OHTN led think tanks bring people together with a variety of expertise and experience to tackle an issue by discovering what we know, where we are and how to move forward.
The Ethnoracial MSM Research Working Group was established by the AIDS Bureau of the Ontario Ministry of Health and Long-Term Care in 2005 to address gaps in research evidence on ethnoracial MSM communities to support policy and program development. Recently, the OHTN took over the role of coordinating the Working Group. As part of the strategic planning process, the working group identified the need for a Think Tank as an important step to foster learning among key stakeholders, facilitate identification of research priorities, and to encourage collaborative research related initiatives amongst ethnoracial MSM communities.
The objectives of the Think Tank were to:
- Share knowledge and information on current ethnoracial MSM research
- Expand upon the needs and priorities for specific communities
- Explore opportunities for collaboration and partnership
Needle Exchange Programming
The Sleeping Giant: A Day in the Life of a Needle Exchange Program
This event launched the document The Best Practice Recommendations for Needle Exchange Programs in Ontario. The first of its kind in Canada, this document is a result of the efforts of community-based advocates and leading researchers who worked together to produce this important initiative. It synthesizes the Canadian and international literatures and provides concrete policy recommendations for the operational, controversial and practical challenges faced by NEPs today.
Needle Exchange Programs are a cornerstone of HIV prevention for injection drug users (IDUs). With this leading-edge document, there is an opportunity to improve HIV prevention efforts and overall well-being for IDUs in Ontario. As part of the Ontario HIV Treatment Network Strategic Plan to 2010 “Advancing HIV Policy and Practice Through a Network of Excellence”, the OHTN is focused on building community-academic-policy partnerships that will harness the expertise, energy and commitment necessary to make a difference while supporting knowledge transfer and exchange among its many stakeholders. The Think Tank was organized by the OHTN in partnership with the Ontario Needle Exchange Coordinating Committee (part of the Ontario Needle Exchange Network).
The main objectives of the Think Tank were to:
- Launch the Best Practice Recommendations for Needle Exchange Programs in Ontario document
- Develop a strategy to ensure application of the recommendations
- Offer networking and partnership building opportunities to further disseminate the recommendations
- Identify necessary policy changes to further improve NEP practice
- Identify a strategy for next steps in terms of research, advocacy and practice
Support for the event was given by the Ontario Harm Reduction Distribution Program, the Canadian Institutes of Health Research, the Centre for Addiction and Mental Health and the Centre for Research on Inner City Health (St. Michael’s Hospital).
Housing HIV and Health
The OHTN stimulated a partnership between community-based AIDS service organizations (ASOs) and researchers from York and McMaster Universities to study the housing needs of people living with HIV as they relate to health and well-being.
The partnership first convened at the Ontario AIDS Network annual retreat for Executive Directors in 2002, when a provincial sub-committee was formed to look at the issues facing PHAs directly related to housing. All geographic regions in Ontario were represented in the partnership and participants included both housing and non-housing providers: AIDS Thunder Bay; AIDS Niagara; Bruce House (Ottawa); Fife House (Toronto); Ontario AIDS Network; Ontario Aboriginal HIV/AIDS Strategy; Community-Linked Evaluation AIDS Resource (CLEAR), McMaster University; School of Social Work, York University; and the Ontario HIV Treatment Network (OHTN).
The partnership identified that housing may be the greatest unmet need among PHAs and that specific housing supports to ensure safety, health and dignity, varied among PHAs. It was also recognized that there was an overall lack of research in the area, particularly in Canada; and this lack of information was seen as a barrier to the adequate understanding of the current situation in Ontario and ability to plan for the future.
Since 2002, the partnership has met regularly to develop a community-based research strategy and to discuss opportunities for networking, information sharing, education and coalition building with local and provincial-level housing organizations. In addition, the Ontario AIDS Bureau’s Proposed Strategy to Address HIV/AIDS in Ontario to 2008 has identified housing as a priority issue for PHAs and reports that increasing numbers of PHA clients are presenting to community-based organizations issues related to their housing.
Most recently, collaborative efforts of the partnership have resulted in the successful funding of a three-year province-wide community-based research (CBR) initiative, with the aim to examine housing and health in the context of HIV; and to assess the current and projected housing needs of PHAs in Ontario. This CBR initiative is being funded by Canadian Institutes of Health Research (CIHR), Ontario HIV Treatment Network (OHTN), Wellesley Central Health Corporation, the AIDS Bureau and the Ontario AIDS Network (OAN).
Mental Health and HIV
Immigrants, refugees, and non-status people living with HIV/AIDS (I/R/N-PHAs) in Canada have complex psychosocial needs and face profound barriers when accessing mental health services. The Community for Accessible AIDS treatment (with support from the OHTN) has undertaken a study involving 47 newcomer PHAs and 103 service providers to identify various IRN-PHA and service provider perspectives.
HIV/HCV Think Tank
The challenges in accessing treatment, care and support for people co-infected with HIV and hepatitis C in Ontario are numerous and span the gamut of the social determinants of health. Issues range from inadequate housing and poverty, to isolation from multiple social stigmas to mental health and addiction issues.
To address these and other issues, The Ontario HIV Treatment Network, along with the Canadian Treatment Access Council, and the AIDS Bureau and Hepatitis C Secretariat of the Ontario Ministry of Health and Long Term Care, hosted a province-wide think tank on treatment, care and support of HIV and Hepatitis C co-infected people in Ontario. The multidisciplinary event brought together diverse interests from across Ontario and Canada to learn, share and brainstorm ideas and solutions to the challenges facing those who are living with HIV/HCV co-infections.
The think tank concluded with the announcement of the creation of a provincial HIV/HCV co-infection taskforce. The taskforce will work to expand on and implement the findings of the think tank.
HIV/HCV Task Force
The Ontario Hepatitis C and HIV Co-infection Task Force acts as a collaborative network of representatives (people co-infected with HCV and HIV, service and health care providers, researchers and policy makers), with a mandate to provide leadership in addressing gaps in research, policy and practice for provision of effective care and support for people living with HCV/HIV co-infection in Ontario.
The responsibilities of the task force are:
- To develop an action plan to address priorities and issues identified through the 2007 think tank Towards Greater Integration: A Think Tank on Hepatitis C and HIV co-infection
- To continue to identify priority issues from relevant stakeholder groups
- To facilitate communication, collaboration, integration and knowledge transfer/exchange amongst different stakeholders
- To promote new strategic partnerships between multiple stakeholders (academic investigators, community-based researchers, community partners, etc.) to develop new projects related to these issues
HIV/HCV Scoping Review
A scoping review of co-infection materials (both published and grey literature) was also conducted to further understand what the co-infection environment looks like. Scoping reviews aim to identify and examine the extent, range and nature of research activity around any given topic, and help to summarize and disseminate research findings, as well as identify any research gaps in the existing literature. The objectives of this review were to identify and share the existing knowledge and action on treatment, care and support services for people living with HIV/HCV co-infections; and to describe the findings and range of research, existing programs and policy implications in the area of co-infection. The broad initial question that guided this review was: “What is known from the existing literature, practices and policy documents on the treatment, care and support for people living with HIV and Hepatitis C Co infection?”
The article entitled Treatment, care and support for people co-infected with HIV and hepatitis C: A scoping review is now published in Open Medicine (an open access journal).
The Ontario HIV/HCV Co-infection Working Group produced a series of video modules to capture the lived experience of people co-infected with HIV/HCV, provide practical information and resources for people at risk of, infected by, or affected by HIV/HCV co-infection, and the people who serve them, and address the gaps in care, treatment and support options available to people with HIV/HCV in Ontario.
Women and HIV in Canada
The 18th Annual Canadian Conference on HIV/AIDS Research was held in Vancouver, BC in April of 2009. The conference provided an opportunity for researchers, students, politicians and other stakeholders with a focus on HIV to come together to present new research findings, to exchange knowledge, and to network with other people who are working in the field of HIV/AIDS in Canada.
The theme of CAHR 2009 was "Facing the Evolving Epidemic" and featured presentations on several key priority areas, including prevention and women's issues.
The following presentations (with audio) highlight research studies with a focus on Women and HIV, as presented at CAHR 2009:
- Women, HIV/HCV and Harm Reduction in Federal Prisons
Anne Marie DiCenso
- Overview of HIV/AIDS Among Women in Canada
Chris Archibald, David Boulos, Kristina Lalonde
- Population-Specific HIV/AIDS Status Reports and the HIV Counselling and Testing Guidelines
Clare Jackson, Marc-André Gaudreau, Jacqueline Arthur, Brooke Ellis, Jocelyne Guay, Christine Villeneuve
- HIV Prevention in Canada: A Meta-Ethnographic Synthesis of Current Knowledge
Jacqueline Gahagan and Tracey Prentice
- Implications of the Blueprint for Action on Women and Girls and HIV/AIDS
- Key Findings of HIV+ Women from the Positive Spaces, Healthy Places Study
Ruthann Tucker, Saara Greene
- National HIV Pregnancy Planning Guidelines
Ms. Shari Margolese, Dr. Mona Loutfy
- Panel Discussion : Women and HIV : Implications for Research, Policy and Practice in Canada
Neurocognitive Disorders and HIV
HIV affects the body's central and peripheral nervous systems and can eventually lead to impairment, including sensory nerve damage and neurocognitive disorders. There is a growing number of clinicians and researchers focusing on the neurocognitive/neuropsychological health of people living with HIV. This field of study is often referred to as "NeuroAIDS".
The expanding NeuroAIDS field has led to tremendous advances in our understanding of HIV-associated neurocognitive disorders and to improved diagnosis, care and treatment. As compared to the early days of the HIV/AIDS epidemic, modern diagnostic tests have been developed to better distinguish between mild cognitive impairment and more severe impairments such as HIV-associated dementia. Advances in combination HIV antiretroviral medication regimens, which are more effective than old regimens at targeting reservoirs of HIV in the central nervous system, have led to better clinical outcomes for people who have been diagnosed with an HIV-associated neurocognitive disorder.
Evaluation of Neurocognitive Disorders in HIV Infection
A joint CTN and OHTN-REACH meeting was held at the OHTN office in Toronto on May 5-6, 2010. Co-chaired by Marie-JosÃ©e Brouillette of the CTN and Sean B. Rourke of the OHTN, this two day think tank assembled twenty-four esteemed professionals currently working in the field of neurocognition or neuropsychology to discuss critical issues related to the assessment, diagnosis, care and treatment of HIV-associated neurocognitive disorders. Special guest, Dr. Robert K. Heaton of the HIV Neurobehavioural Research Centre in San Diego, addressed the delegates on HIV-related neurocognitive disorders, neurocognitive test batteries and cART. The principal aim of the meeting was the development of a national NeuroAIDS research program.