Project 459552

The ongoing drug overdose crisis has devastating effects on the health of the population in British Columbia (BC), with the number of overdoses increasing every year. People living with HIV (PLWH) are at increased risk to experience a drug overdose compared to people without HIV. A large majority of overdose events is not deadly. However, individuals who survived a drug overdose are at increased risk for adverse health outcomes, such as a repeated overdose and death from all causes, in the following year. Little is known about the health impacts of drug overdoses in PLWH. For example, PLWH using antiretroviral therapy (ART) may be at risk for HIV treatment failure (the inability of the ART regimen to suppress the virus) as a consequence of overdose complications and challenges to access health care. This project aims to improve understanding of the risk for adverse health outcomes following an overdose in PLWH, in order to provide recommendations for guidelines as part of a preventive strategy. I will make use of data from the Comparative Outcomes And Service Utilization Trends (COAST) study. COAST includes HIV treatment data on all PLWH, as well as routinely collected health data on all PLWH and a 10% random sample of the general population in BC, between 1992 and 2020. I will investigate whether PLWH, in the year following an overdose hospitalization, are at increased risk for a repeated overdose and death from all causes, compared to people without HIV. Furthermore, I will investigate whether PLWH using ART face increased risk for HIV treatment failure following an overdose, compared to PLWH who did not experience an overdose. Lastly, I will formulate recommendations for clinical guidelines for the care of PLWH who were hospitalized for an overdose, aiming to mediate the impact of overdose complications on health outcomes. Through focus group discussions, I intend to incorporate the perspectives of various stakeholders, including PLWH and health care providers.