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Medscape
28-05-2025
- Health
- Medscape
HIV Medication Adherence Critical for Viral Suppression
A recent study found that antiretroviral therapy adherence below 90% was associated with significantly lower odds of viral suppression among women living with HIV. METHODOLOGY: Researchers analyzed data from community-based prospective cohort study including women living with HIV across British Columbia, Ontario, and Quebec between 2013 and 2018. Overall, 1187 participants (median age, 42 years) who reported antiretroviral therapy use and specified their regimen were included in the analysis. Participants completed questionnaire surveys at three timepoints, at 18 months interval between 2013 and 2018. Analysis focused on the relationship between adherence to antiretroviral therapy and viral suppression using data from the study period between 2017 and 2018. TAKEAWAY: The use of integrase strand transfer inhibitors increased from 13.6% in 2013 to 30.6% in 2018, whereas the utilization of other antiretroviral classes showed declining trends. Among participants, 78.2% reported undetectable viral loads, and viral suppression was achieved by 89.6% of those on regimens consisting of a backbone plus a third agent. Less than 70% adherence (adjusted odds ratio [aOR], 0.06; 95% CI, 0.01-0.27) and 80%-89% adherence (aOR, 0.21; 95% CI, 0.05-0.86) were associated with lower odds of viral suppression compared with ≥ 95% adherence. Researchers found no significant difference in the odds of viral suppression between 90%-94% adherence and ≥ 95% adherence. IN PRACTICE: 'With the chronic nature of HIV and the risk of resistance, supporting patients in overcoming the challenges that accompany long-term medication adherence through cotailored approaches should remain a priority when providing care to women living with HIV,' the authors wrote. SOURCE: The study was led by Alexandra de Pokomandy, Department of Family Medicine, McGill University, Montreal, Quebec, Canada. It was published online on May 2, 2025, in HIV Medicine . LIMITATIONS: The study was limited by a small sample size in groups with lower adherence, which may have reduced the statistical power to detect significant differences. All measures were self-reported, introducing social desirability bias and recall bias. The study also lacked information on the status of mental health treatment and the duration of viral suppression. DISCLOSURES: The study received funding from the Canadian Institutes of Health Research, the Canadian HIV Trials Network, the Ontario HIV Treatment Network, and the Ontario Academic Health Science Centers Alternative Funding Plans Innovation. Two authors reported having financial ties with several pharmaceutical companies.
Winnipeg Free Press
24-05-2025
- Health
- Winnipeg Free Press
A soft touch, a strong will
Dr. Henry Friesen stands among the most distinguished Canadian scientists — if not near the front. A trailblazer whose name echoes not only in the annals of medical science but also the halls of political leadership, the Morden-born doctor made history early in his career. In 1970, three decades before he transformed the medical science landscape by spearheading the Canadian Institutes of Health Research, the young endocrinologist at McGill University had a career-defining breakthrough: he discovered and isolated human prolactin after decades of frustrated attempts by others. Supplied Dr. Henry Friesen, born in Morden, had a long and satisfying career in Canadian health research and advocacy. This has made the difference for many thousands of aspiring mothers, allowing Friesen in collaboration with the pharmaceutical company Sandoz to develop bromocriptine, a drug still used to treat infertility. In 1973, Friesen returned to the University of Manitoba, his alma mater, to take a job seemingly beyond his years, but not his rapidly growing reputation. As head of the department of physiology, he oversaw the department's growth for the next two decades as it matured into an internationally recognized centre for research. 'He was a Manitoban at heart… there's intentionality around him wanting to raise his family here,' says his son Mark Friesen, a clinical pharmacist in Winnipeg. 'Throughout his life, there was a close connection with family… and the larger Mennonite community.' Friesen — who died at the age of 90 on April 30 from complications related to a ruptured gall bladder — spent his final months advocating for Canada to attract American researchers and clinicians alienated by political turmoil under President Donald Trump. Colleagues remember him for being modest, family oriented, religious and generous. 'There was no artifice to him at all. He was a quintessential Prairie person,' Dr. Janet Rossant, chief of research emeritus at the Hospital for Sick Children in Toronto and president of the Gairdner Foundation, told the Globe and Mail. But a soft touch didn't mean a soft will. Beneath his gentle manner was an unwavering commitment to the highest standards. 'One thing is that even though Henry was often reserved… and very amiable to people of all classes and strata, he was very relentless all his life at excellence,' says Dr. John Dirks, another Canadian physician. The two attended med school together in Winnipeg and remained lifelong friends and sometime colleagues. KEN GIGLIOTTI / FREE PRESS files Dr. Henry Friesen at the University of Manitoba, where he worked for 18 years, had a long, satisfying career in Canadian health research and advocacy. 'In evaluating the science of scientists, Henry was very fussy about the calibre of that work.' Such standards ultimately pulled him away from his quiet life in Manitoba to the political drama of Ottawa in the 1990s. By then, he'd authored more than 460 publications and led other breakthroughs, including innovative research on growth hormones enabling replacement therapy in hormone- deficient children. He'd amassed a collection of high honours: the Gairdner International Award (known as the 'baby Nobel'), a Royal Society of Canada fellowship and was made an Officer of the Order of Canada. Other distinctions such as the Koch Lifetime Achievement Award from the Endocrine Society, promotion to the Order of Canada's highest rank (companion), the Canada Gairdner Wightman Award and induction into the Canadian Medical Hall of Fame would come later. Had he retired after his years at the U of M, it would have marked the conclusion of a triumphant career. But his drive still burned. In 1991, he stepped into the heart of the nation's political arena, where he would once again shape Canada's medical science field. He'd been appointed president of the Medical Research Council, based in Ottawa. Since the 1960s, the council had been the country's main agency for funding medical research, but by then it was showing its age — more attuned to the rhythms of basic research than the highly interdisciplinary world that science was becoming. PHIL HOSSACK / FREE PRESS Friesen poses in front of a map of the human genome. Friesen fought passionately for bold, essential reforms and the scientist known for his personal reserve proved a compelling speaker and decisive lobbyist. 'It is about integration,' he told the House of Commons in 1998. 'It is about removing some of the partitions, even the silos, if you will, that have divided both the science and the geography… to (improve) our health care system.' The outcome was the creation of the Canadian Institutes of Health Research in 2000. Through Friesen's advocacy, its annual budget grew from $250 million to $500 million, eventually reaching $1.3 billion. 'People had been trying some standard method to identify (prolactin), and that hadn't worked. He kind of came up with a new creative way to do that,' says Mark. 'All the stuff with the (council) and CIHR was that same creative, out-of-the-box thinking.' Mark recalls eastern colleagues of his father being surprised that he'd move yet again back to Manitoba after his retirement from the CIHR. But for anyone who knew him well, the move home — where his family and cultural community were rooted — seemed inevitable. His parents had settled in Morden after leaving the Soviet Union. Despite modest beginnings, his father, a pastor, became a successful entrepreneur, running a thriving lumber and gas business. Some of his family ultimately stayed in Morden, including his brother John, who spent his career as an optometrist there. Winnipeg was the home to and from which Friesen was in transit for much of his life. Jonathan Hayward / Canadian Press Then governor general Adrienne Clarkson presented Friesen with his promotion to Companion of the Order of Canada in 2003. He moved here for the first time with his brother David, who remained one of his closest friends throughout his life, as a boarding student at Mennonite Brethren Collegiate Institute. He stood out academically at both MBCI and the U of M med school, which his Dirks describes as an exciting environment in the '50s. 'At that time, it was a bit of a boot camp, but (the professor of physiology) made sure that we understood scientific criticism,' he says. 'So, when we left Manitoba and went to Boston, NIH or the big places and immersed with graduates from prestigious American schools, we didn't feel insufficient. Henry is an example of that and there are many leaders who came out of that.' Friesen headed south after graduation, completing his specialist training in endocrinology, the medical study of hormones, at the New England Medical Center Hospital in Boston, now known as Tufts Medical Center. There, he met his future wife, Joyce MacKinnon, at the famous Evangelical Park Street Church. 'His wife was his rock. Part of the secret of his success was her support and prayers,' says Mark. 'For instance, in Ottawa, she was his touchstone and he always bounced ideas off her.' The couple attended Billy Graham crusades together; faith was a constant thread throughout Friesen's life. A deeply religious scientist cut a figure that sometimes surprised colleagues, but Mark said his father saw no contradiction, 'He always said: 'Science can answer the how question, but religion can answer the why question.'' Tuesdays A weekly look at politics close to home and around the world. While some doctors balance their long hours with golf, tennis, social clubs and the luxuries that their professions afford, Friesen preferred the repose of family, church, volunteering and books — with a special taste for 19th-century poetry. He was especially fond of unorthodox Christian poets such as Ralph Waldo Emerson — in particular his call to 'go where there is no path' — and Alfred Lord Tennyson. A fittingly bold motto for someone regarded as perhaps Canada's most significant 20th-century figure of medical science. Friesen is survived by his wife, Joyce, of 57 years, his daughter Janet, son Mark, and grandsons Zachary and Samuel, and was memorialized at a funeral service on May 5. He is buried at Chapel Lawn in Headingley, a stone's throw from his brother David, who predeceased him by a year. Conrad SweatmanReporter Conrad Sweatman is an arts reporter and feature writer. Before joining the Free Press full-time in 2024, he worked in the U.K. and Canadian cultural sectors, freelanced for outlets including The Walrus, VICE and Prairie Fire. Read more about Conrad. Our newsroom depends on a growing audience of readers to power our journalism. If you are not a paid reader, please consider becoming a subscriber. Our newsroom depends on its audience of readers to power our journalism. Thank you for your support.
Hamilton Spectator
02-05-2025
- Hamilton Spectator
Hamilton Native Women's Centre to mark Red Dress Day May 5
The Hamilton Native Women's Centre will hold a memorial ceremony to mark Red Dress Day on May 5. The event, from 10 a.m. to noon, is an opportunity to honour all missing and murdered Indigenous women, girls and two-spirit (MMIWG2S) people. It will take place at Honouring the Circle at 21 Rosedene Ave. Light refreshments and snacks will be provided. Red Dress Day is the National Day of Awareness for Missing and Murdered Indigenous Women, Girls and Two-Spirit People and was coined by Métis artist Jaime Black as 'an esthetic response to this critical national issue.' It was first held in 2010 and continues to be held annually. According to the Canadian Institutes of Health Research, 63 per cent of Indigenous women in Canada have experienced physical or sexual assault in their lifetime and the impact of the disproportionately high rates of violence 'is felt in all areas of life.' To raise awareness and pay tribute to the day, people are encouraged to wear red, inform themselves about MMIWG2S and participate in community events commemorating the day.
