BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Curr HIV/AIDS Rep. 2012 Dec;9(4):394-400. doi: 10.1007/s11904-012-0130-z.
The scope and scale of the HIV outbreak that occurred among injection drug users in Vancouver in the late 1990s was unprecedented and resulted in some 2,000 new HIV infections, with incidence rates reaching 18 per 100 person-years. This outbreak, localized mainly in one neighbourhood, cost the Canadian health care system more than 1 billion dollars to diagnose, care and treat. A number of factors combined to stabilize HIV incidence: 1) HIV prevalence became saturated among those at highest risk; 2) several public health policies focused on drug users were implemented, including increased and additional decentralized needle exchange programs, expanded methadone maintenance services, better addiction treatment services, improved housing, and mental health programs; and 3) increased access and expansion of Highly Active Antiretroviral Therapy. To ensure that a similar outbreak never occurs again in Vancouver and other cities, future health policy must consider the political, psychosocial and socioeconomic factors that contributed to this outbreak. These policies must address the unintended adverse consequences of past policies and their repercussions for marginalized individuals living in this community and beyond.
20 世纪 90 年代末，温哥华注射吸毒者中爆发的艾滋病毒疫情规模空前，导致约 2000 例新的艾滋病毒感染，发病率达到每 100 人年 18 例。这场疫情主要局限在一个街区，加拿大医疗保健系统为此花费了超过 10 亿美元来诊断、护理和治疗。以下几个因素结合起来稳定了艾滋病毒的发病率：1）高危人群中的艾滋病毒流行率达到饱和；2）实施了一些针对吸毒者的公共卫生政策，包括增加和扩大分散的针具交换计划、扩大美沙酮维持治疗服务、更好的成瘾治疗服务、改善住房和心理健康项目；3）获得和扩大高效抗逆转录病毒治疗的机会。为了确保温哥华和其他城市不再发生类似的疫情爆发，未来的卫生政策必须考虑导致此次疫情爆发的政治、心理社会和社会经济因素。这些政策必须解决过去政策的意外负面影响及其对生活在该社区及其他社区的边缘化个人的影响。
