Cohort profile: the STOP HIV/AIDS Program Evaluation (SHAPE) study in British Columbia, Canada

Abstract

PurposeThe Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) Program Evaluation (SHAPE) study is a longitudinal cohort developed to monitor the progress of an HIV testing and treatment expansion programme across the province of British Columbia (BC). The study considers how sociostructural determinants such as gender, age, sexual identity, geography, income and ethnicity influence engagement in HIV care.ParticipantsBetween January 2016 and September 2018, 644 BC residents who were at least 19 years old and diagnosed with HIV were enrolled in the study and completed a baseline survey. Participants will complete two additional follow-up surveys (18 months apart) about their HIV care experiences, with clinical follow-up ongoing.Findings to dateAnalyses on baseline data have found high levels of HIV care engagement and treatment success among SHAPE participants, with 95% of participants receiving antiretroviral therapy and 90% having achieved viral suppression. However, persistent disparities in HIV treatment outcomes related to age, injection drug use and housing stability have been identified and require further attention when delivering services to marginalised groups.Future plansOur research will examine how engagement in HIV care evolves over time, continuing to identify barriers and facilitators for promoting equitable access to treatment and care among people living with HIV. A qualitative research project, currently in the formative phase, will compliment quantitative analyses by taking a strengths-based approach to exploring experiences of engagement and re-engagement in HIV treatment among individuals who have experienced delayed treatment initiation or treatment interruptions.

Evaluation of a Public Health Referral System to Re-Engage Individuals Living With HIV Who Have Interrupted Antiretroviral Therapy in British Columbia, Canada

“…We did not find any sociodemographic or HIV exposure group factors which were associated with the likelihood of re-engaging in care. However, it is important to note that the proportion of men in this analysis, (74%) and MSM (24%) are lower than for the DTP as whole, 26 indicating that these groups are under-represented among those experiencing ART treatment interruptions in BC. It is notable that the DTP does not systematically collect data regarding substance use and mental health conditions, and our data on race or ethnicity is poorly captured.…”

Healthcare and treatment experiences among people diagnosed with HIV before and after a province-wide treatment as prevention initiative in British Columbia, Canada

“…This is the first study, to our knowledge, assessing both patient-level experiences and timeliness of clinical outcomes made before and after the implementation of a TasP strategy from 2010 onwards. This study includes a cohort of diverse and socio-demographically representative PLWH engaged in care across the province of BC, with proportional representation by age, gender, HIV risk group, and geography [ 16 ], and includes major lessons and important considerations for future TasP implementation programs that aim to optimize testing and treatment for all PLWH.…”

“…Beginning in January 2016 and ending in September 2018, our study team enrolled PLWH in a cohort known as the STOP HIV/AIDS Program Evaluation (SHAPE) study. The objectives of the SHAPE study were to evaluate the STOP program and to determine the HIV health care experiences and associated health care needs, beliefs, and behaviours of PLWH in BC, and the study has been described at length previously [ 15 , 16 ].…”