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BackgroundExpanding access to highly active antiretroviral therapy (HAART) has become an important approach to HIV prevention in recent years. Previous studies suggest that concomitant changes in risk behaviours may either help or hinder programs that use a Treatment as Prevention strategy.AnalysisWe consider HIV-related risk behaviour as a social contagion in a deterministic compartmental model, which treats risk behaviour and HIV infection as linked processes, where acquiring risk behaviour is a prerequisite for contracting HIV. The equilibrium behaviour of the model is analysed to determine epidemic outcomes under conditions of expanding HAART coverage along with risk behaviours that change with HAART coverage. We determined the potential impact of changes in risk behaviour on the outcomes of Treatment as Prevention strategies. Model results show that HIV incidence and prevalence decline only above threshold levels of HAART coverage, which depends strongly on risk behaviour parameter values. Expanding HAART coverage with simultaneous reduction in risk behaviour act synergistically to accelerate the drop in HIV incidence and prevalence. Above the thresholds, additional HAART coverage is always sufficient to reverse the impact of HAART optimism on incidence and prevalence. Applying the model to an HIV epidemic in Vancouver, Canada, showed no evidence of HAART optimism in that setting.ConclusionsOur results suggest that Treatment as Prevention has significant potential for controlling the HIV epidemic once HAART coverage reaches a threshold. Furthermore, expanding HAART coverage combined with interventions targeting risk behaviours amplify the preventive impact, potentially driving the HIV epidemic to elimination.

All Canadian governments say that Canada must look to its friends and allies and like-minded partners to achieve greater cooperation on global issues. But who are these countries exactly? To gain a better understanding of where Ottawa stands in the world, with whom and under what conditions, we analyze Canada's voting patterns in the United Nations General Assembly from 1980 to 2017. We find that Canada's overall record tends toward that of Western European states. We find no evidence of greater affinity with US positions either when the Democrats are in power in Washington or when the conservative parties are in power in Ottawa. We identify a sharp pro-US turn in the Harper years and also confirm that the government of Justin Trudeau started off by maintaining rather than reversing this trend.

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