Julio S G Montaner
Datos Biográficos
| ID | 326272 |
|---|---|
| NOMBRE | Julio S G Montaner |
| NOMBRES | Julio S G |
| APELLIDO | Montaner |
| FIRMA | MONTANER J S G |
| AFILIACIONES | British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, BC, Canada |
| VERIFICADO | No |
| TOTAL DE OBRAS | 72 |
| TOTAL DE CITAS | 48 |
| TOTAL COMO AUTOR | 72 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1997 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 4 |
Leaving the emergency department before treatment completion among people with and without HIV with a suspected overdose in British Columbia, Canada
Leaving the emergency department (ED) before treatment completion (LBTC) - either without being seen by a physician or against medical advice - is common in substance use-related presentations and associated with adverse outcomes. We assessed determinants and outcomes of LBTC among people with and without HIV (PWH, PWoH) attending an ED with a suspected overdose between 2012-2020 in British Columbia, Canada, using linked administrative data. We i…
Enhancing identification of suspected unregulated drug toxicity deaths in administrative health records
Accurate and timely cause of death information is important for public health monitoring. In recent years, deaths with an unknown/ill-defined underlying cause have increased markedly in Canada, particularly in British Columbia (BC), among people living with HIV (PWH) in concert with the 2016 unregulated drug toxicity crisis. Using a case study of PWH in BC, who are disproportionately affected, we examined all deaths occurring between 2015 – 2020 …
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
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…
The impact of the Covid-19 pandemic on HIV treatment gap lengths and viremia among people living with HIV British Columbia, Canada, during the Covid-19 pandemic
The SARS-CoV-2 (COVID-19) pandemic has impacted the care of people living with HIV (PLWH). This study aims to characterize the impact of the pandemic on the length of HIV treatment gap lengths and viral loads among people living with HIV (PLWH) in British Columbia (BC), Canada, with a focus on Downtown Eastside (DTES), which is one of the most impoverished neighbourhoods in Canada. We analyzed data from the HIV/AIDS Drug Treatment Program from Ja…
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…
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…
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…
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…
Trends in Awareness and Use of HIV PrEP Among Gay, Bisexual, and Other Men who have Sex with Men in Vancouver, Canada 2012–2016
Assessing the relationship between physician availability and viral load suppression in British Columbia
Key Messages Individuals residing in areas where there are substantially fewer physicians available to provide HIV treatment have a higher chance of not achieving viral suppression. Individuals residing in rural areas have poorer health outcomes when compared to those residing in urban areas. Discrepancies in HIV treatment outcomes exist despite the fact that HIV treatment costs are borne directly by government
Harder-to-reach people living with HIV experiencing high prevalence of all-type mental health disorder diagnosis
People living with HIV/AIDS (PHA) often concurrently cope with mental health disorders that may greatly influence HIV and other health-related outcomes. The objective of this study was to examine the prevalence and correlates of self-reported mental health disorder diagnosis among a cohort of harder-to-reach HIV-positive individuals in British Columbia, Canada. Between 2007 and 2010, 1000 PHA who had initiated ART were enrolled in the Longitudina…
Is there a rural/urban gap in the quality of HIV care for treatment-naïve HIV-positive individuals initiating antiretroviral therapy in British Columbia
Rurally located people living with HIV (PLWH) face unique challenges associated with remoteness that may negatively affect their HIV care outcomes. The Programmatic Compliance Score (PCS) has been used previously as a quality of care metric, and is predictive of mortality for treatment-naïve individuals initiating combination antiretroviral therapy (cART). This study looked at whether the rurality of PLWH impacted their PCS. PCS was calculated fo…
Neighborhood and HIV infection among IDU
High rates of homelessness among a cohort of street-involved youth
Determinants of geographic mobility among participants in a population-based HIV/Aids drug treatment program
The end of the line
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…
Removing barriers to care
The impact of the Covid-19 pandemic on HIV treatment gap lengths and viremia among people living with HIV British Columbia, Canada, during the Covid-19 pandemic
The SARS-CoV-2 (COVID-19) pandemic has impacted the care of people living with HIV (PLWH). This study aims to characterize the impact of the pandemic on the length of HIV treatment gap lengths and viral loads among people living with HIV (PLWH) in British Columbia (BC), Canada, with a focus on Downtown Eastside (DTES), which is one of the most impoverished neighbourhoods in Canada. We analyzed data from the HIV/AIDS Drug Treatment Program from Ja…
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
Needle exchange is not enough
Despite having the largest NEP in North America, Vancouver has been experiencing an ongoing HIV epidemic. Whereas NEP are crucial for sterile syringe provision, they should be considered one component of a comprehensive programme including counselling, support and education.
Determinants of geographic mobility among participants in a population-based HIV/Aids drug treatment program
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…
Elevated rates of antiretroviral treatment discontinuation among HIV-infected 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, …
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
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…
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…
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…
High prevalence of syringe sharing among street involved youth
Syringe sharing continues to play an integral part in HIV epidemics involving injection drug users around the world. We examined the prevalence of syringe sharing among Canadian street youth enrolled in a prospective cohort study known as the At-Risk Youth Study (ARYS), and used logistic regression to examine factors associated with syringe sharing. Among 509 participants, 154 (30%) had injected drugs in the last 6 months and of those 44 (29%) in…
The Canadian government's treatment of scientific process and evidence
Nurse-delivered safer injection education among a cohort of injection drug users
Characteristics of Injection Drug Users Who Participate in Drug Dealing
So-called "balanced" drug policy couples enforcement initiatives targeting drug dealers with health-focused interventions serving addicted individuals. There are few evaluations of this approach, and little is known about how these two populations may overlap. We evaluated factors associated with drug dealing among injection drug users (IDUs) in Vancouver, Canada, and examined self-reported drug-dealing roles and reasons for dealing. Among 412 ID…
High rates of homelessness among a cohort of street-involved youth
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, …
Association Between HIV-1 RNA Level and CD4 Cell Count Among Untreated HIV-Infected Individuals
Objectives. We examined the significance of plasma HIV-1 RNA levels (or viral load alone) in predicting CD4 cell decline in untreated HIV-infected individuals. Methods. Data were obtained from the British Columbia Centre for Excellence in HIV/AIDS. Participants included all residents who ever had a viral load determination in the province and who had never taken antiretroviral drugs (N = 890). We analyzed a total of 2074 viral load measurements a…
HIV antiviral drug resistance
A patient's understanding and use of healthcare information can affect their decisions regarding treatment. Better patient understanding about HIV resistance may improve adherence to therapy, decrease population viral load and extend the use of first-line HIV therapies. We examined knowledge of developing HIV resistance and explored treatment outcomes in a cohort of HIV+ persons on highly active antiretroviral therapy (HAART). The longitudinal in…
Drug-related risks among street youth in two neighborhoods in a Canadian setting
Regional and Temporal Changes in HIV-related Mortality in British Columbia, 1987–2006
Regional and Temporal Trends in Migration among People Living with HIV/Aids in British Columbia, 1993-2005
Adherence and plasma HIV RNA response to antiretroviral therapy among HIV-seropositive injection drug users in a Canadian setting
HIV-positive individuals who use injection drugs (IDU) may have lower rates of adherence to highly active antiretroviral therapy (ART). However, previous studies of factors associated with adherence to ART among IDU have been limited primarily to samples drawn from clinical settings and in areas with financial barriers to healthcare.We evaluated patterns of ART adherence and rates of plasma HIV RNA response among a Canadian cohort of community-re…
Medicine (69 obras) · HIV/AIDS Research and Interventions (59 obras) · HIV, Drug Use, Sexual Risk (50 obras) · Internal Medicine (43 obras) · Demography (40 obras) · Environmental health (33 obras) · Gerontology (30 obras) · Family medicine (27 obras) · Population (26 obras) · Human immunodeficiency virus (HIV (24 obras)