My daughter has a smartphone cover that says: “We’re all mad here”. It’s from Alice in Wonderland. I like it; and when it comes to hepatitis C treatment and pricing, it’s quite on point.
In 2014, Canada and the rest of the world turned a miraculous corner – a cure for viral hepatitis C was on the market. Wonderful and amazing. Why? Well, viral hepatitis C is the only chronic viral infection that now has a cure – that is, a cure for virtually everyone, with a cure rate of 95 per cent.
One of the most memorable moments in my 20 years working in the HIV field happened in a standing-room-only meeting hall in Vienna at the International AIDS Conference in 2010. This was the moment that the clinical trial CAPRISA 004 announced proof-of-concept for prevention of HIV among women using a vaginal microbicide (1% tenofivir gel). The entire room broke out in a standing ovation and tears of joy. Finally! A prevention tool that could allow a woman to protect herself in sexual encounters, regardless of the desires and wishes of her sexual partner. Five years later, microbicides have not yet come to fruition. But pre-exposure prophylaxis (PrEP) holds the same great promise.
The administration of naloxone, a chemical compound that effectively temporarily reverses the effects of an opioid overdose, is recommended by the World Health Organization to be used in the case of an opioid overdose. Naloxone is currently available in Canada only in an injectable form and by prescription only; it can only be administered to the person named on the prescription, not to a third party. With the objective of making naloxone more widely available in Canada to address the growing number of opioid overdoses, and consequent on a review of health and safety data, Health Canada has suggested an amendment to the prescription drug list to allow non-prescription use of naloxone specifically for emergency use for opioid overdose outside hospital settings. A public consultation on the proposal has been initiated and if the change in status continues to be supported by consultation evidence, the change will be finalized.
Lesbian, bisexual and queer women are rarely included in HIV research. Women who have sex with women, and their HIV infection rates, are not captured anywhere because women cannot report having a woman as a sexual partner in Canada’s HIV statistics. The current record only allows women to report HIV exposure either through injection drug use or heterosexual sex. This contributes to the erasure of women’s sexual and gender diversity and fluidity in HIV research. Queer* women are ignored in HIV research: this is a problem and here is why it matters.
There are a lot of new test technologies in the pipeline: both new types of tests in the works, such as rapid syphilis tests or point-of-care HIV viral load testing, and new ways to use existing tests, such as self-testing or online testing.
As testing options increase, we need to think about where they will have the most impact. I learned about this from helping implement a new test technology called pooled nucleic acid amplification testing (pooled NAAT) at six clinics in Vancouver in 2009, as part of a research study to determine the impact of this new type of test on gay men’s lives. With pooled NAAT, blood samples that are negative on a routine screen for HIV antibodies are automatically tested for HIV RNA. This shortens the HIV window period to 10-12 days and means that individuals with very early or acute infection – when HIV viral load and chances of transmission are high – can be diagnosed at a time when standard tests are negative.
The CATIE Blog hosts the views and opinions of people and organizations working and volunteering in Canada’s response to HIV and hepatitis C.