Putting optimal health and well-being at the centre of HIV care, treatment, and support
Over the past 25 years, for people living with HIV who have access to combined antiretroviral therapy (cART), HIV has evolved from a progressive condition with a high fatality rate into a manageable chronic condition that many will live with into older age. Today, with early diagnosis and prompt treatment, people living with HIV can expect to live as long as the general population. Additionally, the number of people newly diagnosed with HIV annually in Canada increased 25.3% between 2014 and 2018. Longer life spans and greater numbers of new HIV diagnoses mean there is a growing number of people living with HIV (PLWHIV) across Canada. For people living with HIV, the shift from deadly infection to long‐term condition requires a corresponding shift in focus from basic medical management to improving health and wellbeing.
People living with HIV continue to face significant challenges: a higher risk of age-related conditions such as heart disease and osteoporosis; reduced quality of life resulting from years of treatment, side effects of treatment, and other health conditions that often accompany HIV; and persistent stigma and discrimination that can impact mental health and (when stigma or discrimination come from a healthcare professional) act as a barrier to accessing needed care.
Realize has taken a leadership role in investigating what optimal health and wellbeing mean to people living with HIV. Our goal is to better understand the supports and circumstances that contribute to optimal health and wellbeing for people living with HIV as well as the issues, barriers, and gaps that interfere with attaining it. This process has included: consensus-building activities with researchers, and health professionals; holding community consultations with people living with HIV; and co-hosting a series of meetings with subject matter experts and people living with HIV to conceptualize optimal health and wellbeing for this population. Read more about our work on optimal health and well-being and the work of the Optimal Health and Wellbeing in HIV Steering Committee.
Rehabilitation and other wellness supports/actions are among the tools that can help make a difference in optimal health and well-being – by helping people living with HIV (and other episodic disabilities) remain healthy, participate in the workforce and be active in their homes and communities. Realize defines rehabilitation as any services or activities that address or prevent body impairments, activity limitations, and social participation restrictions experienced by an individual. We bring together the traditionally separate worlds of HIV, disability, and rehabilitation – through leadership in research, education, and cross-sector partnerships. You can read more about HIV and rehabilitation in the linked pages in the secondary navigation of this page.
HIV and Rehabilitation Resources
Optimal Health and Wellbeing for People Living with HIV: The Role of Health Systems
In July 2021 Jeffery Lazarus et al. published the Consensus statement on the role of health systems in advancing
the long-term well-being of people living with HIV (“the statement”) in the journal Nature. The development of this
global statement involved participation from HIV experts from around the world, including two representatives from Canada. The statement culminated in six ‘key next steps’ to be taken by health systems to advance the long-term wellbeing of people living with HIV.
Realize, in collaboration with Gilead Sciences Canada Inc., and the National Community Advisory Group on
Optimal Health and Wellbeing (NCAG)*, coordinated six deliberative dialogues to determine whether the global
statement resonated with people living with HIV in Canada, and whether there are any modifications that should be made to ensure the ‘key next steps’ are relevant in the Canadian context.
This Report (Consensus Statement companion document) is the culmination of the deliberative dialogue process.
Optimal Health and Wellbeing in HIV: Opinion Paper
Optimal Heath & Wellbeing in HIV Steering Committee; 2021
Optimal Health and Wellbeing in HIV: From Prolonging Life to Quality of Life
An Opinion Paper from the Optimal Heath & Wellbeing in HIV Steering Committee
E-Module for Evidence-Informed HIV Rehabilitation
E-Module: E-Module for Evidence-Informed HIV Rehabilitation. Toronto, Canada. Author: Realize.
2020 Update