Grant: Project Grant

People living with HIV taking therapy can now live longer, but they are aging and are at high risk of acquiring other diseases such as cancer. HIV health care must now integrate prevention. As a research team of patients, providers, policy makers and researchers, we propose to use existing health databases to verify if we can improve prevention of cancer and maintain good health in this population. The overall goal of this study is to improve cancer prevention for people living with HIV using a learning health system approach. The primary objectives are: 1) To describe the 10-year successes in primary prevention through smoking cessation and HPV vaccination and identify factors associated with success; 2) To estimate the mean frequency of cancer screenings (cervical, breast, and colon cancer) over the past 10 years and identify factors associated with lower frequency than recommended; 3) To describe the prevention histories of cervical, breast and colon cancer cases diagnosed during the past 10 years, and measure overall incidence and mortality from cancer in the cohort; and 4) To co-design change to prevention strategies with stakeholders and measure the short-term impact of these changes. The Québec HIV Cohort includes more than 10,500 patients followed in one of the four largest HIV clinics in Québec, and it will be linked to Québec administrative health databases (Régie de l'Assurance Maladie du Québec, MED-ECHO, Fichier des décès) to answer our objectives. Patient-partners are part of the research team, and will be engaged in all steps of the research. This project will provide evidence and justification to rapidly improve prevention of cancers in people living with HIV, and will demonstrate the benefit of engaging patients in healthcare improvement. Our approach will provide justified, meaningful and sustainable solutions to improve primary care and maintain the wellbeing for people living with HIV locally and internationally.