Since Highly Active Antiretroviral Therapy was introduced in 1996, HIV treatment has transformed HIV from a condition with a high fatality rate into a manageable chronic health condition. Today, early diagnosis, and effective treatment mean that people living with HIV can expect to live almost as long as the general population. This shift from deadly infection to long‐term illness requires a corresponding shift in focus from saving lives to improving health and wellbeing. The focus of most international, national, and regional programs seems to be on the UNAIDS 90-90-90 targets and the ultimate goal of achieving an undetectable viral load (reference UNAIDS, PHAC 90-90-90 endorsement, provincial HIV/AIDS plan).
In April of 2018, the Optimal Health and Wellbeing in HIV Steering Committee (now known as the National Community Advisory Group on optimal health and wellbeing in the HIV community – NCAG) was formed to address the challenges associated with long-term management of HIV in a Canadian context, beyond the 90-90-90 targets. Through multiple conversations and much deliberation, the Steering Committee arrived at six key “Calls to Action”, each with corresponding next steps and recommendations. Based on these calls to action, the Optimal Health and Wellbeing in HIV: Opinion Paper was developed to spark ongoing discussion and debate on how to maximize quality of life for people aging with HIV in Canada.
The concept of optimal health and wellbeing beyond 90-90-90 is not new. In 2017, a European initiative called “HIV Outcomes: Beyond viral suppression” launched a set of recommendations focused on optimal health and wellness for people living with HIV that were shared with the European Parliament (https://hivoutcomes.eu/). In July 2021, the Co-Chairs of HIV Outcomes spearheaded the publication of a Consensus statement on the role of health systems in advancing the long-term well-being of people living with HIV in the academic journal Nature. Realize is one of the many global signatories on this statement. Working with the NCAG, in February 2024, Realize published a Canadian companion doc to the Global Consensus Statement.
With our Canadian Optimal Health and Wellbeing in HIV: Opinion Paper, we have joined a chorus of voices around the world that are advocating for change; the addition of a 4th “90” incorporating quality of life and wellness for people living with HIV into the HIV care cascade.
Relevant Documents
Optimal Health and Wellbeing for People Living with HIV: The Role of Health Systems
Optimal Health and Wellbeing in HIV: Opinion Paper
Living your best life with HIV: Recommendations for Policy Makers
Living your best life with HIV: Recommendations for Healthcare Practitioners
Living your best life with HIV: Recommendations for Researchers
Living your best life with HIV: Recommendations for Community-Based HIV Organizations
“HIV Outcomes: Beyond viral suppression”
COVID-19 and Physical Activity
Upcoming Events
Please email Puja Ahluwalia, National Lead: Rehabilitation, Optimal Health and Wellbeing at pahluwalia@realizecanada.org if you have any upcoming events related to Optimal Health and Wellbeing to share.
Previous Events
Real Talk with Realize:HIV and Chronic Pain
- Video – coming soon
Workshop on Healthy Living with HIV 2021
3rd Canadian HIV & Aging Symposium and HIV & Aging “Unconference”: HIV and Aging WELL: WE Live & Learn Together
- Videos – HIV & Aging Symposium videos coming soon
Living Your Best Life – Community Consultations and National Meetings
Gauging Gaps and Gaining Ground: A Pan-Canadian Perspective on HIV and Aging Research and Setting Research Priorities – Think Tank
Real Talk with Realize: HIV, Brain Health, and the Role of Physical Activity
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