Grant: CIHR REDI Early Career Transition Award - HIV/AIDS and STBBI

There are a high number of people living with HIV-PLHIV (38.4 million) and drugs-user (284 million) worldwide. Some studies have reported that drug use affects bacteria living in the body, but the relationship is poorly studied. In the same way, the bacteria in the body affect the risk of new Sexually Transmitted and Blood-Borne infections (STBBI). There is limited information about the new STBBIs different from HIV. Goal: To understand whether drug use is associated with changes in bacteria that live in the body (genitals, gut, and throat), the risk of new STBBI, and the HIV treatment outcomes (number of virus and CD4 cells in the body, and if the person takes their medications as prescribed). Objectives: We want to know the following: -How many PLHIV use drugs in Winnipeg -The effect of drug use on HIV treatment outcomes. -Whether drug use modified the bacteria living in the genitals, gut, and throat. -The bacteria changes are related to the new STBBI in PLHIV in Winnipeg, Canada. Methods: We will carry out two studies. The first one will use data from the Manitoba HIV Program to know the number of people using drugs and if the drug use affects the way people take HIV treatment. The second one will include a group of PLHIV (n=333) in Winnipeg to evaluate if drug use modified the HIV treatment outcomes and the bacteria living in the genitals, gut, and throat. We will collect, in the first meeting and the follow-ups (every six months), genital, respiratory, and fecal samples in a subgroup of randomly selected participants (n=60). We will also diagnose 10 STBBIs during the follow-ups. After that, we will correlate the changes in the bacteria that live in the body with the new STBBI. We will consider clinical, socio-demographical, and substance use information in both studies. These results will help health providers and researchers to design new strategies to improve HIV treatment adherence and decrease the new STBBI diagnosis.