It is well understood that a few key populations in British Columbia bear a disproportionately high burden of HIV and hepatitis C compared to the general population. These key populations include gay men and other men who have sex with men (MSM), people who use injection drugs (PWID), and heterosexuals who engage in high-risk behaviours (i.e., sex work).
In order for HCV and HIV services to determine if their programs are adequately serving these key populations, they need reliable estimates of key population sizes, ideally in their local jurisdiction. However, these estimates are difficult to get because many of these populations are hard to reach or hidden due to stigma, or occur too infrequently to be measured through the usual methods (i.e. censuses).
Estimating population sizes
Beginning in 2015, the BC Centre for Disease Control (BCCDC) partnered with the Pacific AIDS Network (PAN), the BC Centre for Excellence in HIV/AIDS (BC CfE) and other key provincial stakeholders to contract the Centre for Global Public Health (University of Manitoba) to develop size estimates for priority populations in BC.
This project is the first of many steps that will help us understand the coverage of our current prevention programs and identify gaps in services.
The project was divided into two phases. In Phase I, a literature search was performed to identify published, peer-reviewed scientific journal articles containing information on size estimations of the three key populations. In Phase II, interviews were conducted with key informants from each health authority, First Nations Health Authority and the community-based organizations (CBOs) that serve the three key populations. The goal of the key informant interviews was to understand how health authorities and CBOs plan and evaluate programs in the absence of key population size estimates.
The project team developed a first set of population size estimates for gay, bisexual and other MSM and for people who inject drugs (Table 1). These estimates were developed provincially and for each health region, and can be used for program planning, implementation and evaluation. The team also developed a set of recommendations to guide the use of these estimates.
Table 1: Estimated population sizes for MSM and PWID in BC