British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
BMJ Open. 2020 May 12;10(5):e033649. doi: 10.1136/bmjopen-2019-033649.
The 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.
Between 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.
Analyses 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.
Our 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.
“寻求和治疗以实现艾滋病毒/艾滋病最佳预防（STOP HIV/AIDS）”计划评估（SHAPE）研究是一个纵向队列研究，旨在监测不列颠哥伦比亚省（BC）艾滋病毒检测和治疗扩大计划的进展。该研究考虑了性别、年龄、性身份、地理位置、收入和族裔等社会结构决定因素如何影响艾滋病毒护理的参与。
2016 年 1 月至 2018 年 9 月期间，644 名至少 19 岁且被诊断患有艾滋病毒的 BC 居民参加了该研究，并完成了基线调查。参与者将完成另外两次关于他们的艾滋病毒护理经验的后续调查（相隔 18 个月），同时持续进行临床随访。
对基线数据的分析发现，SHAPE 参与者的艾滋病毒护理参与度和治疗成功率很高，95%的参与者接受抗逆转录病毒治疗，90%的参与者实现了病毒抑制。然而，与年龄、注射吸毒和住房稳定性相关的艾滋病毒治疗结果持续存在差异，在向边缘化群体提供服务时需要进一步关注。
我们的研究将检查艾滋病毒护理的参与度如何随时间演变，继续确定促进艾滋病毒感染者获得治疗和护理的平等机会的障碍和促进因素。一个目前处于形成阶段的定性研究项目将通过采取基于优势的方法来补充定量分析，探索经历延迟治疗开始或治疗中断的个体在艾滋病毒治疗中的参与和重新参与的经验。
