HIV Endgame Program Results

Co-Designing and Implementing a Peer Support Model for Older Adults Living with HIV 

Kristina Kokorelias, Program Manager and Associate Scientist at the Department of Medicine’s Healthy Ageing and Geriatrics Program, Sinai Health and the University Health Network

Co-Principal Investigators: Luxey Sirisegaram (University Health Network), Marina Wasielewski (St. Johns Rehab), Andrew Eaton (Jane Addams College of Social Work)

This project will co-design and pilot a peer-support model for older adults living with HIV within the Sinai/UHN Geriatric-HIV Partnership Clinic. Through Experience-Based Co-Design (EBCD), older adults living with HIV, peer supporters, caregivers, and healthcare professionals will work together to identify priorities and shape the peer-support model. The project seeks to address challenges related to engagement in care, social isolation, stigma, mental health, and navigating health and social services. Using implementation science and mixed methods approaches, the study will include co-design workshops, interviews, and a pilot evaluation informed by developmental evaluation principles. The project will assess the feasibility, acceptability, and potential impact of peer support while generating practical guidance for integrating peer-support approaches into geriatric HIV care and supporting healthy aging among older adults living with HIV.

Harnessing Naturally Occurring Communities to Enhance Wellbeing, Adherence, and Engagement Among Older Adults Living with HIV 

Luxey Sirisegaram, Staff Geriatrician at Sinai Health System and the University Health Network 

Co-Principal Investigators: Kristina Kokorelias (Sinai Health), Stephanie Hatzifilalithis (Women’s College Hospital)

This project examines an understudied source of support for older adults (aged ≥50) living with HIV: organically formed housing and community networks, including naturally occurring retirement communities, shared living arrangements, and neighborhood mutual aid. It addresses how aging with HIV involves social isolation, multimorbidity, polypharmacy, mental health challenges, and age-related frailty, which contribute to gaps in care access, retention, and wellbeing. This study uses a qualitative realist evaluation, and will identify how and why interventions work, for whom, and under what circumstances, by analyzing context–mechanism–outcome configurations through interviews, surveys, focus groups, and realist synthesis. Anticipated outcomes include a refined program theory, practical guidance for policy and practice, and scalable, equity-focused evidence to strengthen engagement, adherence, mental health, and wellbeing among older adults living with HIV.

Diagnostics Without Barriers: Evaluating Novel Point-of-Care Testing for HIV, Syphilis, and HCV in People Experiencing Homelessness

Dr. Marek Smieja, Infectious Diseases Physician and Medical Microbiologist at St. Joseph’s Healthcare Hamilton and Jodi Gilchrist, PhD Candidate, McMaster University & Research Manager, St. Joseph’s Healthcare Hamilton

This research proposes a prospective, multi-center, point prevalence study of undiagnosed HIV, syphilis and hepatitis C virus (HCV) in the Shelter Health Network in Hamilton, Ontario. It will evaluate the feasibility and acceptability of on-site screening using novel methods, such as the Health Canada-approved INSTI Multiplex HIV-1/HIV-2 Syphilis & HCV Antibody Tests and Dried Blood Spot (DBS) testing. The study will explore the use of these novel testing methods for detecting infections, verifying results and expediting access to treatment and follow-up in people experiencing homelessness. By offering a population-specific screening program, this project aims to increase the number of clients screened, contribute to reaching otherwise undiagnosed individuals, and will provide tools for improved confirmatory testing and treatment monitoring, which are essential components of a successful point-of-care screening program.

Theatre Making Impact (TMI): Scaling-Up a Youth-Led HIV Prevention Play Across Ontario 

Sarah Flicker, Professor and Research Chair in Community Based Participatory Research at York University

This project seeks to strengthen HIV prevention among Ontario youth by scaling up TMI’s peer-led theatre intervention across multiple regions, particularly among racialized, Indigenous, newcomer, and 2SLGBTQIA+ youth. This intervention uses theatre, music, comedy, and storytelling to spark open conversations and improve youth self-efficacy around sexual health, HIV prevention, mental health, and healthy relationships. The project will deliver performances and evaluate effectiveness using mixed methods, including surveys, focus groups, and participatory analysis. Anticipated outcomes include reducing stigma, increasing HIV/STI knowledge, prevention, self-efficacy and help-seeking, expanding awareness of testing, and generating comparative, community-grounded evidence on the effectiveness, adaptability, and scalability of theatre-based HIV prevention interventions.

Resilience and Sexual Empowerment (RISE) Study 

Trevor Hart, Professor of Psychology at Toronto Metropolitan University (TMU)

This study pilot tests a novel adaptation of Cognitive Processing Therapy (CPT), an effective psychotherapy for post-traumatic stress disorder (PTSD). This adaptation includes both treatment of PTSD and sexual health promotion and risk reduction.  The study’s goal is to determine whether this novel adaptation, called RISE (Resilience and Sexual Health Empowerment) can reduce PTSD among gay, bisexual, queer, and other men who have sex with men (GBQM) who are also at higher risk for sexually transmitted and blood-borne infections (STBBIs). The RISE study delivers weekly one-hour virtual psychotherapy sessions, with assessments before, after, and three months following psychotherapy. Results will provide preliminary data on training, supervision and fidelity monitoring for a future randomized control trial using this psychotherapy for GBQM with PTSD.

---

Implementation Science

PROBE-AC: Probing Anal Cytology and hrHPV Co-Testing 

David Bulir, MD, PhD, Adjunct Professor in the Department of Chemical Engineering at McMaster University 

Co-Principal Investigator: Kevin Woodward (McMaster University)

This study proposes a three-year project to assess the impact of deploying the new International Anal Neoplasia Society (IANS) recommendations for anal cancer screening among gay, bisexual and other men who have sex with men (gbMSM) and transgender women (TW), both those living with HIV and without HIV. The project will evaluate a co-testing strategy combining anal cytology with high-risk human papillomavirus (hrHPV) testing to improve screening efficiency and reduce unnecessary high-resolution anoscopy (HRA) referrals. Methods include offering anal pap testing at HQ Toronto, hrHPV testing using validated assays, and semi-structured interviews to explore barriers and facilitators to screening. Anticipated outcomes include increased screening uptake, early detection of pre-cancerous lesions, reduced HRA referrals, improved acceptability, and a scalable, cost-effective screening program that reduces anal cancer morbidity and mortality

---

Winston Husbands Leadership Award in Strengthening the Response to HIV Among Black Communities 

Advancing Equity in HIV Prevention and Care for Black Communities: Strengthening Peer Programs and HIV Service Coordination 

Bethelehem Girmay, Research Associate at the Black Health Equity Lab (BHEL), University of Toronto

The aim of this project is to strengthen HIV service coordination and improve client experience for Black communities by developing and piloting standardized peer workflows, improving the coordination of referrals and follow-up processes, and strengthening communication pathways between peers, clients, and providers across “TAIBU” and “Women’s Health in Women’s Hands” Community Health Centres (CHCs). This study will use qualitative methods to identify system-level barriers and facilitators. Co-designed workshops will collaboratively develop a Peer toolkit and standardized processes, which will be pilot-tested in real service settings. Outcomes include real-time evidence, piloting practice improvements, and iteratively refining approaches based on ongoing feedback that will enhance peer capacity and strengthen program effectiveness, promoting equitable, community-based HIV care with tools designed for scalability and adaption across CHCs in Ontario and jurisdictions in Canada.

---

Community-Based Project and Participatory Evaluation Project Award 

Advancing Equitable HIV/STBBI Care and Prevention for Queer West Asian and North African Communities: A Community-Based Exploration of Barriers and Facilitators to Sexual Health Care Across Ontario 

Jad Sinno, Director of Research at the Community-Based Research Centre (CBRC)

Co-Principal Investigators: Daniel Grace (University of Toronto), Roula Kteily-Hawa (Western University)

This exploratory community-based project aims to understand the sexual health experiences of Queer West Asian/North African (WANA) populations in Ontario, including care pathways and program fit, particularly around HIV prevention, testing, linkage/retention, and stigma in clinical and community settings. Through a critical lens, this study will use a qualitative approach that includes focus groups with interest-holders and semi-structured interviews with queer WANA adults. Data will be analyzed using reflexive thematic analysis informed by community-based research approach and guided by intersectionality and postcolonial queer theory. This project will generate the first Ontario-focused qualitative evidence on how colonial histories, migration precarity, racism/Islamophobia, language access, and clinical norms shape HIV/STBBI prevention, testing, treatment, and retention for intersectional queer WANA communities, and will advance knowledge by co-producing culturally sensitive, evidence-based recommendations to inform health policy, care delivery, and community programming.

Economic Empowerment of Women Living with HIV in Peel and York Region: A Community-led Collaborative Needs Assessment 

Jillian Watkins, Executive Director at Moyo Health and Community Services 

Co-Principal Investigator: Marie Morton (CAYR Community Connections)

This study proposes a community-led collaborative needs assessment to generate insights from the lived experiences of immigrant women aged 50+ living with HIV (WLWH) in Peel and York Regions. The project will establish two Women’s Advisory Committees to co-lead, co-design, and jointly conduct the community needs assessment, focusing on economic autonomy, employability, social determinants of health, and the unique lived realities of women aging with HIV. Anticipated outcomes include a co-developed set of tailored recommendations and culturally responsive strategies for service providers in health and social sectors, an improved understanding of the economic barriers that affect 50+ immigrant WLWH, and better support for their economic empowerment.

Financial Empowerment for Healthy Aging with HIV 2.0 – Voices of People Living With HIV 

Kate Murzin, Interim Co-Executive Director at Realize 

Co-Principal Investigator: Sergio Rueda (Centre for Addiction and Mental Health)

This study will undertake the first comprehensive needs assessment of financial literacy, access to financial services, and unmet financial planning and system navigation needs among people living with HIV (PLWH) aged 50+ in Ontario. A mixed methods survey will collect demographic, financial, HIV-related, and aging-related data, with recruitment achieved through localized promotion directed at community-based health organizations, through the networks of team members, and collaborating organizations. Descriptive statistics will be used to analyze the data. The results of this study will support PLWH and their carers to advocate for improved services and funding and provide policymakers outside the HIV sector with evidence on barriers to financial inclusion. The goal is to strengthen the relevance of financial empowerment initiatives and expand the library of financial empowerment resources for people aging with HIV thereby increasing equity.

Guelph Community Health Centre, Hive Health Services Needs Assessment 

Naima Mohamood, Manager of Specialty Clinics at Hive Health Services, Guelph Community Health Centre 

Co-Principal Investigator: Rachelle Marek Sparrow (Hive Health Services at Guelph Community Health Centre)

This needs assessment of Hive’s HIV/AIDS clinical program aims to understand the strengths, challenges, and opportunities for improvement to enhance program capacity to deliver low-barrier, high-quality HIV services free from stigma, and to address the gap in knowledge on rural HIV and gender affirming care/community needs. This project will employ a participatory approach to form a project advisory team made up of service providers, clients, and community partners to complete the needs assessment and program evaluation. Methods include client and staff surveys, focus groups, community partner key informant interviews, and a Health Equity Impact Assessment (HEIA), with data analyzed thematically. This project will result in a formal evaluation of the program and the collaboration of the project advisory team and Hive leadership to translate evaluation findings into concrete actionable recommendations for program improvement.  

HIV Service Integration Through Volunteerism in Early Refugee Resettlement

Nester Tom, Service Access Manager at the People With AIDS Foundation 

Co-Principal Investigator: Vanessa Wright (Women’s College Hospital)

This project, a collaboration between The People With AIDS Foundation and Women’s College Hospital, aims to evaluate the contextual factors shaping HIV-related volunteerism among refugees in Ontario. Using qualitative descriptive inquiry, the study will explore motivations for HIV-related volunteerism, identify characteristics of community-based AIDS organizations that foster social cohesion and engagement, and investigate strategies to improve service integration. Methods will include semi-structured interviews with refugee HIV volunteers and administrators, as well as focus groups guided by implementation frameworks such as the Capability, Opportunity, and Motivation for Behaviour Framework, realist evaluation, and the Consolidated Framework for Implementation Research. Anticipated outcomes include co-designed strategies and a refugee volunteer implementation toolkit, which will enhance HIV education, service navigation, and care connectivity, strengthen collaboration across health and social care sectors, and ultimately improve health outcomes for refugees.

Building Capacity for Culturally Tailored HIV Support: Developing and Evaluating a Facilitator Training Program for GPS Latino Among Latino Immigrants Living with HIV in Ontario 

Ower Oberto, Steering Committee Chair at Latinos Positivos (People With AIDS Foundation)  

Co-Principal Investigators: Beatriz Alvarado (Queens University), Eliana Orrego (Latinos Positivos), Jorge L Martinez (Queens University), Trevor Hart (Toronto Metropolitan University)

This community-based project addresses gaps in culturally responsive programs for Latino immigrants living with HIV (LILH). It will develop and deliver a Facilitator Training Program (FTP) to support the implementation of GPS Latino, an intervention previously evaluated with Latino gay and bisexual immigrant men in Toronto. Using a mixed-methods participatory design guided by RE-AIM and PRISM, the project will pilot and evaluate the FTP. Expected outcomes include strengthening Latinos Positivos’ capacity to expand and sustain relevant services for LILH, addressing mental health, harm reduction, social support, HIV stigma, sexual health education, condom negotiation self-efficacy, and HIV care navigation. Long term, the project seeks to improve equitable access to culturally responsive HIV care and reduce disparities among immigrant and racialized communities.

Reality Check – Formative Realist Evaluation in CBAOs 

Ruth Cameron, Executive Director at Thrive HIV Prevention and Support (Formerly ACCKWA) 

Co-Principal Investigators: Ciann Wilson (Wilfrid Laurier University), Todd Coleman (Wilfrid Laurier University), Felix Munger (Wilfrid Laurier University)

This participatory evaluation project aims to engage in capacity building, measurement and reporting tool development processes to strengthen community-based AIDS organizations (CBAOs) and facilitate partnerships with Ontario Health Teams (OHTs). The project will use a primarily quantitative mixed methods approach to collect data through surveys and focus groups, followed by external data analysis, internal validation, and the development of report templates. Using a formative, realist, participatory evaluation approach, this study will assess participant needs related to social determinants of health, service engagement, referral patterns, and priority OTH indicators. Anticipated outcomes include improved internal evaluation capacity, and stronger evidence for Regional Service Network (RSN) partnerships. Findings will be used to determine overall CBAO status neutral service volume, referral patterns, programmatic gaps, and the facets and complexity of participant needs, to map the OHT organizational partnerships needed for each respective CBAO-RSN partnership.