Background: Only 15% of people in prison with chronic hepatitis C virus (HCV) are linked to HCV care following release from Quebec provincial prisons. We evaluated the impact of a prison-based model of care in the largest provincial adult male prison in Quebec on linkage to HCV care following community re-entry.

Methods: We conducted a prospective, single arm study; men sentenced 2-12 weeks were approached. Participants underwent nurse-led point-of-care HCV-antibody (HCV-Ab) testing (fingerprick OraQuick® test). HCV-Ab+ individuals underwent confirmatory HCV RNA testing via venipuncture. HCV RNA+ individuals were assessed by a social worker, who provided community referrals, and a patient navigator, who accompanied participants to their post-release appointment. The primary outcome was linkage to care, defined as the proportion of individuals who presented for an HCV appointment within 30 (“early linkage”) or 90 days (“delayed linkage”) from release. Secondary outcomes included the proportion of released individuals who initiated direct-acting antivirals (DAAs), completed DAAs, and achieved sustained virologic response (SVR).

Results: From January 7, 2020 to December 21, 2022 (interrupted by the COVID-19 pandemic), 335/461 (73%) incarcerated individuals agreed to participate. Overall, 32 (10%) were HCV-Ab+ and 12 (38%) were HCV RNA+ (0 co-infected with HIV). Median age was 43 years; nine (75%) self-identified as white and seven (58%) reported injection drug use one week prior to incarceration. Of the 12, seven (58%) were linked to care, four and three within 30 and 90 days of release, respectively. Of these, six (86%) initiated and five (71%) completed DAAs and, among the three with SVR data, three (100%) achieved SVR.

Conclusions: A multidisciplinary model of care increased linkage to HCV care by four-fold among untreated individuals released from a Quebec provincial prison. Public policy should support similar models of care to promote linkage to care and treatment uptake in this high-risk population.

Objectives: Our objective is to describe the frequency and type of sexually transmitted and blood-borne infections (STBBIs) amongst people living with HIV (PLHIV) in Manitoba prior to their HIV diagnosis, at entry into HIV care, and during follow-up, disaggregated by sex at birth, gender, drug use, and unstable housing.

Methods: A retrospective cohort study was completed. Clinical charts of all people ≥18 years old newly diagnosed with HIV in Manitoba, Canada between January 1st, 2018 and December 31st, 2021 were reviewed. We collected sociodemographic data such as sex at birth, gender, and age, as well as information regarding housing status, prior or current drug use, including use of injection drugs, past and current STBBIs.

Results: 90% of females and 83.3% of males newly living with HIV in 2021, presented with at least one STBBI prior to their HIV diagnosis. At time of HIV diagnosis 88.9% of females and 86.3% of males had a concurrent STBBI. Between 2018-2021, 25-40% of newly diagnosed PLHIV experienced houselessness and had higher proportions of multiple concurrent STBBIs compared to those with stable housing. People who inject drugs had higher numbers of concurrent STBBIs at time of HIV diagnosis, and the number of STBBIs among PWID increased from 2018-2021. Rates of syphilis, hepatitis C virus, Chlamydia and Gonorrhea all increased from 2018-2021. In 2021 56% of newly diagnosed PLHIV had a syphilis infection and 42% had a hepatitis C virus infection at time of diagnosis.

Conclusions: The significant burden of additional STBBIs prior to HIV diagnosis, and during HIV follow up support the need for comprehensive STBBI testing, point-of-care testing and treatment and greater resources to prevent STBBI transmission, particularly among at-risk groups.

Les hommes ayant des relations sexuelles avec d’autres hommes (HARSAH) ont un risque accru d'infections sexuellement transmissibles (IST). Les données sur les IST chez les HARSAH sont rares au Bénin. Cette étude visait à évaluer la prévalence et les facteurs associés à Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) et Treponema pallidum (TP) chez 204 HARSAH VIH-négatifs de Cotonou au Bénin. Un questionnaire a été complété et les participants ont subi un examen physique fait par un médecin. Des échantillons de sang, anaux, pharyngés et urinaires ont été prélevés. Les prévalences des IST ont été présentées avec un intervalle de confiance à 95% et la régression de Poisson a permis d’identifier leurs déterminants. La prévalence était de 18,6%, 15,2%, 9,8% et 27,9% pour CT, NG tous sites confondus, NG anorectal et NG/CT respectivement. La co-infection CT/NG était de 21% et la localisation multisite de 6,9%. Les IST étaient généralement asymptomatiques (84,2% pour CT/NG) et de localisation extra-génitale (61,4% pour CT/NG). Un seul cas de syphilis non confirmée a été observé. En analyse multivariée, le fait d’avoir moins de 25 ans, de ne pas être célibataire et d’avoir plus de quatre partenaires féminines était associé à CT et CT/NG alors qu’un faible revenu mensuel était associé à CT/NG seul. Le jeune âge, le sexe anal réceptif et les rapports sexuels payants étaient associés à NG. Seul le sexe anal réceptif était associé à NG anorectal. Les infections à CT et à NG sont fréquentes chez les HARSAH VIH-négatifs de Cotonou au Bénin. Leur caractère asymptomatique et extra-génital rend la prise en charge syndromique inefficace et le dépistage aux sites anal et pharyngé incontournable. La syphilis est rare chez ces HARSAH. Les interventions de contrôle et de prévention devraient cibler particulièrement les jeunes HARSAH et leurs partenaires sexuelles féminines.

Background: We describe demographics, antiretroviral treatment during pregnancy, and vertical transmission rates in the Canadian perinatal HIV surveillance cohort of births to women living with HIV (WLWH) and assess the effect of the COVID-19 pandemic on access to optimal therapy and perinatal transmission.
Methods: 22 Canadian pediatric and HIV centres update data including demographics, antiretroviral treatment during pregnancy, and perinatal transmission, on births in WLWH yearly each January. The results reported in this abstract reflect births up to the end of 2021.
Results: The number of HIV-exposed infants per year has increased over time in Canada, but experienced a 17% downturn from 254 births in 2020 to 210 births in 2021. The biggest change was amongst Black women, in whom the number of births decreased from 151 in 2020 to 108 in 2021. The proportion and number of pregnant women sub-optimally treated was 6.6% (86/1297) in the period from 2015-2019 compared to 7.7% (12/155) in May-December 2020; the rate in 2021 was only 4.8% (10/210). The corresponding transmission rates were 1.3% (17/1297) in 2015-2019, 3.2% (5/155) in May-December, 2020, and reverted to 1% (2/210) in 2021. Among those who had acquired HIV through IDU, the sub-optimal treatment rate was 13.6% in the pre-COVID-19 period, 26.1% (6/23) during 2020, and reverted to 7.7% (3/39) in 2021.
Conclusions: The perinatal transmission rates in 2015-19, May-December 2020, and 2021, are consistent with a negative impact during the first year of the pandemic, and resilience in the second year. This was mirrored by the decline of the sub-optimal treatment rate from 2020 to 2021 in women who had contracted HIV through injection drug use. The decline in births in WLWH may reflect a change in reproductive decisions during the pandemic.

Background: Persons living with HIV are at increased risk for severe outcomes if infected with COVID-19. Thus, these individuals were eligible for immunization during the early COVID-19 vaccine roll out, ahead of the general population. This study aimed to: (1) explore COVID-19 vaccine uptake, cases, deaths, and hospitalizations among those with HIV residing in Saskatchewan First Nations communities, and (2) compare the findings of objective (1) with provincial and national data.

Methods: Individuals included in the analysis were persons residing in Saskatchewan First Nations communities who were living with HIV as of March 11, 2020 (declaration of the global COVID-19 pandemic by the WHO). Case-based data from Saskatchewan’s public health surveillance system, Panorama, was used. The variables of interest were total COVID-19 vaccinations, cases, deaths and, ICU and non-ICU hospitalizations.

Results: Overall, among persons living with HIV (PLWH) in Saskatchewan First Nations communities, COVID-19 vaccine uptake rates were lower than in Saskatchewan and Canada. Additionally, when compared to the general Saskatchewan and Canadian populations, the COVID-19 case rate was higher among PLWH in Saskatchewan First Nations communities, while the death and ICU hospitalization rates were lower. See Table 1.

Conclusions: Despite low COVID-19 vaccination rates and high case rates among PLWH in Saskatchewan First Nations communities, there were no reported COVID-19-related deaths or ICU hospitalizations. This could possibly be due to the public health measures that were put in place as well as the continuation of services provided by HIV programs (including Know Your Status programs) during the pandemic.

Background: The COVID-19 pandemic resulted in disruptions to sexual health services as well as changes to sexual and health-seeking behaviours. The objective of this study was to examine the impact of the COVID-19 pandemic on syphilis and HIV screening in British Columbia (BC), Canada.

Methods: Monthly HIV and syphilis test episodes (30-day window) in BC from January 1, 2018 to June 30, 2022 were examined. Analysis periods were: 1) Pre-Pandemic (January 2018-February 2020); 2) Pandemic – Initial Restrictions (April 2020); and 3) Pandemic – Subsequent Restrictions (June 2020-June 2022; following gradual re-opening of services in BC beginning May 2020). March 2020 and May 2020 were excluded as transition periods. Segmented regression analyses were conducted to assess level and trend changes in syphilis and HIV screening volumes, with adjustment for seasonality and autocorrelation.

Results: Mean monthly pre-pandemic HIV and syphilis screening rates per 100,000 population were 630.4 and 389.6, respectively. During initial restrictions, there were immediate level decreases of 56% for HIV screening (303.8 tests per 100,000; rate ratio [RR] = 0.44 [95% CI: 0.41-0.48, p<0.0001) and 66% for syphilis screening (138.3 tests per 100,000; RR = 0.34 [95% CI: 0.31-0.37, p<0.0001]). During subsequent restrictions, HIV and syphilis screening levels partially recovered (HIV screening RR = 0.82 [95% CI: 0.80-0.85, p<0.0001]; syphilis screening RR = 0.75 [95% CI: 0.72-0.78, p<0.0001]) though remained below pre-pandemic levels, with monthly averages of 561.6 and 345.2 tests per 100,000, respectively. In June 2022, monthly screening rates remained at -22% (HIV) and -24% (syphilis) from the counterfactual.

Conclusion: In BC, HIV and syphilis screening declined as a result of the COVID-19 pandemic, with screening levels not having returned to counterfactual levels by June 2022. Decreased screening for HIV and syphilis may result in delayed diagnoses and undetected infections, potentially leading to increased clinical complications and transmission.