Why is BC restricting access to long-acting HIV treatment?

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      By Sarah Chown and M. Furqan Waleed

      For too long, people living with HIV in British Columbia have been waiting on the sidelines while the rest of the country gets access to the first long-acting HIV treatment. A much-awaited development, this treatment can greatly improve quality of life and community connection for those living with HIV.

      Three years ago, Health Canada approved Cabenuva: the first (and for now, only) HIV treatment that can last up to two months. For years, people living with HIV have been dreaming about this alternative to daily pills.

      However, in BC, the government currently provides long-acting HIV treatment only on a case-by-case basis, requiring additional approval processes to gain access. Ultimately, the decision on whether a person will receive long-acting treatment is made by someone who has never met the patient. Unlike other provinces and territories, in BC, people must prove they are unable to continue oral medications—a criterion without scientific evidence to back it up. This process also discourages health care providers and people living with HIV from even applying, knowing they will likely be told no. It is concerning that people living with HIV—including newcomers to Canada, many people living in poverty, and those without housing—are being blocked from long-acting treatment. In many of these situations, these individuals would have access to long-acting treatment if they simply lived in another part of Canada. This is particularly true for First Nations people who have broad access to long-acting HIV treatment across the country, except here in BC.

      We work with people living with HIV every day and hear from folks who are distressed because they cannot access a medication that they, and their care providers, believe is best. Before the long-acting treatment option, taking medically necessary pills every single day, for a lifetime, was the reality for people living with HIV. The pill can be a daily reminder of the many loved ones lost to HIV before treatment, or the sexual assault that led to an HIV diagnosis; there’s also the general day-to-day stressors of trying to remember if you took the pill, and wanting to ensure that the pills—and the diagnosis behind them—stay private. Some people worry about roommates finding pills in their medicine cabinet or backpacks. The reality is, too many people living with HIV still experience stigma and violence because of their HIV status. Giving people privacy and relief from this daily pressure is one reason long-acting treatments are sought after.  

      Cost and logistics aren’t a barrier in other provinces, and it does not make sense why they would be a unique issue here. Many clinics in BC are ready to make treatment happen now, and are just waiting for the BC Government to give the green light.

      Over three years after its approval by Health Canada, the fact we don’t have a solution in BC is disappointing and underserving the HIV community. A person living with HIV recently told us it feels like they are being shut out of a decision about their own health, and that they are not being heard.

      This is an issue of equity. Many people in BC are asking for access to long-acting HIV treatment options, including Indigenous people, people living with HIV since childhood, and refugees. Hearing from these communities is why we are working together with community organizations across the province on our letter-writing campaign to BC MLAs and the Minister of Health.

      Long-acting HIV treatment is a huge scientific win. BC is known as an international leader in HIV innovation and treatment. Why are we falling behind now?  

      We’re confident British Columbians will agree that it’s unfair that people cannot access a drug that will improve their quality of life simply because they live in this province. People can make their voices heard by visiting here to urge the BC Government to give broad access to long-acting HIV treatment now.

      Sarah Chown is executive director at AIDS Vancouver. M. Furqan Waleed is director of programs at YouthCO.