Recommendations For Prevention Of Hiv Transmission In Health Care Settings In The Province Of British Columbia

This report represents the Interministry Committee's initial response to the British Columbia Framework for action on HIV/AIDS. It first expands on information & government actions described in the framework, reviews the current status of HIV and AIDS in the province, and discusses the role of the Committee, including its principles, goals, and objectives. It then presents an overview of existing HIV/AIDS-related policies & programs of various ministries & governments, including the federal government. The final section sets out future directions for HIV/AIDS-related policies & programs in British Columbia under the following broad headings: prevention & education; care, treatment, & support; research & training; and leadership & co-ordination of efforts. The appendix includes a list of goals & objectives under the Framework.

This document begins with an overview of the HIV epidemic in British Columbia and an outline of objectives & strategies of the province's response to this epidemic. Part 2 sets out the case for investment in HIV prevention & care and section 3 presents an epidemiological review of HIV & AIDS in British Columbia that shows how the single epidemic of the 1980s has become a series of epidemics affecting different groups of people. Part 4 reviews current HIV/AIDS initiatives & lessons from other jurisdictions, then presents a vision & guiding principles for the provincial HIV/AIDS strategy. Key strategies & objectives are listed under goals related to prevention, care, treatment & support, and co-ordination & co-operation, and the impact of the strategy on health care costs & on health programming is discussed. Part 5 outlines the roles & responsibilities of government, health authorities, & others in implementing the strategy. The final part lists indicators & data sources used to monitor progress in reaching the goals of the strategy. A glossary is appended.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

In 2014, the United States (US) Centers for Disease Control and Prevention (CDC) released comprehensive clinical practice guidelines for the use of PrEP in the US (8). [...] In 2015, the World Health Organization (WHO) released updated guidance on the use of PrEP for HIV prevention in populations at risk for HIV (9). [...] The Committee for Drug Evaluation and Therapy at the BC Centre for Excellence in HIV/AIDS has been tasked to provide guidance to BC clinicians for the use of TDF/FTC in the context of PrEP. [...] III GUIDANCE ON THE USE OF HIV PRE-EXPOSURE PROPHYLAXIS (PrEP) 1. Recommendations for PrEP in Men Who Have Sex With Men (MSM) and Transgender Women (TGW): PrEP is recommended for MSM and TGW at high risk of acquiring HIV infection (GRADE A recommendation for MSM; GRADE B recommendation for TGW). [...] Rationale for use of PrEP in MSM and TGW in BC: 1. MSM constitute the largest at-risk population in BC, making up over 50% of all new HIV diagnoses in the province (11).