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HIV Endgame Program Results (2019-2020)

The OHTN is pleased to announce the results of its 2019-2020 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 five funding streams:

  1. Innovator
  2. Junior Investigator
  3. Student Leadership
  4. Breaking New Ground
  5. Community-Based Project

1. Innovator

Paul ShuperSenior Scientist and Section Head at the Centre for Addiction and Mental Health (CAMH)

Bolstering Resilience and Addressing Addictions and Mental Health Concerns in the Context of HIV Prevention and Treatment

Paul Shuper’s OHTN-funded program of data, evidence-sharing, and impact explores linkages between alcohol consumption, substance use, depression, and PrEP-relevant behaviors for gay, bisexual, and other men who have sex with men (gbMSM); as well as factors contributing to resilience among middle-aged and older HIV-negative and HIV-positive gbMSM. Through the development and evaluation of various e-interventions, this program of data, evidence-sharing, and impact will help reduce the negative impacts of mental health and addiction issues on HIV prevention, treatment, and the well-being of people living with and at risk of HIV.

2. Junior Investigator

Ciann WilsonAssociate Professor and Co-Director of the Centre for Community Research, Learning and Action at Wilfrid Laurier University

Community-Informed and Evidence-Based Research for HIV Prevention in Black and Indigenous Communities

Ciann Wilson’s OHTN-funded program of data, evidence-sharing, and impact works to address the complex factors impacting HIV incidence, and overall health of Indigenous and African, Caribbean, and Black (ACB) communities, including Indigenous and Black people who identify as youth, Two Spirit, and/or LGBTQ2S+. This program will explore barriers and facilitators to HIV prevention, care, and treatment for Black and Indigenous communities across Ontario, and addresses the multifaceted and complex drivers that impact STI and HIV prevalence, and the overall health and wellbeing of Indigenous and ACB communities affected by HIV. The program of data, evidence-sharing, and impact will produce findings that have practical application and uptake potential for health service delivery, policy, and programming for ACB communities, thereby improving health and HIV care access, retention, and treatment adherence.

3. Student Leadership

Apondi Judith Odhiambo, PhD Candidate at the Dalla Lana School of Public Health, University of Toronto

Actioning Black Health: An Institutional Ethnography of the Structural and Legislative Inequities and Injustices in the Social Organization of HIV Healthcare and Treatment for African, Caribbean and Black Immigrants Living with HIV in Canada

Apondi Judith Odhiambo’s OHTN-funded project seeks to understand how African, Caribbean and Black immigrants living with HIV access, engage in, and adhere to HIV care; identify how immigration, healthcare and health-related legislative frameworks and their enforcement affect African, Caribbean and Black immigrants’ access to HIV healthcare and treatment; and identify resistance, resilience, and advocacy strategies that emerge in response to these laws, practices, and regulations. This project aims to inform policy change and contribute to the development of pragmatic interventions that address the systemic injustices and inequities impacting the health and wellbeing of African, Caribbean and Black immigrants and other communities affected by HIV.

4. Breaking New Ground

Emergency Safe Supply Programs (ESSPs): Bridging the HIV Prevention, Treatment, and Care Cascade for People Who Inject Drugs

Carol Strike, Professor at the Dalla Lana School of Public Health, University of Toronto

Co-Principal Investigator: Adrian Guta

This project hypothesizes that emergency safe supply programs (ESSPs) have the potential to play a critical role in changing injection drug use patterns in Ontario while improving HIV and hepatitis C (HCV) testing, prevention, engagement in care, and viral suppression. The project will explore the benefits, challenges, and ability of ESSPs to address HIV and HCV prevention, testing, linkage, adherence, and engagement in care. To understand ESSPs from the perspectives of patients and providers, the project team will conduct interviews with patients, prescribers, pharmacists, and nurses from four ESSPs. This project will provide much-needed evidence about implementation factors for the ESSP model, and will inform health systems decision-making and scale-up across Canada.

This project involves collaboration with London InterCommunity Health Centre, Parkdale Queen West Community Health Centre, South Riverdale Community Health Centre, and Street Health.

Beyond Blue Door: Evaluating Interventions to Bridge Knowledge and Service Gaps for People with HIV with Precarious or No Health Insurance Coverage

Alan Li, Primary Care Physician at Regent Park Community Health Centre and Research Chair at the Committee for Accessible AIDS Treatment (CAAT)

Co-Principal Investigators: Mandana Vahabi and Josephine Wong

This project will evaluate the implementation of the Blue Door Clinic, a free biweekly drop-in clinic that is being piloted in Toronto to address the healthcare needs of people living with HIV (PHAs) with precarious or no health coverage. Access to healthcare is among the social determinants impacting HIV outcomes, especially for PHAs struggling with precarious immigration status and/or precarious or no healthcare coverage. This project aims to: identify the determinants of HIV-related health disparities experienced by uninsured or precariously-insured people living with HIV; evaluate the effectiveness and sustainability of the Blue Door Clinic initiative and its ability to support linkage to long-term primary care; and identify evidence-based strategies to advance policy and service access for marginalized and vulnerable PHAs. This project will improve linkage, adherence, and retention in care; service integration; clinical care standards and capacity; and the health of uninsured or precariously-insured people living with HIV.

The Blue Door Clinic is a partnership between CAAT, Casey House, Regent Park Community Health Centre, Sherbourne Health Centre, Hassle Free Clinic, Parkdale Queen West Community Health Centre, Hassle Free Clinic, Black Coalition for AIDS Prevention, and the Centre for Spanish Speaking Peoples.

Hamilton Outreach HIV Treatment and Prevention Clinic

Timothy O’SheaAssociate Professor at McMaster University and Medical Director of the Hamilton Social Medicine Response Team (HAMSMaRT)

Co-Principal Investigator: Shariq Haider

This project evaluates a low barrier, patient-centred service delivery model, which aims to improve access to care for people who inject drugs. Service gaps in Hamilton are addressed through a low-barrier HIV treatment and prevention clinic, a mobile outreach HIV treatment and prevention clinic designed to engage clients in non-traditional settings, a peer support worker who will assist with patient engagement, and the ability for service providers and patients to move seamlessly between service models as their circumstances and preferences allow. The goal of the evaluation is to improve the design of treatment and prevention programming for people who inject drugs.

This project involves cross-sector partnerships between organizations engaged with those living with or at risk of HIV: McMaster University, Hamilton Health Sciences Special Immunology Clinic; McMaster Family Practice; Hamilton Shelter Health Network; The AIDS Network; and Keeping Six, an advocacy organization of people who inject drugs and their allies.

Cannabis Use and Impacts Among Ontarians Living with HIV in the Era of Recreational Legalization

Sergio RuedaScientist at the Centre for Addiction and Mental Health (CAMH)

This project aims to document the health and service use of Ontarians living with HIV during the first 3 years of cannabis legalization and develop data-gathering strategies to inform a long-term evaluation of legalization impacts. The project team will: evaluate the impacts of cannabis legalization on mental health and health service use; develop a profile of people living with HIV who use cannabis, to better document their care needs post-legalization; and engage health care providers to document the facilitators of and barriers to service provision post-legalization. This project will generate early-legalization knowledge to support the evolution of cannabis policy development and its impacts on mental health and service provision.

This project involves collaboration with the Ontario Cohort Study, the Institute for Clinical Evaluative Sciences, University of Toronto, St. Michael’s Hospital, Ryerson University, the Evidence Exchange Network, Health Canada, and community members living with HIV who consume cannabis.

5. Community-Based Project

Evaluating A Peer Driven POC HIV Testing Model: Utilizing Community Health Ambassadors as Testers to Optimize HIV testing amongst African, Caribbean and Black people in Toronto

Wangari Tharao, Director of Research and Programs at Women’s Health in Women’s Hands Community Health Centre (WHIWH)

This project is a process evaluation of a peer-driven point of care HIV testing program at WHIWH. The model engages ACB community health ambassadors as peer testers as an alternative to clinical or staff-led delivery of point of care testing. The evaluation aims to determine fidelity; assess the experience of peers in the process; understand attrition; and establish the effectiveness and sustainability of the program. This model will have multiple benefits for ACB communities: 1) reduced barriers to HIV prevention and HIV testing leading to an increase of early diagnosis of HIV; 2) increased access and linkage to care through a tailored HIV testing program, and 3) increased community capacity to respond to public health needs.

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