Grant: CIHR New Investigator

The substantial toll from the intertwined epidemics of addiction to illicit drugs and infection with viruses like HIV and hepatitis C remains a leading public health concern in Canada. People addicted to illicit drugs, especially those who use them via intravenous injection, suffer high levels of preventable morbidity and mortality from a variety of causes. Although much research to date has focused on interventions to prevent new cases of HIV and HCV, the determinants of access and adherence to treatment for these infections remain poorly investigated. Understanding ways to optimize treatment outcomes among drug users is becoming increasingly important, especially in light of new efforts to eliminate new cases of HIV through improved testing and care, such as the United Nations' recently announced 90-90-90 initiative, based on the Treatment-as-Prevention (TasP) approach. Over the next five years, my goal is to continue to develop my programme of rigorous and consequential research that contributes to efforts to reduce the extremely elevated rates of morbidity, mortality and associated healthcare costs among people addicted to illicit drugs. The objectives of my research programme are to identify contextual barriers to optimal HIV care; map areas of elevated levels of uncontrolled HIV infection and investigate their causes; evaluate new efforts to improve HIV/AIDS treatment outcomes, like harm reduction-based services; and evaluate knowledge and attitudes towards new treatments for hepatitis C virus infection. I will address these objectives using data from the ACCESS study, my ongoing prospective cohort study of approximately 900 HIV-positive people who use illicit drugs living in Vancouver's Downtown Eastside. My strong research foundation includes an appointment as an assistant professor at the University of British Columbia and a research scientist at the BC Centre for Excellence in HIV/AIDS.