based PrEP (in combination with emtricitabine (FTC), or in two studies as TDF alone) is effective as part of an HIV prevention package in individuals with high levels of adherence to medication (1-6).

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BC Centre for Excellence in HIV/AIDS announces the virtual end of the domestic HIV epidemic in British Columbia

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