Julio Montaner
Datos Biográficos
| ID | 1735657 |
|---|---|
| NOMBRE | Julio Montaner |
| NOMBRES | Julio |
| APELLIDO | Montaner |
| FIRMA | MONTANER J |
| AFILIACIONES | University of British Columbia |
| ORCID | 0000-0002-6201-9829 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 144 |
| TOTAL DE CITAS | 95 |
| TOTAL COMO AUTOR | 144 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2000 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 6 |
Removing barriers to care
Healthcare Provider Strategies and Approaches to Supporting People Living With HIV Who Are Experiencing HIV Treatment Disengagement in British Columbia, Canada
We conducted a strengths-based, qualitative study to elucidate the approaches and strategies utilized by healthcare providers (HCPs) to support HIV treatment engagement in British Columbia (BC), Canada. Healthcare providers (e.g., nurses, peer navigators, and pharmacists) across the province of BC were recruited through regional HIV programs and by word of mouth through purposive sampling strategies. An academic and community researcher co-conduc…
Housing matters
Dynamics of overdose and non-overdose mortality among people living with HIV amidst the illicit drug toxicity crisis in British Columbia
We sought to characterize overdose and non-overdose mortality among PLWH amidst the illicit drug toxicity crisis in British Columbia, Canada. A population-based analysis of PLWH (age ≥19) in British Columbia accessing healthcare from April 1996 to March 2017 was conducted using data from the Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) cohort linkage. Underlying causes of deaths were stratified into overdose and non-overdose …
Impact of Substance Use and Mood/Anxiety Disorders on the HIV Continuum of Care in British Columbia, Canada, from 2001 to 2019
Retention in primary care among unstably housed residents of a low-income, inner-city neighborhood with a high prevalence of substance use and related disorders
We found that a primary healthcare model of care was successful in retaining over two-thirds of clients in primary healthcare after more than 18 months of follow-up. Additional supports for those diagnosed with alcohol use disorder are needed to retain them in care
Hour Induction of Transdermal Buprenorphine to Buprenorphine Extended-Release
Buprenorphine is an effective treatment for opioid use disorder but can be slow when using a standard low-dose titration protocol to avoid precipitated withdrawal. This presents a substantial practical barrier in clinical practice. Recent low-dose induction strategies have attempted to simplify and shorten the process required for successful induction, including our own transdermal buprenorphine method, which achieves induction to sublingual bupr…
Associations between psychosocial factors and antiretroviral therapy outcomes differ by gender and sexual orientation among people living with HIV in British Columbia, Canada
Little is known about how the co-occurrence of psychosocial factors affect sub-populations of people living with HIV (PLWH). We used cross-sectional data from 999 PLWH, aged ≥19, accessing antiretroviral therapy (ART) in British Columbia, Canada (2007-2010) to examine associations between psychosocial factors and ART-related outcomes separately for trans/cis inclusive women; heterosexual men; and gay, bisexual, and other men who have sex with men…
Treatment interruptions and community connectedness among gbMSM living with HIV in Metro Vancouver, Canada
public health concern that demonstrate a lack of engagement in care and is detrimental to the health of people living with HIV. Community connectedness have demonstrated a protective effect for psychosocial health but are not well understood for HIV treatment outcomes. We explored associations between community connectedness and treatment interruptions among gay, bisexual and other men who have sex with men (gbMSM) living with HIV in Vancouver, B…
Examining the secondary impacts of the Covid-19 pandemic on syndemic production and PrEP use among gay, bisexual and other men who have sex with men (GBM) in Vancouver, Canada
There were increasing PrEP interruptions since March 2020. However, those most at risk for HIV were less likely to have interruptions. Additional mental health services and targeted follow-up for PrEP continuation may help to mitigate the impacts of the COVID-19 pandemic on GBM
Disability-adjusted life years associated with chronic comorbidities among people living with and without HIV
Life span of people living with HIV (PLWH) has increased dramatically with the advent of modern antiretroviral therapy. As a result, comorbidities have emerged as a significant concern in this population. To describe the burden of chronic comorbidities among PLWH and HIV-negative individuals in British Columbia (BC), Canada, we estimated disability-adjusted life years (DALYs) related to these comorbidities. Based on a population-based cohort in B…
Healthcare and treatment experiences among people diagnosed with HIV before and after a province-wide treatment as prevention initiative in British Columbia, Canada
We found favourable treatment experiences and more timely ART initiation and virologic suppression after a targeted TasP provincial program. Our results illustrate the importance of accessible low-barrier HIV testing and treatment in tackling the HIV epidemic
The opioid crisis is driving mortality among under-served people living with HIV in British Columbia, Canada
Overdose is - the leading cause of mortality among a cohort of under-served PLWH in BC, Canada. Public health efforts to end the HIV epidemic and support the health and well-being of PLWH are being thwarted by persistent health inequities and the enormous and persistent risks facing people who use drugs. Integrated low-barrier primary care is essential for supporting under-served PLWH, and safe drug supply is needed to support PLWH who use drugs
Overdose mortality is reducing the gains in life expectancy of antiretroviral-treated people living with HIV in British Columbia, Canada
Disparities in multimorbidity and mortality among people living with and without HIV across British Columbia’s health regions
Crystal Methamphetamine Use and Initiation among Gay, Bisexual, and Other Men Who Have Sex with Men Living with HIV in a Treatment as Prevention Environment
Background Risk compensation in an HIV Treatment as Prevention (TasP) environment may increase high-risk sexual and substance use behaviors among people living with HIV. Objective: To examine recent crystal methamphetamine (CM) use/initiation in a longitudinal cohort of gay, bisexual, and other men who have sex with men (GBMSM) living with HIV in Metro Vancouver, Canada. Methods: Eligible participants were GBMSM aged >15 years who reported sex wi…
Longitudinal Factors Associated with Used Syringe Lending Among HIV-Positive Antiretroviral Therapy-Naïve People Who Inject Drugs in a Canadian Setting
The impact of high-dose opioid prescription on mortality rates among people living with HIV
Factors associated with delayed and late ART initiation among people living with HIV in BC
We examined correlates of late and delayed initiation of antiretroviral therapy (ART) in British Columbia, Canada. From December 2013 to December 2015 we recruited treatment-naïve people living with HIV who initiated ART within the previous year. 'Late initiation' was defined as CD4 cell count ≤500 cells/μL at ART initiation and 'delayed initiation' as ≥1 year between HIV diagnosis and initiation. Multivariable logistic regression assessed indepe…
Prescription of High-Dose Opioids Among People Living with HIV in British Columbia, Canada
Correlates of opioid and benzodiazepine co-prescription among people living with HIV in British Columbia, Canada
The syndemic effect of HIV/HCV co-infection and mental health disorders on acute care hospitalization rate among people living with HIV/Aids
Factors associated with low neighborhood cohesion among women living with HIV impacted by social-structural inequities in British Columbia
Built and social environments, including one's perception of their environment, are important determinants of health. The intersection of gender and HIV status may complicate the role of neighborhood cohesion in safety, personal well-being, and health outcomes for populations impacted by social and structural inequities. Among women in particular, social cohesion within the neighborhood they reside in may have a greater influence on health outcom…
Mortality among people living with HIV/Aids with non-small-cell lung cancer in the modern Haart Era
People living with HIV (PLWHA) with adequate access to modern combination antiretroviral therapy (cART) are living longer and experiencing reduced AIDS-related morbidity and mortality. However, increases in non-AIDS related conditions, such as certain cancers, have accompanied these therapeutic advances over time. As such, our study objective was to determine the impact of HIV on all-cause and lung cancer-specific mortality amongst PLWHA with dia…
Prevalence and Correlates of Reporting Difficulty Taking Antiretroviral Treatment Among HIV-Positive Illicit Drug Users in Vancouver, Canada
Associations between childhood maltreatment and sex work in a cohort of drug-using youth
Neighborhood and HIV infection among IDU
Complexities of Short-Term Mobility for Sex Work and Migration among Sex Workers
Transitions into and out of homelessness among street-involved youth in a Canadian setting
High rates of homelessness among a cohort of street-involved youth
The end of the line
Social and Structural Factors Shaping High Rates of Incarceration among Sex Workers in a Canadian Setting
Syringe Sharing and HIV Incidence Among Injection Drug Users and Increased Access to Sterile Syringes
Objectives. We assessed the effects of syringe exchange program (SEP) policy on rates of HIV risk behavior and HIV incidence among injection drug users. Methods. Using a multivariate generalized estimating equation and Cox regression methods, we examined syringe borrowing, syringe lending, and HIV incidence among a prospective cohort of 1228 injection drug users in Vancouver, British Columbia. Results. We observed substantial declines in rates of…
Public injecting among a cohort of injecting drug users in Vancouver, Canada
BACKGROUND: Despite the implementation of policy interventions to address open drug consumption, public injecting continues to occur in many urban settings. This study sought to examine public injecting among a community-recruited cohort of injecting drug users (IDUs) in Vancouver. METHODS: The prevalence and correlates of recent public injecting among participants enrolled in the Vancouver Injection Drug User Study during the period of 1 Decembe…
Burden of HIV Infection Among Aboriginal Injection Drug Users in Vancouver, British Columbia
Objectives. We sought to examine whether there were differential rates of HIV incidence among Aboriginal and non-Aboriginal injection drug users in a Canadian setting. Methods. Data were derived from 2 prospective cohort studies of injection drug users in Vancouver, British Columbia. Using the Kaplan–Meier method and Cox proportional hazards regression, we compared HIV incidence among Aboriginal and non-Aboriginal participants. Results. Overall, …
Service Uptake and Characteristics of Injection Drug Users Utilizing North America’s First Medically Supervised Safer Injecting Facility
In 2003, the city of Vancouver, British Columbia, opened North America’s first government-sanctioned safer injecting facility, where injection drug users (IDUs) can inject preobtained illicit drugs under the supervision of nurses. Use of the service by IDUs was followed by measurable reductions in public drug use and syringe sharing. IDUs who are frequently using the program tend to be high-intensity cocaine and heroin injectors and homeless indi…
The relationship between social, policy and physical venue features and social cohesion on condom use for pregnancy prevention among sex workers
BACKGROUND: This study aims to report on a newly developed Safer Indoor Work Environmental Scale that characterises the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers' (SWs') condom use for pregnancy prevention. METHODS: Drawing on a prospective open cohort of female SWs working in indoor venues, a newly developed Safer …
Migration adversely affects antiretroviral adherence in a population-based cohort of HIV/Aids patients
Removing barriers to care
Benzodiazepine Use and Hepatitis C Seroconversion in a Cohort of Persons Who Inject Drugs
Objectives. To examine the relationship between benzodiazepine (BZD) use and HCV seroconversion in 2 linked prospective cohorts of persons who inject drugs (PWID). Methods. We examined prospective cohorts of 440 PWID (baseline BZD users: n = 102; 23.2%) from the AIDS Care Cohort to Evaluate Access to Survival Services (ACCESS) and the Vancouver Injection Drug Users Study (VIDUS) cohorts, followed-up from 1996 to 2013 in Vancouver, Canada. Results…
Employment predicts decreased mortality among HIV-seropositive illicit drug users in a setting of universal HIV care
OBJECTIVE: Given the link between employment and mortality in the general population, we sought to assess this relationship among HIV-positive people who use illicit drugs in Vancouver, Canada. METHODS: Data were derived from a prospective cohort study of HIV seropositive people who use illicit drugs (n=666) during the period of May 1996-June 2010 linked to comprehensive clinical data in Vancouver, Canada, a setting where HIV care is delivered wi…
The Holy Grail
Regional and Temporal Changes in HIV-related Mortality in British Columbia, 1987–2006
The end of the line
Intermittent use of triple-combination therapy is predictive of mortality at baseline and after 1 year of follow-up
OBJECTIVE: To characterize the impact of intermittent use of triple drug antiretroviral therapy on survival. DESIGN, SETTING AND PARTICIPANTS: Population-based analysis of 1282 antiretroviral therapy naive HIV-positive individuals aged 18 years and older in British Columbia who started triple-combination therapy between August 1996 and December 1999. Therapy use was estimated by dividing the number of months of medications dispensed by the number…
Outpatient pharmacy care and HIV viral load response among patients on Haart
Adherence to highly active antiretroviral therapy (HAART) is necessary to achieve long-term effectiveness. The impact of HIV/AIDS-specific pharmacy services on patient adherence and HIV viral suppression is currently not well described. This study aimed to compare the impact of differing levels of HIV-pharmacy care on adherence and time to HIV viral suppression among participants on HAART enrolled in a population-based HIV/AIDS drug treatment pro…
Elevated rates of antiretroviral treatment discontinuation among HIV-infected injection drug users
The potential health and economic impact of implementing a medically prescribed heroin program among Canadian injection drug users
Safer injection facility use and syringe sharing in injection drug users
Back to work
The aim of this study was to quantify the level of employment at one-year and to determine potential predictors of future employment among HIV-positive persons on highly active antiretroviral therapy (HAART) in the province of British Columbia. Of the 392 individuals that were initially unemployed at baseline 63 (16.1%) found a job over the subsequent year. Factors associated with becoming employed included a baseline income over 10,000 dollars, …
Determinants of Haart discontinuation among injection drug users
The objective of this study was to identify psychosocial determinants of, and self-reported reasons for, HAART discontinuation among HIV-positive injection drug users (IDUs). We examined correlates between sociodemographic characteristics, drug use and risk behaviors, outcome expectations, adherence self-efficacy, social support and HAART discontinuation among 160 HIV-positive participants in the Vancouver Injection Drug Users' Study (VIDUS). Log…
Quality of life, depression and fatigue among persons co-infected with HIV and hepatitis C
The objective of the study was to describe the additional burden generated by hepatitis C (HCV) infection among HIV-infected individuals as measured by self-reported quality of life, depression and fatigue. The provincial HIV/AIDS Drug Treatment Program (DTP) distributes all antiretroviral medication in the province of British Columbia. Eligibility for accessing antiretrovirals is based on published guidelines commensurate with the International …
Factors associated with sex-trade involvement among female injection drug users in a Canadian setting
Background: We undertook this study to evaluate the factors associated with sex-trade involvement among a cohort of female injection drug users (IDUs).Methods: We performed a prospective analysis of factors associated with sex-trade involvement among female participants enrolled in a prospective cohort study of Vancouver injection drug users. We examined HIV-status during follow-up and measured time updated social, sex- and drug-related variables…
Safer injecting education for HIV prevention within a medically supervised safer injecting facility
Rationale to Evaluate Medically Supervised Safer Smoking Facilities for Non-injection Illicit Drug Users
The case for expanding access to highly active antiretroviral therapy to curb the growth of the HIV epidemic
Drastic elevations in mortality among female injection drug users in a Canadian setting
The health and social conditions of women living in Vancouver's Downtown Eastside has recently been the focus of substantial international attention. Since few studies have examined rates and correlates of death among addicted women in Canada, we have characterized patterns of mortality among female injection drug users (IDUs) in Vancouver. The Vancouver Injection Drug Users Study (VIDUS) is a prospective open cohort study of IDUs. The analyses p…
Differences in access to care among injection drug users infected either with HIV and hepatitis C or hepatitis C alone
Access to HCV (Hepatitis C virus) care for HIV/HCV-co-infected patients is an urgent public health concern. The objective of the present study was to describe the self-reported health status of HIV/HCV-co-infected and HCV-mono-infected injection drug users and to describe their access to HCV-related care. Beginning in May 1996, persons who had injected illicit drugs in the previous month were recruited into the Vancouver Injection Drug User Study…
Inadequacies in antiretroviral therapy use among Aboriginal and other Canadian populations
We undertook this study to provide a profile of Aboriginal people initiating antiretroviral therapy and their response to treatment. Aboriginal peoples were identified through self-report. Baseline socio-demographics and risk factors were compared between Aboriginal and non-Aboriginal participants as were baseline factors associated with two consecutive plasma viral load measures below 500 copies/ml using contingency table analysis. Multivariate …
Drug-related overdoses within a medically supervised safer injection facility
Neighborhood and HIV infection among IDU
Service Uptake and Characteristics of Injection Drug Users Utilizing North America’s First Medically Supervised Safer Injecting Facility
In 2003, the city of Vancouver, British Columbia, opened North America’s first government-sanctioned safer injecting facility, where injection drug users (IDUs) can inject preobtained illicit drugs under the supervision of nurses. Use of the service by IDUs was followed by measurable reductions in public drug use and syringe sharing. IDUs who are frequently using the program tend to be high-intensity cocaine and heroin injectors and homeless indi…
The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating Haart
OBJECTIVE: To determine the impact of depressive symptoms on mortality among HIV/AIDS patients first initiating HAART and the potential role of patient adherence as a confounder and effect modifier in this association. METHODS: The study comprised HIV-positive individuals who were first prescribed HAART between August 1996 and June 2002. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Cox proportiona…
Income generating activities of people who inject drugs
Predictors of non-fatal overdose among a cohort of polysubstance-using injection drug users
Exploring Disparities Between Global Hiv/Aids Funding and Recent Tsunami Relief Efforts
Objective: To contrast relief efforts for the 26 December 2004 tsunami with current global HIV/AIDS relief efforts and analyse possible reasons for the disparity. Methods: Literature review and ethical analysis. Results: Just over 273,000 people died in the tsunami, resulting in relief efforts of more than US$10 bn, which is sufficient to achieve the United Nation’s long‐term recovery plan for South East Asia. In contrast, 14 times more people di…
Characteristics of young illicit drug injectors who use North America's first medically supervised safer injecting facility
The study examined whether North America's first medically supervised safer injection facility (SIF) attracts young injection drug users (IDUs) who are at high risk of health-related harm. Prevalence of SIF use was determined based on data obtained after the SIF's opening. Predictors of initiating future SIF use were determined based on behavioral information obtained from the participant's study visit immediately preceding the SIF's opening. The…
Circumstances of First Injection Among Illicit Drug Users Accessing a Medically Supervised Safer Injection Facility
There have been concerns that safer injecting facilities may promote initiation into injection drug use. We examined length of injecting career and circumstances surrounding initiation into injection drug use among 1065 users of North America’s first safer injecting facility and found that the median years of injection drug use were 15.9 years, and that only 1 individual reported performing a first injection at the safer injecting facility. These…
Medicine (143 obras) · HIV, Drug Use, Sexual Risk (106 obras) · HIV/AIDS Research and Interventions (100 obras) · Internal Medicine (83 obras) · Demography (78 obras) · Environmental health (75 obras) · Psychiatry (59 obras) · Family medicine (56 obras) · Cohort (53 obras) · Public health (52 obras)