British Columbia

HIV spike among B.C. drug users associated with COVID-19-related service closures, research says

A new study says reduced access to HIV services amid early COVID-19 closures in British Columbia was associated with a "sharp increase" in HIV transmission among some drug users.

Study published Friday shows that virus spiked as people had less access to services in early 2020

A hand holding a fistful of syringes and needles.
An injection drug user deposits used needles into a container at the IDEA exchange, in Miami in 2019. A study has shown that HIV rates increased among some drug users in B.C. after services were closed in early 2020. (Lynne Sladky/The Associated Press)

A new study says reduced access to HIV services amid early COVID-19 closures in British Columbia was associated with a "sharp increase" in HIV transmission among some drug users.

The study by University of British Columbia researchers says that while reduced social interaction from March to May 2020 worked to reduce HIV transmission, that may not have "outweighed" the increase caused by reduced access to services.

The study, published in Lancet Regional Health, found that fewer people started HIV antiretroviral therapy or undertook viral load testing while services were shuttered, while visits to overdose prevention services and safe consumption sites also decreased. It used data that stretched from 1996 to 2021, and included thousands of samples.

The overall number of new HIV diagnoses in B.C. continues a decades-long decline.

But Dr. Jeffrey Joy, lead author of the report published on Friday, said he found a "surprising" spike in transmission among some drug users as businesses were closed.

Joy said transmission rates among drug users had previously been fairly stable for about a decade.

"That's because there's been really good penetration of treatment and prevention services into those populations," he said in an interview.

An outdoor space is seen covered by graffiti on a busy street.
The Overdose Prevention Site at 99 W Pender St. is one of the services that was closed in early 2020 amid COVID-19 health measures. (Ben Nelms/CBC)

B.C. was a global leader in epidemic monitoring, which means the results are likely applicable elsewhere, Joy said.

"We are uniquely positioned to find these things," he said. "The reason that I thought it was important to do this study and get it out there is [because] it's probably happening everywhere, but other places don't monitor their HIV epidemic in the same way that we do."

Rachel Miller, a co-author of the report, said health authorities need to consider innovative solutions so the measures "put in place to address one health crisis don't inadvertently exacerbate another."

"These services are the front-line defence in the fight against HIV/AIDS. Many of them faced disruptions, closures, capacity limits and other challenges," Miller said in a news release.

"Maintaining access and engagement with HIV services is absolutely essential to preventing regression in epidemic control and unnecessary harm."

"Although the long-term effects of disruptions to engagement with HIV care services are yet to be seen, mathematical modelling studies estimate the negative impacts to be substantial," the study reads.

The Health Ministry did not immediately respond to requests for comment.

Researchers said the spike among "select groups" could be attributed to a combination of factors, including housing instability and diminished trust, increasing barriers for many people who normally 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, alongside measures like safe supply and safe needle exchanges, will make a difference preventing similar issues in the future.

"The take-home message here is, in times of crisis and public health emergency or other crises, we need to support those really vulnerable populations more, not less," he said.

"Minimally, we need to give them continuity and the access to their services that they depend on. Otherwise, it just leads to problems that can have long, long-term consequences."