Vancouver – British Columbia will be the first in Canada to use a new, more accurate HIV detection test following the results of a BC Centre for Disease Control study which found nucleic acid amplification testing (NAAT) greatly improved the diagnosis of early or acute HIV infection.
The study released today in the AIDS Journal estimated that between 25 and 75 new HIV infections were avoided as a result of a pilot program that has introduced and promoted the pooled NAAT method since April 2009 at six clinics accessed by gay and bisexual men in Vancouver.
Pooled NAAT detects the virus as soon as one to two weeks after the virus enters the body, compared to up to four weeks using standard HIV testing. During this very early stage of infection, people have a greater risk of transmitting HIV to others. As most patients with a new diagnosis change their behaviours and access HIV treatment, improving the diagnosis of acute HIV can help prevent new infections and reduce HIV transmission, which also lowers long-term costs to the health care system.
The study also concluded that the combination of pooled NAAT and social marketing campaigns was found to be highly effective in almost doubling the rate of acute HIV detection in the clinics, resulting in a 12 per cent increase in the total number of HIV diagnoses. In total, 25 men with acute HIV were diagnosed by pooled NAAT who otherwise would have received a negative result.
As a result of the success of the pilot program, the BC Public Health Microbiology and Reference Laboratory will maintain pooled NAAT at the six clinic sites in Vancouver and is collaborating with BCCDC to implement the test method at other clinics in the province.
This research was funded through the Canadian Institutes of Health Research and supported through the provincial STOP HIV/AIDS program. The investment of the provincial government in the STOP HIV/AIDS program and initiatives such as this has helped to increase the uptake of HIV testing and diagnosis and has improved the connection to HIV care and treatment.
Terry Lake, Minister of Health
“Our government is committed to reducing the spread of HIV by ensuring those living with HIV/AIDS have access to the best care and treatment, and it is very exciting that this groundbreaking research is going on right here in BC. As part of our vision of an AIDS-free generation, we’ve committed $19.9 million in annual funding to health authorities to support the expansion of STOP HIV/AIDS throughout BC, and we are the only province in Canada showing a consistent decline in new HIV diagnoses.”
Dr. Mark Gilbert, physician epidemiologist, Sexually Transmitted Infections, BCCDC; study co-author
“Accurate, timely test results means reducing the spread of HIV in the gay community. The sooner people know they have contracted HIV, the sooner their behaviour changes,”
Dr. Mel Krajden, associate medical director, BC Public Health Microbiology and Reference Laboratory; study co-author
“Using pooled HIV NAAT in populations where HIV is more common highlights how laboratories can add value to the health system. By rapidly identifying people when they are at the greatest risk of transmitting to others, secondary infections are reduced. Most importantly, the social, societal and cost impact of lifetime treatment can be substantially reduced.”
Wayne Robert, executive director, Health Initiative for Men; study co-author
“Gay men responded eagerly to the social marketing campaigns that for many introduced the concept of acute HIV and its impact on transmission. Their high recall of this message and appropriate uptake of this tool shows us that new information and response service that builds partnerships between researcher, health care provider and community organizations can have substantial impacts.”
Dr. Julio Montaner, Director, BC Centre for Excellence in HIV/AIDS
"Expanded HIV testing as part of the treatment as prevention approach has proven to be highly effective at improving community health outcomes. Earlier detection of HIV means we will be able to engage individuals into life-saving treatment sooner and prevent further HIV transmissions."
Study title - “Targeting screening and social marketing in British Columbia to increase detection of acute HIV infection in men who have sex with men in Vancouver, British Columbia”
Funding - The research was assisted through a $2.5 million grant from the Canadian Institutes for Health Research as part of a five year study of acute HIV infection in gay men. Pooled NAAT was also supported through resources provided from the Public Health Agency of Canada and funds through the provincial STOP HIV/AIDS program.
Other key findings:
- Social marketing campaigns developed during the period of the research and led by the Health Initiative for Men helped augment the impact of NAAT testing.
- Campaigns helped encourage more frequent testing including soon after a potential exposure to HIV. Testing awareness and promotion activities resulted in an increase over time in acute HIV diagnosis rates and more frequent HIV testing.
- 238 cases of HIV were diagnosed in BC last year, which is the lowest number of HIV diagnoses since the high point of 929 cases in 1987. Numbers have been declining historically.
- Gay, bisexual and other men who have sex with men (MSM) continue to comprise the greatest number of new HIV diagnoses in BC (63% of all new HIV diagnoses in 2012).
BC Centre for Disease Control, an agency of the Provincial Health Services Authority, provides provincial and national leadership in public health through surveillance, detection, treatment, prevention and consultation services. The centre provides both direct diagnostic and treatment services for people with diseases of public health importance and analytical and policy support to all levels of government and health authorities.
Alex Dabrowski, Communications, BC Centre for Disease Control
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