B.C. experts join Indiana team to fight HIV crisis

VANCOUVER — Worldrenowned HIV experts from British Columbia are stepping in to help control a massive outbreak of the disease in rural Indiana.

The B.C. Centre for Excellence in HIV/AIDS is partnering with Indiana University’s school of medicine in an effort to stymie an epidemic in Scott County where 184 people have tested positive for HIV since December 2014.

Nearly 10 per cent of the county’s 4,200 residents are believed to be injection drug users, with many crushing and injecting the opioid painkiller Opana.

The B.C. Centre for Excellence is known for its innovative “treatment as prevention” approach to HIV, where patients who test positive for the virus immediately receive free treatment to stop its transmission from progressing and reduce the chance of others getting infected.

“We wanted to be able to collaborate with them because thus far, we’ve not had an HIV outbreak such as what we’re seeing in Indiana, in Scott County, in a rural setting in the United States,” said Dr. Diane Janowicz, an expert in infectious disease at Indiana University.

Combining treatment as prevention with harm reduction and addiction management has brought epidemic levels of HIV in Vancouver’s Downtown Eastside virtually under control, said Dr. Julio Montaner, director of the B.C. Centre for Excellence.

“What the Indiana colleagues are trying to do is learn from our experience and trying to export and adapt this strategy that has proven so successful here,” he said.

The two-year partnership — funded in part by the National Institute on Drug Abuse — will focus on research instead of treatment, looking at what factors influence a patient in accessing care or prevention tools.

Since the HIV epidemic began in Scott County, several groups have been working to provide treatment options, including a needle exchange.

About 130 kilometres south of Indianapolis, Scott County is an economically deprived area where many live below the poverty line, Janowicz said. The economic challenges often mean people don’t have health insurance and need to be enrolled in the state Medicaid program before they can access care.

The centre’s treatment as a prevention strategy has already been used in several other countries including China, France and Panama. It was also adopted by the United Nations as part of a plan to significantly reduce HIV rates by 2020.

Montaner said he is convinced the strategy could stop the spread of the HIV epidemic in Indiana, too.