HIV, Hepatitis C and Diabetes: Co-morbidities affecting HIV positive people
Co-morbidities are a vital and ever-growing area of focus for CTAC, particularly as growing numbers of people living with HIV age. This research project focuses on treatment access issues affecting people living with HIV and/or hepatitis C is diabetes.
Currently, 11 million Canadians are living with prediabetes or diabetes: this means that almost one in three people in Canada are affected by these conditions. In Canada, almost 35-44% of individuals remain unaware that they are living with diabetes, and are not getting the vital education, facts, and care needed to manage this serious disease.
Evidence shows that people living with HIV (PLWH) have a higher incidence of diabetes relative to the general population. Older age and obesity are associated with the development of diabetes, but data also shows that PLWH are more likely to develop diabetes at younger ages (without obesity) when compared to the general population.
Plus, certain factors specific to HIV itself, as well as the medications needed to treat HIV, put a person at greater risk of developing diabetes. Both HIV and diabetes have independent associations with cardiovascular disease, the leading cause of mortality in PLWH.
The risk for diabetes is also greater in people who have hepatitis C virus (HCV).
HIV and/or Hepatitis C and Diabetes: Comorbidities affecting HIV Positive People ‐ A Tip of an Iceberg
This publication is the outcome of research that included focus groups with people living with HIV and/or hepatitis C and diabetes, interviews with service providers, and a literature review.
Diabetes is manageable if individuals, communities, health care providers, and policymakers are given the information and tools to motivate and support behavioural change. Currently, there is a paucity of programming aimed at educating PLWH about the prevention and maintenance of their diabetes.
Strategies for chronic disease management, including for people living with HIV, must be expanded with a view to multimorbidity. Understanding factors that contribute to the risk of multimorbidity is important as this can assist in developing interventions to reduce modifiable factors, which in turn reduces multimorbidity.
As a result of this work, CTAC has uncovered a number of barriers that hamper the ability of PLWH, who are also living with diabetes, to optimally access treatment and care. The recommendations below are essential first steps to addressing these barriers.
Recommendation 1: Eliminate the deductible for Trillium, and the co-payments for the Ontario Disability Benefit (ODB).
Recommendation 2: Provide compassionate access to care and treatment for people without status in Canada. Equal and timely access to medications, as clinically appropriate, is important to all individuals living in Canada, especially for those with chronic diseases such as HIV, diabetes, and related complications.
Recommendation 3: Develop diabetes-specific information for PLWH (brochures/videos) that is easy to understand, and leads to participatory diabetes education programs in different, relevant languages.
Recommendation 4: Increase awareness of the symptoms and long-term complications of diabetes among PLWH, and health care providers, through a variety of methods including basic diabetes education, coping strategies, diabetes self-management education, reading food labels, healthy cooking classes, exercising etc.
Recommendation 5: Address the need for the incorporation of diabetic-friendly corners in food banks.
Recommendation 6: Stimulate networking and improved collaborations (ASOs, HIV specialists, endocrinologists, nurses, dieticians, Diabetes Canada etc.) to optimally support PLWH living with comorbidities, in ways that are inclusive of First Nations/Inuit/Métis communities. Management of HIV must gradually expand to include the chronic, and metabolic, complications of the disease, and the adverse effects associated with its treatments.
HIV and Diabetes: Impact and Action
CTAC’s new publication, HIV and Diabetes: Impact and Action, provides useful information about living with HIV and Diabetes.
It looks at the impact of living with HIV and Diabetes, and the actions that can be taken to mitigate the impact – including helpful tips about how to plan what’s best to eat.
The brochure includes quotes from focus groups with people living with HIV and Diabetes, which were conducted as part of this project. For more information please contact Rounak Khan, Director of Community Engagement, at firstname.lastname@example.org.