IJPDS International Journal of Population Data Science

COAST, one of the world's most comprehensive studies of people living with HIV, has been significantly updated in order to provide even deeper insight into the health outcomes of people living with HIV, compared to people without HIV.

Researchers from the British Columbia Centre for Excellence in HIV/AIDS (BC-CfE) have updated COAST (Comparative Outcomes And Service Utilization Trends) to 17,119 people living with HIV and 615,264 without HIV. COAST now has data from 1992 to 2020 extending the study period from 17 to 28 years. This will enable researchers to gain deeper insight into a variety of more recent health and societal shifts, including the introduction of new medications, and the long-term effects of HIV treatment guidelines implemented after 2013.

The original COAST study included 13,907 people living with HIV and 516,340 without HIV, and integrated data from 1996 to 2013. It has contributed to significant gains in our understanding of antiretroviral therapy use, health service utilisation, chronic diseases, mental health and substance use disorders, and mortality among people living with HIV in BC.

COAST is a remarkably detailed study, which includes data on virtually all known people living with HIV in BC and a 10% random sample of the BC population without HIV. The study is set in a province that provides free antiretroviral therapy (ART) for the treatment and prevention of HIV. As a result, COAST is uniquely positioned to study the complex interaction between HIV, use of ART, concurrent health conditions, and demographic and social determinants of health, such as income, geographic location, and sex. Advancements in accessing BC’s health data allowed the integration of more robust data on emergency department use, which will enable researchers to capture crucial details associated with overdose events treated in the emergency setting.

BC is home to one of the most devastating illicit drug-use crises in the world, which has disproportionately affected people living with HIV in terms of drug use disorders and overdose mortality. An enhanced understanding of how HIV affects individuals will help improve the lives of people living with HIV, as new knowledge is translated into better treatment guidelines, more powerful advocacy efforts, and tailored healthcare policies.

“With a larger, more comprehensive database, the expanded COAST study is an important step forward in increasing our understanding of the determinants of health among people with HIV Nin BC,” said Michael Budu, MD MPH. “It has already provided new insights into the changing nature of the population living with HIV in BC and will continue to be a solid foundation for critical research in future. We intend to update the COAST datasets every two years, so we can continue exploring and extending our knowledge of people living and aging with HIV in BC.”

For more information on the COAST study, please visit: bccfe.ca/coast

 

Click here to read the full article

COAST team [From L-R: Robert S. Hogg, Michael O. Budu, Katherine W. Kooij, Mark W. Hull, Viviane D. Lima, Julio S.G. Montaner, Kate Salters, Paul Sereda, Claudette Cardinal, Jason Trigg, Rolando Barrios, Scott D. Emerson, Erin Ding(Not Pictured), Kate Heath(Not Pictured), Jenny Li(Not Pictured) and Taylor McLinden(Not Pictured)]

Budu, M. O., Kooij, K. W., Heath, K., McLinden, T., Cardinal, C., Emerson, S. D., Sereda, P., Trigg, J., Li, J., Ding, E., Hull, M. W., Salters, K., Lima, V. D., Barrios, R., Montaner, J. S. G., Hogg, R. S. and COAST Study Team (2025) “Cohort Profile Update: Reflecting back and looking ahead: Updating the Comparative Outcomes and Service Utilization Trends (COAST) Study to include 28 years of linked data from people with and without HIV in British Columbia, Canada”, International Journal of Population Data Science, 10(1). doi: 10.23889/ijpds.v10i1.2496.