Hasina Samji

BC Centre for Disease Control

Introduction The COVID-19 pandemic has had widespread effects on adolescent mental health. However, little is known about support-seeking, unmet need and preferences for mental health care among adolescents. Methods The Youth Development Instrument (YDI) is a school-administered survey of adolescents (N = 1928, mean age = 17.1, SD = 0.3) across Br...

Introduction La pandémie de COVID-19 a eu des effets importants sur la santé mentale des adolescents. Toutefois, on en sait peu sur la recherche de soutien, les besoins non comblés et les préférences des adolescents en matière de soins de santé mentale. Méthodologie L’instrument YDI (Youth Development Instrument, ou Instrument de mesure du dévelop...

Background We estimated the effectiveness of COVID-19 vaccines against laboratory-confirmed SARS-CoV-2 infection among people living with HIV (PLWH) and compared estimates with a matched HIV-negative cohort. Method We used the British Columbia COVID-19 Cohort, a population-based data platform which integrates COVID-19 data on SARS-CoV-2 tests, lab...

Objective: People with HIV were underrepresented in coronavirus disease 2019 (COVID-19) vaccine clinical trials. We estimated vaccine effectiveness (VE) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for the BNT162b2, mRNA-1273, and ChAdOx1 vaccines among a population-based cohort of people with HIV in Ontario, Cana...

Purpose A needs-based model of health systems planning uses a systematic estimate of service needs for a given population. Our objective was to derive annual prevalence estimates of specific mental disorders in the adult population of British Columbia, Canada and use a novel triangulation approach encompassing multiple data sources and stratifying...

Background Research findings on the association between outpatient service use and emergency department (ED) visits for mental and substance use disorders (MSUDs) are mixed and may differ by disorder type. Methods We used population-based linked administrative data in British Columbia, Canada to examine associations between outpatient primary care...

Background Gay, bisexual and other men who have sex with men (gbMSM) who attend STI clinics represent an easily accessible population for promoting HIV prevention interventions. We examined characteristics of gbMSM STI clinic attendees to identify those who could most benefit from pre-exposure prophylaxis (PrEP). Setting GbMSM STI clinic attendees...

Introduction Extreme weather events caused by climate change pose a risk to mental health. Illustrating this reality, this study estimates the impact of the 2021 Western North American heat dome (June 25th, 2021 – July 1st, 2021) on climate change anxiety among British Columbians. Methods We conducted an online survey of British Columbians, aged ≥...

Objectives Information on emergency department (ED) visits for mental and substance use disorders (MSUDs) is important for planning services but has not been explored in British Columbia (BC), Canada. We describe all MSUD ED visits for people ages 15 and older in the province of BC in 2017/2018 and document trends in MSUD ED visits between 2007/200...

This Research is Currently in Press.

Objective: People who are incarcerated experience social exclusion and have higher rates of mental and substance use disorders than the general population. Prisons are not suitable for treating mental illness, and understanding how the profile of prison populations changes provides essential information for correctional service planning. This stud...

Background Women living with hepatitis C virus (HCV) are rarely addressed in research and may be overrepresented within key populations requiring additional support to access HCV care and treatment. We constructed the HCV care cascade among people diagnosed with HCV in British Columbia, Canada, as of 2019 to compare progress in care and treatment a...

Background & Aims Public health measures introduced to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), also disrupted various healthcare services in many regions worldwide, including British Columbia (BC), Canada. We assessed the impact of these measures, first in...

Background: The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and l...

This study linked data from two large population monitoring surveys in British Columbia, Canada, (N = 17,181) to examine associations between teacher-rated social-emotional functioning at school entry (age 5) and child self-reported internalizing and wellbeing in Grade 4 (age 9). Latent profile analysis identified seven profiles of early childhood...

Background Evidence that opioid agonist therapy (OAT) is associated with increased odds of hepatitis C virus (HCV) treatment initiation among people who use drugs (PWUD) is emerging. The objective of this study was to determine the association between current OAT and HCV treatment initiation among PWUD in a population-level linked administrative da...

Background: We evaluated the effect of sustained virologic response(SVR) from direct acting antiviral(DAA) treatments on all-cause, liver- and drug-related mortality in a population-based cohort in British Columbia(BC), Canada. Methods: We used data from the BC Hepatitis Testers Cohort, which includes people tested for hepatitis C virus(HCV) sin...

Introduction Increasing evidence indicates that chronic hepatitis C virus (HCV) infection is associated with higher risk of diabetes. Previous studies showed ethnic disparities in the disease burden of diabetes, with increased risk in Asian population. We described the incidence of type 2 diabetes related to HCV infection and assessed the concurren...

Aims To estimate the treated prevalence of mental illness, substance use disorder (SUD), and dual diagnosis, and the association between dual diagnosis and fatal and non-fatal overdose, among residents of British Columbia, Canada. Design A retrospective cohort study using linked health, income assistance, corrections, and death records. Setting B...

Objective To estimate the prevalence of specific mental and substance use disorders (MSUDs), by age and sex, as a first step toward informing needs-based health systems planning by decision-makers. Methods We developed a conceptual framework and a systematic methodology for combining available data sources to yield prevalence estimates for specifi...

Objectives Addressing the needs of ethnic minorities will be key to finding undiagnosed individuals living with hepatitis B (HBV), hepatitis C (HCV) or human immunodeficiency virus (HIV). To inform screening initiatives in British Columbia (BC), Canada, we assessed the factors associated with HBV and/or HCV and/or HIV infection among different ethn...

Background The majority of new HCV infections in Canada occur in people who inject drugs. Thus, while curative direct antiviral agents (DAAs) herald a promising new era in hepatitis C virus (HCV) treatment, improving the lives and wellbeing of people living with HCV (PLHCV) must be considered in the context of reducing overdose-related harms and wi...

Objectives To determine the time to CD4 : CD8 ratio normalization among Canadian adults living with HIV in the modern ART era. To identify characteristics associated with ratio normalization. Patients and methods Retrospective analysis of the Canadian Observational Cohort (CANOC), an interprovincial cohort of ART-naive adults living with HIV, recr...

Background Hepatitis C (HCV) affects diverse populations such as people who inject drugs(PWID), baby boomers’, gay/bisexual men who have sex with men(gbMSM), and people from HCV endemic regions. Assessing HCV syndemics (i.e.relationships with mental health/chronic diseases), among subpopulations using Latent Class Analysis(LCA) may facilitate targe...

Objective To explore sexually transmitted infection (STI) clinic client attitudes and preferences towards STI vaccines and STI vaccine programming in an urban clinic setting. Methods A 31-item questionnaire was administered during check-in by clinic clerical staff at two STI clinics in Vancouver, Canada. Demographic characteristics and preferences...

Background: Processes for epidemiology embedded with Indigenous methodology are needed. Building Bridges was developed to engage Indigenous peoples in epidemiology to address health issues relevant to them. Objectives: We describe our process for meaningfully engaging Indigenous leaders and peoples living with human immunodeficiency virus (HIV)...

Effectiveness of direct‐acting antiviral (DAA) therapies could be influenced by patient characteristics such as co‐morbid conditions, which could lead to premature treatment discontinuation and/or irregular medical follow‐ups. Here we evaluate loss to follow‐up and treatment effectiveness of sofosbuvir/ledipasvir ±ribavirin (SOF/LDV±RBV), ombitasvi...

Background & aims: HCV infection is associated with several extrahepatic manifestations (EHMs). We evaluated the impact of sustained virological response (SVR) on the risk of 7 EHMs that contribute to the burden of extrahepatic disease: type 2 diabetes mellitus, chronic kidney disease or end-stage renal disease, stroke, ischemic heart disease, maj...

Objective: To characterize the incidence of select chronic comorbidities in the era of modern (pre-integrase inhibitor) highly active antiretroviral therapy (HAART) in British Columbia, Canada. Methods: We used data from the Comparative Outcomes And Service Utilization Trends (COAST) study, a population-based cohort study of people living with HIV...

Background Sexually transmitted infections (STIs) contribute to a large global health burden, potentially leading to cancer, infertility, and increased risk of contracting other STIs. Several STI vaccines are in development, with the potential to decrease STI prevalence and morbidity. However, concerns remain regarding acceptability across populati...

Background Improvements in tolerability and cure rates of hepatitis C virus (HCV) with direct acting antiviral (DAA) treatment led to expansion of patients treated for HCV; however, research examining the impact of these changes on linkage to care and treatment initiation among patients with hepatitis B (HBV) and HIV co-infection is limited. We com...

We evaluated the effectiveness of ledipasvir/sofosbuvir (LDV/SOF) in treating hepatitis C virus (HCV) genotype 1 and SOF/velpatasvir (SOF/VEL) for all genotypes among people who inject drugs (PWID) and those not injecting drugs and who were on or off opioid agonist therapy (OAT). Study participants comprised a population‐based cohort in British Col...

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...

Context: Sexually transmitted infections (STI) and mental health and substance use (MHSU) disorders all occur at elevated rates in sexual and gender minorities. These overlapping epidemics, or syndemics, are exacerbated by challenges these same populations face in accessing sexual/gender minority-affirming services. Many publicly funded STI clinic...

Background Understanding differences in HIV incidence among people living with hepatitis C virus (HCV) can help inform strategies to prevent HIV infection. We estimated the time to HIV diagnosis among HCV-positive individuals and evaluated factors that could affect HIV-infection risk in this population. Patients and methods The British Columbia He...

Although achieving sustained virological response (SVR) through anti‐viral therapy could reduce the risk of hepatocellular carcinoma (HCC) attributable to hepatitis C virus (HCV) infection, the impact of early viral clearance on HCC is not well defined. In this study we compared the risk of HCC among individuals who spontaneously cleared HCV (SC),...

NOT PUBLISHED AT AUTHOR’S REQUEST Funding Agencies CIHR

Background: Large linked healthcare administrative datasets could be used to monitor programs providing prevention and treatment services to people who inject drugs (PWID). However, diagnostic codes in administrative datasets do not differentiate non-injection from injection drug use (IDU). We validated algorithms based on diagnostic codes and pre...

Purpose The Comparative Outcomes And Service Utilization Trends (COAST) Study in British Columbia (BC), Canada, was designed to evaluate the determinants of health outcomes and health care services use among people living with HIV (PLHIV) as they age in the period following the introduction of combination antiretroviral therapy (cART). The study al...

Background: Age-associated conditions are increasingly common among persons living with HIV. A longitudinal investigation of their accrual is needed given their implications on clinical care complexity. We examined trends in the co-occurrence of age-associated conditions among persons living with HIV receiving clinical care, and differences in the...

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...

Background: We applied syndemic theory to explore the degree to which syndemic conditions explain the syphilis epidemic affecting Canadian gay and bisexual men who have sex with men (GBMSM). Methods: Data from a national survey comprising 7872 GBMSM were analyzed using multivariable logistic regression to measure associations between recent syph...

Background Co-occurrence of social conditions and infections may affect HIV/HCV disease risk and progression. We examined the changes in relationship of these social conditions and infections on HIV and hepatitis C virus (HCV) infections over time in British Columbia during 1990–2013. Methods The BC Hepatitis Testers Cohort (BC-HTC) includes ~1.5...

Multivariate multinomial logistic regression model for factors associated with HIV and HCV infection status in the BC Hepatitis Testers Cohort (model excluding individuals not tested either for HIV or HCV) a. (DOCX)

Characteristics of testers by HCV and HIV test category in the British Columbia Hepatitis Testers Cohort stratified by year of diagnosis. (DOCX)

Definitions for comorbid conditions. (DOCX)

Multivariate multinomial logistic regression model for factors associated with HIV and HCV infection status in the BC Hepatitis Testers Cohort presenting depression and psychosis instead of mental illness a. (DOCX)

Multivariate multinomial logistic regression model for factors associated with HIV and HCV infection status in the BC Hepatitis Testers Cohort presenting assessments at the time of diagnosis a. (DOCX)

Criteria and data sources for the BC Hepatitis Testers Cohort (BC-HTC). (DOCX)

Characteristics of participants by HIV and HCV status in BC Hepatitis Testers Cohort. (DOCX)

Multivariate multinomial logistic regression model for factors associated with HIV and HCV infection status in the BC Hepatitis Testers Cohort stratified by year of diagnosis a. (DOCX)

Multivariate multinomial logistic regression model for factors associated with HIV and HCV infection status in the BC Hepatitis Testers Cohort presenting birth cohort instead of age a. (DOCX)

Background and aims We measured the timing of HBV and HCV diagnoses relative to detection of decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC) as an indicator of late hepatitis diagnosis. Methods HBV and HCV diagnoses were defined relative to the diagnosis of DC or HCC such that HBV/HCV diagnoses within two years prior, at the time o...

The nature of the HIV epidemic in the United States and Canada has changed with a shift towards rural areas. Socioeconomic factors, geography, cultural context, and evolving epidemics of injection drug use are coalescing to move the epidemic into locations where populations are dispersed and healthcare resources are limited. Rural-urban differences...

Objectives: We sought to compare all-cause mortality of people living with HIV and accessing care in Canada and the UK. Methods: Individuals from the Canadian Observational Cohort (CANOC) collaboration and UK Collaborative HIV Cohort (UK CHIC) study who were aged ≥ 18 years, had initiated antiretroviral therapy (ART) for the first time between 2...

Background Non-HIV/AIDS-related diseases are gaining prominence as important causes of morbidity and mortality among people living with HIV. The purpose of this study was to characterize and compare changes over time in mortality rates and causes of death among a population-based cohort of persons living with and without HIV in British Columbia (BC...

We evaluated the shift in the characteristics of people who received interferon-based Hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV, HIV, reported cases of hepatitis B, and...

Background: There remains concern regarding the occurrence of non-communicable diseases (NCDs) among individuals aging with HIV but few studies have described whether disparities between demographic subgroups are present among individuals on antiretroviral therapy (ART) with access to care. Methods: We assessed the first documented occurrence of...

Background People living with HIV (PLHIV) who are also marginalized by social and structural inequities often face barriers to accessing and adhering to HIV treatment and care. The Dr. Peter Centre (DPC) is a non-profit integrated care facility with a supervised injection room that serves PLHIV experiencing multiple barriers to social and health se...

Background & aims: Evidence is limited on hepatocellular carcinoma (HCC) risk after sustained virological response (SVR) to interferon-based treatment of hepatitis C virus (HCV) infection. We evaluated the effect of SVR on the risk of HCC and estimated its incidence in post-SVR HCV patients from a large population-based Canadian cohort. Methods:...

Objectives: Injuries are responsible for 10% of the global burden of disease; however, the epidemiology of injury among people living with HIV (PLHIV) has not been well-elucidated. This study seeks to characterize rates and predictors of injury among PLHIV compared to the general population in British Columbia (BC), Canada. Design: A population-...

Background: Gay, bisexual and other men who have sex with men (MSM) are disproportionately affected by HIV in Canada. Combination antiretroviral therapy has been shown to dramatically decrease progression to AIDS, premature death and HIV transmission. However, there are no comprehensive data regarding combination antiretroviral therapy outcomes amo...

Background There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)–infected patients in care in the United States and Canada. Methods We studied HIV-infected participants in 16 cohorts in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) during 20...

Background: Population-level monitoring of hepatitis C virus (HCV) infected people across the cascade of care identifies gaps in access and engagement in care and treatment. We characterized a population-level cascade of care for HCV in British Columbia (BC), Canada and identified factors associated with leakage at each stage. Methods: The BC He...

Objectives: To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. Methods: We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up...