HIV Endgame Program Results

Clay JonesUncategorized

The OHTN is pleased to announce the results of its first HIV Endgame Funding Program competition!
This funding program supports people and projects that have the potential to:

  • meet the needs of populations in Ontario most affected by HIV
  • drive changes in policy and practice across the HIV prevention, engagement, and care cascade
  • lead to more integrated health and social services
  • identify effective ways to address the social determinants that have a negative impact on the health of communities most affected by HIV
  • contribute to a rapid learning HIV health and social system

We are proud to support participants in each of four funding streams:

1. Endgame Leader Award

This program provides salary support for research and community leaders at different stages of their careers who are interested in working with the OHTN to drive change.

OHTN Chairs

David Brennan, OHTN Chair in Gay and Bisexual Men’s Health (Social Work)
University of Toronto

Shifting Paradigms: Developing the Next Generation of HIV/STI Prevention Tools for Gay, Bisexual, and Other Men Who Have Sex with Men

David’s program employs community-based principles and methods to enhance resiliency and mitigate risks to the health and well-being of gay, bisexual, TwoSpirit, and other men who have sex with men (GB2M). His projects focus on engaging GB2M across Ontario to develop better prevention tools for HIV/STBBIs, mental health/substance use concerns, and access to care. Key initiatives will include the assessment of different models of care for ASOs working with GB2M, and the deployment of technologies to support evidence gathering and interventions aimed at prevention and self-care. David’s mentorship program, called “The Investigaytors”, is a capacity-building program for a diverse group of guys who are engaged community members.

 
Trevor Hart, OHTN Chair in Gay and Bisexual Men’s Health (Psychology)
Ryerson University

Integrating Mental Health into HIV/STI Prevention for Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM)

Trevor’s program focuses on conducting community-engaged activities to identify the needs of gbMSM and develop, implement and evaluate sexual and mental health counselling, and STI/HIV prevention interventions. Trevor’s projects will: evaluate the effectiveness of ARV-based HIV prevention for HIV positive and negative gbMSM; pilot in Ontario a psychosocial intervention that engages HIV+ gbMSM with a history of trauma in care; and advance treatments for social anxiety by adding risk reduction counselling to reduce STI/HIV sexual risk behaviour. Trevor is combining knowledge translation with mentoring by building a Virtual Training Hub for counselling in gbMSM substance use and mental and sexual health.

 
Patrick O’Byrne, OHTN Chair in Public Health and HIV Prevention
University of Ottawa

Nurse-Led PEP, PrEP, and Rapid HIV Treatment: Producing Real-Life Impact for Patients in Ottawa and Ontario

Patrick plans to scale-up the nurse-led PEP and PrEP clinic at the Ottawa STI clinic (known as PEP-RN and PrEP-RN, respectively) to start offering HIV treatment at the point of diagnosis (“rapid ART”) and implement a seamless transition from PEP to PrEP (PEP2PrEP).  Persons who used PEP-RN, PEP2PrEP, and PrEP-RN will be engaged to identify areas of improvements, as well as to explore patient conceptualizations of risk to ensure that PrEP and PEP implementation strategies are aligned. Patrick’s mentorship program will involve improving capacity, and increasing information among health care providers, and training existing health care workers to increase their clinical service capabilities.

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OHTN Senior Scientist

Mario Ostrowski, OHTN Senior Scientist in HIV Cure
St. Michael’s Hospital

An HIV Cure Endgame: Synergizing Science with the Community

Mario’s program will translate new ideas from the laboratory into state-of-the-art treatments that can lead to clinical trials and cure HIV infection.  His projects include the “Pathology to Cure” HIV study with people living with HIV and receiving end-of-life care, whose tissues will be examined at autopsy. The aim is to determine where the virus resides in the body while on anti-viral medicine and how the virus continues to damage tissues like the brain and lymph nodes. Other projects will attempt to harness killer T cells, test the effect of Nef inhibitors, examine the merits of personalizing immune responses and use genetic engineering techniques to improve killer cells.

 
OHTN Scientist

Ann Burchell, OHTN Scientist in Sexually Transmitted Infection
St. Michael’s Hospital

Evidence-informed Prevention of Sexually Transmitted Infections (STIs) and STI-related Cancers Among People Living with HIV and Gay and Other Men Who Have Sex with Men

Ann’s program of work focuses on optimizing testing services for syphilis, gonorrhoea and chlamydia in order to: prevent HPV and associated disease among MSM and persons living with HIV (PLHIV), and minimize cancer burden among PLHIV.  A range of projects will: produce evidence of the benefits of making syphilis testing a routine part of HIV viral load testing; support informed decision-making regarding choice of new/modified STI testing services; monitor HPV vaccine uptake and impact; and gather evidence on cancers among persons living with HIV.  Together, these projects aim to improve programs and services and promote the integration of cancer prevention within the HIV care sector.

 
OHTN Emerging Scientists

Todd Coleman, OHTN Emerging Scientist in HIV Population Health
Wilfrid Laurier University

Southwestern Ontario GBTMSM Assessment of HIV/AIDS Issues Initiative

Todd will establish a community-based partnership between ASOs, academics, and GBTMSM in six southwestern Ontario regions that will 1) identify gaps and theoretical approaches to the study of HIV related issues among GBTMSM in smaller urban centres; 2) identify outreach strategies to GBTMSM, issues unique to each city region, and challenges to implementing knowledge uptake; 3) interview investigators on similar multi-city projects to identify challenges and facilitating factors; and 4) engage GBTMSM community members to understand their experiences with health care and access. This information will support the development of a quantitative survey that will be used to inform region-specific design of programs and services.

 
Lawrence Mbuagbaw, OHTN Emerging Scientist in HIV Care Cascade
McMaster University

Optimizing Outcomes at Critical Points in the Cascade of HIV Care in Ontario

Lawrence’s program seeks to fill knowledge gaps at critical points of the HIV care continuum with a focus on populations most affected by HIV. A mixed-methods study involving an overview of systematic reviews and interviews with health workers and people living with HIV will help mobilize evidence of effective, pragmatic interventions that enhance initiation of treatment, adherence to medication, and retention in care. A cross-sectional analytical study of administrative databases from the Institute for Clinical Evaluative Sciences, the Ontario HIV Treatment Network Cohort Study and Public Health Ontario will be conducted to explore the compliance, outcomes, cost-effectiveness, and socio-demographics of drug resistance testing in people starting HIV treatment.

 
OHTN Student Leaders

Eric Armstrong, OHTN Student Leader in Biomedical Prevention
University of Toronto

Targeting the Genital Microbiota to Reduce HIV Susceptibility in African, Caribbean and other Black women

Research suggests that ACB women are disproportionately affected by bacterial vaginosis (BV), which is linked to HIV acquisition. This project will study antibiotic and probiotic based treatment strategies for BV to investigate their influence on the vaginal microbiome and HIV risk. A clinical trial has tested a probiotic treatment strategy and this study will test an antibiotic strategy. The study will conduct follow-ups for 6 and 3 months respectively, where vaginal microbiomes will be investigated for bacterial composition and immune indicators will be tested to measure HIV risk.

 
Natasha Darko, OHTN Student Leader in ACB Youth and HIV Services
Wilfrid Laurier University

Project AYA: Assessing Sexual Health Services and HIV Prevention Programming for ACB youth in the GTA

This project is a community-based needs assessment to understand sexual health services, and HIV prevention programming available to ACB youth in the GTA. It will consist of an environmental scan to identify existing sexual health services, electronic surveys of service providers, and focus groups with young ACB men, women, stakeholders, and queer youth. This project seeks to: understand whether ACB youth are aware of and access sexual health services and HIV prevention programming in the GTA, where they receive them, and where they would like to receive them; and identify gaps in programming.

 
Zoe Dodd, OHTN Student Leader in Harm Reduction and HIV Prevention
York University

Drug Treatment System Experiences 

This project seeks to understand the effectiveness of the current drug treatment system and its policies by engaging individuals who use the system and are at risk of HIV. There will be four facilitated group discussions with people who use drugs at community health centres located in Toronto. This work will take a political ethnography approach to understand whether current abstinence-based drug system practices meet the needs of people who use drugs and to explore alternate addiction treatment service delivery methods.

 
Andrew Eaton, OHTN Student Leader in HIV and Aging
University of Toronto

HIV-Associated Neurocognitive Disorder (HAND) and Psychosocial interventions

This project focuses on people ageing with HIV/AIDS who have HIV-Associated Neurocognitive Disorder (HAND). The study will pilot test having support groups for adults with HAND to help them better cope with symptoms (combined with their usual medical treatment and follow up). The project will involve collaboration with community and other key stakeholders to report the results of the pilot which, if the intervention proves effective, will be followed by consultations and acquiring funding to assemble a larger study that provides HAND-specific group support to more people who are affected.


2. Game Changer Award

This program provides project funding to generate game-changing knowledge, and pilot and scale-up game-changing interventions

Reina Bendayan
University of Toronto

Interactions between Antiretroviral Drugs and Folate Transporters/Receptor in Human and Rodent Placenta: Potential Mechanisms Involved in Dolutegravir-Induced Neural Tube Defects

Dr. Bendayan and team will explore whether Dolutegravir interferes with folate transporters and/or receptors in the placenta, which could impair delivery of folates to the fetus resulting in a higher risk of fetal neural tube defects. They will use human placenta tissues obtained from various groups of women living with HIV receiving Dolutegravir and other antiretroviral drugs and an animal pregnancy model to test their hypothesis. This project will help advance knowledge and inform treatment guidelines for women of reproductive age living with HIV. This work will be of significance to women living with HIV considering pregnancy – in particular women at risk of being folate deficient.

 
Ann Burchell
St. Michael’s Hospital

The Burden of Cancer and the Role of Engagement in HIV Care in Mitigating Cancer Risk in People Living with HIV in Ontario

Ann’s aim is to gather evidence on cancers among people living with HIV in Ontario, and to understand how HIV care engagement lowers risk. The team will focus on engagement in HIV care as a means to: a) control HIV viral load and improve immune function, thereby reducing cancer risk; b) engage patients in holistic health care, improving general self-management of health and early diagnosis; and c) improve participation in existing, population-based cancer screening programs. Her team will analyze existing health databases to characterize cancer burden by calculating incidence, prevalence, and cancer mortality, and will explore pathways of engagement in HIV care that lead to reduced cancer risk.


3. Community Participation and Evaluation Award

This program provides project funding for community based agencies and people living with HIV to undertake program evaluation that will have a meaningful impact on services for those most affected by HIV

Kate Murzin
Realize

Preference and Needs for Aging Care among HIV Elders in Ontario (“PANACHE Ontario”)

This PANACHE-led project is a qualitative study looking at how older people (60+) living with HIV define their care and support needs and their expectations of aging-related services. They will engage over 100 older PLWH to help conduct eight community consultations in different parts of Ontario, with half of the consultations focusing on older people most affected by HIV in the province (ie. ACB, gbMSM etc.). The information will be used to create a community report with recommendations for policy makers and other key stakeholders, and to create a survey that can be used to collect information on the care needs and preferences of older PLWIH.


4. Emerging Issues Award

This program provides project funding for urgent or emerging issues where OHTN, in consultation with its stakeholders, have identified clear knowledge gaps

Deanna Chaukos
Mount Sinai Hospital

Enhancing Models of Care for Patients with HIV and Mental Illness through Community Collaboration

This study will evaluate the feasibility of an innovative educational opportunity in a tertiary care HIV Psychiatry clinic designed for a postgraduate medical education elective experience in HIV Psychiatry, and a community AIDS Service Organization (ASO) caseworker called the Mental Health Clinical Fellowship (MHCF). The purpose of the MHCF is to provide education and mentorship in evidence-based mental health treatments to ASO frontline caseworkers, while bridging the role between community organizations and hospital clinics. The study will evaluate logistical feasibility based on interest generated in the HIV psychiatry resident elective and MHCF positions, ability to recruit qualified candidates, retention in the program, new collaborations and participant experience. Mixed methods will be used to explore patient outcomes.