British Columbia Researcher Helps China Fight HIV/AIDS

Chinese officials are looking to B.C. as they face the massive public health challenge of treating the country's estimated 740,000 people with HIV and 105,000 with AIDS.

Aside from the logistical obstacles to delivering treatment to so many people spread throughout a vast country, the bigger challenge still may be combating the stigma associated with the disease. Health care workers regularly refuse to treat or operate on HIV-positive patients, a recent study found.

Dr. Julio Montaner, director of the B.C. Centre for Excellence in HIV/AIDS based at St. Paul's Hospital, said Chinese health officials approached him several years ago for advice because of B.C.'s success over the last two decades in treating infected individuals and slowing the spread of the disease.

Montaner said in an interview that he was surprised to learn in February of this year that high-level Chinese officials had decided to use the made-in-B.C. treatment-as-prevention model as the centrepiece of China's overall strategy.

Several prominent studies have shown the benefits of treating HIVpositive patients with highly active anti-retroviral therapy (HAART), drugs that disrupt the virus's ability to replicate. Not only does the death rate go down, but the rate of transmission drops off significantly, Montaner said. Increased HAART coverage in B.C. has decreased overall HIV new diagnoses by greater than 60 per cent and by more than 50 per cent among injection drug users over the last three years, he said, adding that B.C. has virtually eliminated mother-to-child transmission. HIV-positive people in treatment in this province can also now look forward to a near-normal life expectancy.

B.C. researchers are helping Chinese officials adapt this province's model, which advocates widespread HIV testing and access to free HIV treatment to all medically eligible individuals, to the realities in that country, Montaner said. They are helping write protocols and providing background information and implementation ideas based on B.C.'s experience.

But in China, as elsewhere, the biggest obstacle to treatment continues to be the stigma associated with the disease, said Montaner, who will head to Beijing later this month to offer his thoughts on the progress the country is making. HIV-positive patients are regularly denied surgery or treatment in Chinese hospitals, according to a study released in May of this year by the International Labour Organization. HIV-positive patients were told by doctors they didn't want to risk operating on them for fear of infecting others.

Montaner said the problem is not specific to China. "I still face stigma and discrimination at all levels of our work. Doesn't really matter where we are. My patients tell me horror stories, still, with alarming frequency."

He is optimistic, however, that once health care workers in China learn that HIV patients treated with HAART are no longer likely to transmit the disease, the discrimination will start to disappear.

"If [the treatment-as-prevention model] can succeed in China, then we have a very likely possibility that it can succeed elsewhere."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.

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