Research Project: Assessment of geographic distance between Canadian HIV-infected individuals and their care-providers on treatment adherence and virologic suppression

Postdoc Year(s): 2014-2016

Dr. Lauren MacKenzie is looking at the impact of geographic barriers to care on clinical outcomes in HIV in British Columbia and Canada.

Dr. MacKenzie’s research was inspired by her experience as a resident physician at the University of Manitoba. “The seemingly simple act of attending a medical appointment can be a huge challenge for people living in rural or remote communities. It can take over a day just to travel to the appointment,” she highlights.

She adds that “the lack of confidentiality in a small community, increased discrimination, the absence of services such as addiction treatment and mental health care, and HIV care-provider inexperience” can make geographic location a significant barrier for individuals living with HIV.

While research in the disparity of outcomes between rural and urban populations living with HIV is plentiful in the U.S., in Canada it is “an underexplored area that is extremely relevant, given our country’s large non-urban population and vast geographic size,” says Dr. MacKenzie. She hopes that her research will provide a better understanding of how rurality impacts HIV care, in turn allowing healthcare specialists to fine-tune the delivery of HIV care in rural and remote regions of Canada.

So far, the research indicates several differences between individuals living in rural versus urban regions, in terms of antiretroviral prescription patterns, as well as HIV care outcomes. For example, rural patients were found to have worse Programmatic Compliance Scores, a HIV-specific metric that is predictive of mortality among individuals starting antiretroviral therapy. Dr. MacKenzie’s Fellowship Award has been renewed for another year to allow her to further build on these findings.

Dr. MacKenzie obtained her MD at the University of Calgary, then moved to the University of Manitoba to complete residency training in Internal Medicine and Adult Infectious Diseases, and finally to the University of British Columbia where she is currently pursuing a Master of Public Health postgraduate degree, alongside her work at the BC Centre for Excellence in HIV/AIDS. Her postdoctoral co-supervisors are Drs. Julio Montaner and Mark Hull, two leading HIV researchers.

Dr. MacKenzie’s Publications