Researchers examine new and existing challenges this World AIDS Day

It has been more than four decades since the start of the HIV/AIDS pandemic, which has killed about 42.3 million people worldwide.  

While a diagnosis of HIV, the virus that causes AIDS, is no longer considered a death sentence, HIV/AIDS remains one of the world’s most serious public health challenges. Across Canada, some 62,790 people live with HIV. 

Health researchers at the University of Victoria are continuing to work on effective, responsive, and equitable HIV services while raising awareness of the history and continued impact of this pandemic.  

Ahead of World AIDS Day on Sunday (Dec. 1), read more about the good work of four researchers in the Faculty of Human and Social Development.  

Nathan Lachowsky

A community-based oral history project that captured the stories of HIV survivors and caregivers—and transformed them into theatre—has received funding to expand to other regions across Canada.

Nathan Lachowsky, a professor in the School of Public Health and Social Policy, received a $200,000 Social Science and Humanities Research Council (SSHRC) Partnership Development Grant to expand the HIV in My Day project.

The new grant builds on an existing partnership between UVic and the Community-Based Research Centre, as well as new partnerships between the Critical Health and Social Action Lab, Ontario HIV Treatment Network, and Pandemic Theatre, which will explore bringing the verbatim play In My Day to Ontario.

In My Day, written by Victoria-based playwright Rick Waines, premiered at Vancouver’s The Cultch theatre in 2022. The play’s script drew from almost 120 interviews, conducted between 2017 and 2020, which are publicly and digitally available online through UVic Libraries.

Lachowsky says the expanded project will support dialogue across Canada, as well as increase intergenerational and intercommunity awareness of people’s experiences with the HIV/AIDS pandemic.

“It is an honour to lift up the incredible stories of people living with HIV, and important that we share the history of HIV in Canada with new generations,” he says.

Ingrid Handlovsky

Discrimination towards Two-Spirit, lesbian, gay, bisexual, transgender, queer and other gender-diverse (2S/LGBTQ+) people is on the rise in Canada.

Ingrid Handlovsky, an assistant professor in the School of Nursing, says historical events offer valuable knowledge that can inform contemporary efforts to resist discrimination.

Her proposed research project will examine how gay men and allies effectively collaborated to resist discrimination to improve the lives of those living with HIV/AIDs in the pandemic’s early years. Handlovsky will interview 2S/LGBTQ+ community members and health and social service allies to better understand allyship and the roles and expectations of allies within collective action to resist discrimination.  

“I really want to understand how people came together meaningfully to effectively make change and uphold human rights in the absence of any public health response during this horrid crisis,” she says.  

Handlovsky’s research takes a strengths-based, community-engaged approach. Her previous work examined the quality of life of older gay men who lived through the HIV/AIDS pandemic before the introduction of highly active antiretroviral therapy in the mid-90s. She has also explored their experiences across two pandemics, HIV/AIDS and COVID-19.  

“We underestimate the far-reaching and diverse longstanding impacts that something like living through the HIV/AIDS pandemic means for people, and we can overlook there are things we need to be doing to offer meaningful supports,” she says.  

Tyrone Curtis

No vaccine exists for HIV but pre-exposure prophylaxis (PrEP), the daily use of oral antiretroviral medicines before potential HIV exposure, offers the next best thing.

For Tyrone Curtis, a postdoctoral fellow with the Community-Based Health Equity Research group in the School of Public Health and Social Policy at UVic, PrEP is an incredibly powerful preventative tool for people at higher risk of contracting HIV.

“If you’re adherent to this medication ,your chance of getting HIV is practically zero. In theory, we shouldn’t have any new HIV infections,” Curtis says.

After PrEP became more widely available in Canada in 2018, there was an initial decline in new HIV diagnoses in the country. Unfortunately, in 2022, 1,833 people were newly diagnosed with HIV in Canada, an almost 25 per cent increase on the previous year.

“We have this incredible intervention, but we’re still seeing new diagnoses of HIV every year. Why is that?” Curtis asks.

Curtis, who was awarded a three-year fellowship as a Michael Smith Health Research BC Research Trainee, focuses his research on inequities in access to PrEP, particularly for marginalized subpopulations of men who have sex with men. He is working with the Community-Based Research Centre in Vancouver and community members to make PrEP more equitable and accessible to underserved groups.

Curtis hopes newer long-acting forms of PrEP, which are given as injections every two-to-six months instead of oral tablets taken daily, will cause new HIV infections to decline once they become widely available.

Although access to PrEP is not universal across Canada, BC’s healthcare system covers the cost for those who are eligible, with similar programs in many other provinces. Curtis suggests speaking to your local sexual health clinic if you think you’d benefit from PrEP.

Kathleen Inglis

Kathleen Inglis is working to engage people with lived and living experience in big data HIV research.

Inglis is a Canadian Institutes of Health Research (CIHR) CTN+ and Health System Impact postdoctoral fellow at UVic and the BC Centre for Excellence in HIV/AIDS. She wants to build a framework for greater, authentic engagement of community members in data science research.

She is part of a collaborative community-led team that is using administrative health data research to examine the recurrence of cardiovascular events among people living with HIV compared to people living without HIV in BC.

“By their own experience and knowing of their peers’ experiences, the peer researchers knew that people were having cardiovascular events,” she says. “Having taken antiretroviral drugs in the early years, they were worried about the effects on them and their community.”

Inglis says data science research isn’t often community-led, so part of the group’s work is to figure out how it can be done well and to empower the community.

“I feel like my entire purpose is to make sure I am helping support HIV community members to do work that’s important to them,” she says.

Inglis says there is still a lot to learn about how people living with HIV are aging.

“HIV looks different now and it’s wonderful that it’s not considered a death sentence for some people in the world anymore, but there are still existing and new challenges.”

– 30 –