Collaborations et solutions en recherche sur le VIH, le VHC et les ITSS

Provinces Atlantiques

CIHR Best Brains Exchange: The Atlantic Region Takes Action on STBBI Testing

The CIHR Best Brains Exchange (BBE) was held June 24th in Halifax, bringing together 40 leading regional and national STBBI public health officials, researchers and other stakeholders to talk about testing in the Atlantic region and to mobilize toward concrete actions on testing and linkage to care. It focused on the “Pan-Canadian Framework for Action: Reducing the Health Impact of Sexually Transmitted and Blood-borne Infections in Canada by 2030” and the development of STBBI policies, programs and actions aimed at reaching the undiagnosed.

This one-day event was facilitated by Dr. Jean Shoveller.  Presenters included Genevieve Tremblay, Drs. Todd Hatchette, John Kim, and Debbie Kelly, as well as Rick Galli, Ken English, and medical officers of health from the four Atlantic provinces.  More information on the background, presentation summaries, and recommended readings can be found on the BBE website.

The CIHR Best Brains Exchange program is designed to improve engagement between researchers, stakeholders and senior decision makers, and to help accelerate the translation and uptake of research evidence in decision-making. Four main objectives were established for this BBE:

  1. Increase understanding of the unique characteristics of STBBIs in the Atlantic region including potential barriers and innovative solutions to testing;
  2. Explore collaborative and interprovincial actions to help support increased access to testing, as a key pillar of the Pan-Canadian Framework for Action, in an effort to reach the undiagnosed and expedite access to treatment;
  3. Examine the potential utility of newer STBBI testing technologies and approaches for use in Atlantic Canada; and
  4. Determine potential interprovincial agreements for testing-related actions needed to help reduce the health impact of STBBIs in the Atlantic region.

The evaluation results were extremely positive.  More specifically:

  • More than three-quarters (78%– 83%) of participants agreed that each of the four main objectives were met;
  • The vast majority (88% – 95%) were satisfied with the various BBE components – i.e. The workshop overall; the expert presentations; the afternoon small group discussion; and the afternoon plenary session;
  • Almost all (93% – 98%) respondents were satisfied with the facilitation and individual presentations; 94% reported an interest in attending a similar event in the future; and
  • Everyone (100%) agreed that they gained new knowledge from the BBE that will be relevant to their future work, and that they fostered relationships/collaborations as a result of the BBE.

Stay tuned for information pertaining to additional outcomes from this successful event.

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Being Safe, Being Me in the Atlantic Provinces: Results of the Canadian Trans youth Health Survey

To mark the International Day Against Homophobia and Transphobia, the public was invited to the launch of the report titled “Being Safe, Being Me in the Atlantic Provinces: Results of the Canadian Trans youth Health Survey”.  Held the evening of May 17th at the Art Gallery of Nova Scotia in Halifax, the event featured a panel discussion led by one of the report’s co-investigators, Dr. Jacqueline Gahagan, followed by a Q&A period and reception with local trans youth serving organizations.

As explained by Shannon (2018) on the website of the Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC):

The Canadian Trans Youth Health Survey was a national online survey conducted by researchers from several Canadian universities and community organizations. This report specifically examines trans youth located in the Atlantic Provinces. The survey included 122 participants from the Atlantic Provinces and used somewhat different questions for younger (14-18 years) and older (19-25 years) trans youth about a wide range of life experiences and behaviours that influence young people’s health. This regional report is a first snapshot of the survey results.*

To download the Atlantic report, click here.

To download the national report and reports from other regions, click here.

For more information, please contact:

Jacqueline Gahagan, PhD
Dalhousie University
jacqueline.gahagan@dal.ca
(902) 494.1155
_______________________________________________________________________________________

* Shannon, M. (2018, March 28). Being Safe, Being Me in the Atlantic Provinces: Results of the Canadian Trans Youth Health Survey [Blog post] Retrieved from http://www.saravyc.ubc.ca/2018/03/28/being-safe-being-me-in-the-atlantic-provinces-results-of-the-canadian-trans-youth-health-survey/

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Survey on the Current Estimates of HIV Testing and Treatment in Canada

Brief Online Survey for health care practitioners involved in HIV service delivery.

Dr. Nitika Pant (McGill University) and Dr. Alice Zwerling (University of Ottawa) invite you to complete a brief online questionnaire on HIV testing. The project seeks to develop an economic model for HIV self-testing in Canada, which will be used to guide policy for HIV self-testing across the country. This work is funded by an operating grant from CIHR (HPP-137872), and supported by the CIHR REACH National Working Group on Point-of-care Testing (POCT).

The team needs some estimates on HIV testing and treatment that are not readily available. They have drafted questions on HIV testing to be filled in by physicians and health professionals involved in taking care of HIV patients across Canada.

The survey will take approximately 10-15 minutes of your time. For your time, they are offering all participants $25 gift cards to Amazon.ca.  Please click here to see the flyer for this project.

The English version of the survey can be accessed at the following link:
http://www.surveygizmo.com/s3/1979575/Current-Estimates-of-HIV-Self-Testing-and-Treatment

Vous pouvez accéder la version française du questionnaire au lien ci-dessous:
http://www.surveygizmo.com/s3/2046051/Tests-et-Traitement-du-VIH-Situation-Actuelle

For more information, please contact:

Dr. Nitika Pant Pai, MD, MPH, PhD
Associate Professor, Department of Medicine
McGill University
nitika.pai@mcgill.ca

Dr. Alice Zwerling, MSc, PhD
Assistant Professor, School of Epidemiology and Public Health
University of Ottawa
azwerlin@uottawa.ca

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AIRN Poster Presentation at CAHR 2018

The Atlantic Interdisciplinary Research Network on Social and Behavioral Issues in Hepatitis C and HIV/AIDS (AIRN) had the opportunity to present a poster – Recommended Models for Introducing Safer Consumption Sites (SCSs) in Nova Scotia – at the recent annual 27th Canadian Conference on HIV/AIDS Research (CAHR), held in Vancouver in late April.

Two key data sources were used to assess needs, challenges, opportunities feasibility and acceptability of introducing SCSs in Nova Scotia and to develop recommendations for preferred provincial models: (1) Literature review on SCS best practices and delivery models nationally and internationally; and (2) Consultations with 54 service providers, provincial-level stakeholders and people who use drugs (PWUD).

Strong support for the introduction of SCSs was found, with participants noting that they save lives, offer connections, and can link PWUD to other critical services. Findings highlighted the need for SCSs to be coordinated within an equitable province-wide systems perspective that: spans the range of health and social services needed by PWUD; provides equitable access to all Nova Scotians, while allowing flexibility in approach by location/context as appropriate; meaningfully engages PWUD and works to address stigma; and incorporates rigorous monitoring and evaluation.

The SCS model must be based on the harm reduction expertise of existing CBOs who must be funded sufficiently and sustainably. Other recommended key features of SCSs for Nova Scotia are outlined under the headings of site, services and staffing, which should include health and social service professionals, along with a strong presence of people with lived experience. The toxicity of the street drug supply was highlighted, as was the need to consider prescription opioids, including medical-grade heroin or hydromorphone.

A phased approach to establishing three different SCS models (integrated, mobile and embedded) across multiple sites (Halifax, Cape Breton and Truro/Amherst or Shelburne) in Nova Scotia is recommended. An implementation team – informed by a panel of PWUD and other harm reduction experts – is needed to develop a multi-year action plan to move the specific recommendations forward.  To view the poster, please click here.

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New Implementation Science Research Design Tool

The Centre for Implementation Science at King’s College London has recently developed the ImpRes Tool. Its purpose is to support research teams who are in the process of designing implementation research and work to implement evidence-based interventions into practice.See: http://www.kingsimprovementscience.org/files/ImpRes_Guide_April_2018.pdf?utm_source=EIC+Stakeholders&utm_campaign=7c2e35f8b4-EMAIL_CAMPAIGN_2018_04_22&utm_medium=email&utm_term=0_ea81bd44fe-7c2e35f8b4-295895941

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MB HIV Collective Impact Network April Symposium Great Success!

A Great Success!
The Symposium was an overwhelming success with over 95 people in attendance on April13. The purpose of the event was for knowledge exchange, idea generation and for network building. We had people from Saskatchewan, Ontario, Nova Scotia as well as people from all over Manitoba!
We were pleased to have 18 posters including a quilt as a poster!
We particularly appreciated the many out-of-town presenters and participants who were able to attend.
Many thanks to all the helpers who made this happen: including volunteers, staff, students, & our Stewardship Team.
We will be preparing a report. Watch for it in our next Monthly e-news in June!

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Preventing the spread of HIV: The critical role of addiction treatment services

Dr. Lois Jackson of Dalhousie University (NPI) and Cindy MacIsaac of Direction 180 (PKU) recently received some great news from CIHR. Their team’s project, Preventing the spread of HIV: The critical role of addiction treatment services, has been funded under the HIV/AIDS CBR Operating Grant program.

This research will help us to better understand the barriers and facilitators of access to and retention in various publicly funded addiction treatment programs across Atlantic Canada for people who use drugs (PWUD). It will also examine the implications of accessing and/or not accessing these critical services in terms of HIV and hepatitis C-related risks. Very importantly, the proposed approach will provide for an open and meaningful discussion with PWUD and other key stakeholders about the barriers, and potential actions for reducing them and improving access.

Addressing issues of access to and retention in publicly-funded addiction treatment program is critical to Canada’s response to HIV, not only in terms of prevention, but also in engagement and care. Studies conducted within Atlantic Canada have documented a number of systemic barriers to treatment access and retention, including various policies and practices which serve to deter, hinder or facilitate access to and success of treatment. Research is clearly needed to highlight these key barriers and facilitators and to develop strategies and actions for addressing the barriers in moving forward effectively.

For more information about this initiative, please see http://webapps.cihr-irsc.gc.ca/cfdd/db_results_submit. Stay tuned for more details.

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Project Update: Additional Harm Reduction Services in Two Sites in Nova Scotia

additional In the spring of 2017, Dr. Lois Jackson, Diane Bailey, Christine Porter, Dr. Margaret Dechman, and the other members of the CBR team* received some support from REACH 2.0 to conduct a one-year study titled, “Additional harm reduction services in two sites in Nova Scotia: An exploration of advantages, community interest and methods of delivery.” The results will help inform decisions about additional harm reduction services in Nova Scotia, and will likely form the foundation for future research. This blog provides a brief update on the developments of this project. A poster outlining the objectives and methods was presented at the 1st CRISM Maritimes Symposium/Exchange session held in Halifax December 5, 2017.  CRISM – Canadian Research Initiative in Substance Misuse – is a national multi-year initiative launched by the CIHR Institute of Neurosciences, Mental Health and Addiction. The theme of the CRISM symposium was Collaborative Research & Implementation Science in Addiction Intervention. The purpose of this collaborative, community-based study is to explore what people who use drugs (PWUD) and key local stakeholders think about additional harm reduction services in their communities of Halifax and Sydney, Nova Scotia.  More specifically, the objectives are to understand what PWUD and key local stakeholders perceive as: the advantage(s) of each of the additional harm reduction services; the implementation climate (e.g. support for implementing the additional harm reduction services); and how to adapt additional harm reduction services to meet local needs (e.g. how should the services best be delivered – fixed site, mobile site, etc ?). Additional harm reduction services for the purpose of this project refer to:

  • A no cost naloxone program for PWUD;
  • A peer-staffed community detox or withdrawal management program;
  • A supervised consumption room;
  • A peer-run navigation service (to assist in accessing supportive housing, navigating social services, etc.); and
  • A no cost needle syringe distribution and disposal (NSDD) program within existing local services (e.g., hospital emergency department).

For the Sydney site, additional harm reduction services also includes a non-governmental, community-based, low-threshold opioid substitution program, which is currently not available in Sydney (but available in Halifax). Approval was received from the Research Ethics Boards at both Dalhousie University and Cape Breton University. The project is being conducted in two main phases, the first involving the administration of questionnaires for PWUD through Mainline Needle Exchange in Halifax (100 participants) and Sharp Advice Needle Exchange in Sydney (50 participants) sites. The second phase will be launched in early 2018, and will involve a small number of interviews with various local key stakeholders. Data collection with PWUD is almost complete across both sites, and the data analysis for the questionnaire portion will begin soon. For more information about this project, please contact Dr. Lois Jackson, School of Health and Human Performance, Dalhousie University at lois.jackson@dal.ca. ______________________________

  • L. Jackson1; D. Bailey2; C. Porter3, M. Dechman4, J. Gahagan1, J. Karabanow5, S. MacKenzie6, P. Melanson7, M. Proctor-Simms8, N. Tousenard9

1 School of Health and Human Performance, Dalhousie University, 2 Mainline Needle Exchange, Halifax, NS, 3 Sharp Advice Needle Exchange, Cape Breton, 4 University of Cape Breton, 5 School of Social Work, Dalhousie University, 6 Nova Scotia Health Authority, 7 Mobile Outreach Street Health, 8 NS Advisory Commission on AIDS, 9 Halifax Area Network of Drug Using People (HANDUP)

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Free Naloxone Now Available in Nova Scotia Pharmacies

THN

Naloxone, a life-saving antidote to an opioid overdose, is now much more available and accessible throughout Nova Scotia thanks to the government’s Take Home Naloxone Program, announced earlier in 2017 as part of its Opioid Use and Misuse Framework.

At the end of September 2017, Take Home Naloxone kits became available free of charge at more than 240 participating community pharmacies across Nova Scotia.  These kits are available anonymously without a prescription or health card to anyone who is at risk of an opioid overdose or is likely to witness and respond to an overdose (e.g. family/friends and frontline service providers).  Individuals wanting a naloxone kit must first complete basic opioid overdose/naloxone administration training at the pharmacy which takes approximately 20 minutes. To learn more about Nova Scotia’s Take Home Naloxone Program, including a map of participating pharmacies, visit www.nsnaloxone.com.  For media coverage surrounding this program, click here.

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RÉFLEXIONS SUR LES PRINCIPES DE LA RC : LA PARTICIPATION SIGNIFICATIVE ET LES PRINCIPES GIPA/MIPA

MEPA

Participation significative et GIPA/MIPA : L’ordre du jour de la RC doit : être dirigé par la communauté; démocratiser le savoir (tous les partenaires ayant des voix égales); et miser sur les forces et ressources présentes dans la communauté. La communauté et les personnes ayant une expérience vécue participent activement et de façon significative à toutes les étapes du processus de la recherche, ce qui respecte et intègre activement les principes du domaine du VIH concernant l’implication accrue et significative des personnes vivant avec le VIH/sida (GIPA/MIPA) et a été mis en vigueur à l’échelle des pratiques du Collaboratif de RC.

J’ai participé à du travail lié au VIH, de la fin des années 1980 jusqu’au milieu de la première décennie de notre millénaire, puis mon parcours est allé vers une perspective plus large d’équité en santé et de justice sociale. Je suis de retour dans le domaine du VIH depuis moins de deux ans. En plus des changements en matière de prévention, de dépistage et de traitement, j’ai été emballée de constater le progrès touchant la participation significative et les principes GIPA/MIPA. Il reste encore bien du travail à faire, mais un changement d’attitude est palpable : on s’éloigne de la simple présence symbolique – j’ai observé ce progrès dans des équipes de recherche qui cherchent vraiment à intégrer et appliquer ce principe fondamental de la RC. Pour être concise et pour respecter la terminologie privilégiée lors de l’atelier dont je parle ci-dessous, j’utiliserai le terme GIPA/MEPA pour désigner simultanément la participation accrue et significative des personnes vivant avec le VIH dans tous les aspects du processus de la recherche.

Le recours à des pairs associés de recherche (PAR) fait partie intégrante des principes GIPA/MEPA. En novembre dernier, j’ai fait partie des 41 individus des quatre coins du pays qui ont participé à un atelier d’une journée intitulé Supporting Peer Research Associates Effectively [Soutenir efficacement les pairs associés de recherche]. Quoique conçu pour tous les intervenants en recherche, il s’adressait plus

particulièrement aux 31 pairs chercheurs et chercheurs universitaires en devenir qui étaient présents. Je ne cadre dans aucune de ces catégories. À titre d’employée du REACH, mon rôle était de prendre des notes et de rédiger le rapport de l’atelier – mais l’expérience est allée bien au-delà.

Les réflexions qui suivent au sujet des principes GIPA/MEPA sont tirées de quelques-unes des choses que j’ai apprises de cet événement inspirant, où le mot de bienvenue aux participants incluait ceci :

« L’élément principal de notre vision est que les principes GIPA/MEPA soient réalisés. C’est plus facile à dire qu’à faire. Cependant, les principes de l’engagement, de l’équité et de la justice sociale que nous affirmons et appliquons aux personnes vivant avec le VIH sont réalisables. Chacun et chacune d’entre nous ont des comportements, petits et grands, des attitudes et des tâches qui contribuent à faire de GIPA/MEPA une réalité, chaque jour. Par cet atelier, nous vous aiderons à affiner et à organiser vos idées sur GIPA/MEPA dans la perspective de la recherche. Dans tout type de recherche, en particulier dans la recherche communautaire, les personnes vivant avec le VIH ont une importance cruciale. La façon dont nous les traitons, dont elles se traitent les unes les autres, les occasions que nous développons pour elles, les façons par lesquelles nous communiquons – tout ça compte. » — Francisco Ibáñez-Carrasco, directeur de l’éducation et de la formation à l’OHTN

Le message de Francisco a résonné en moi toute la journée et même au-delà. J’ai souvenir de divers projets auxquels j’ai participé (mais pas tous) où GIPA/MEPA signifiait d’inviter quelques rares personnes ayant une expérience vécue à siéger à un comité consultatif ou d’orientation composé en très grande partie d’universitaires, de représentants gouvernementaux et d’employés d’organismes communautaires ou du domaine du VIH qui vivaient eux-mêmes, ou pas, avec le VIH. Pour plusieurs personnes ayant une expérience vécue, ceci était probablement très intimidant, plutôt qu’habilitant. Qu’est-ce que nous pensions? Comme je l’ai entendu pendant l’atelier, il est important d’impliquer des pairs comme conseillers dès les premières étapes d’un projet de recherche – même avant de préparer la demande de financement. Des idées que nous trouvons fabuleuses peuvent être vues très différemment par les membres de la communauté. Les personnes ayant une expérience vécue sont d’une valeur inestimable qui enrichit toutes les étapes de la recherche – du développement de l’idée jusqu’aux initiatives d’application/échange des connaissances, en passant par la planification du projet, le recrutement des participants ainsi que la collecte et l’analyse de données.

La discussion a également mis en relief le fait que, de nos jours, les PAR sont fréquemment impliqués dans le recrutement de participants et la collecte de données. Toutefois, plusieurs souhaitent avoir une participation accrue à d’autres aspects également, y compris l’analyse des données et l’application/échange de connaissances (AÉC). Sans cette implication, elles se sentent privées de pouvoir. Les perspectives des pairs renforcent grandement l’analyse de données et l’AÉC; pourtant, plusieurs chercheurs ne voient pas bien comment impliquer les PAR dans ces rôles. On peut favoriser cette participation par divers moyens, mais il faut de la souplesse, du soutien et une ouverture au non conventionnel. Le temps est venu d’instaurer les conditions gagnantes pour que les PAR s’épanouissent.

Nous avons beau avoir fait beaucoup de progrès au cours des récentes décennies, je reconnais que la vision évoquée par Francisco n’est pas encore réalité. Mais tout au long de l’atelier, nous avons expliqué que le fait de travailler avec des personnes ayant une expérience vécue, dans des postes de PAR, est bénéfique pour les équipes de recherche et tout autant pour le processus et les données de la recherche. Dans un rôle en recherche, les pairs contribuent à la confiance, à la crédibilité et à l’obtention de contributions de la communauté, que nous ne pourrions atteindre autrement. Engager comme chercheurs des individus ayant une expérience vécue comporte également la grande responsabilité de soutenir les PAR de manières spécifiques, y compris dans les domaines de l’administration, des finances, des émotions et de l’éducation. L’implication significative des PAR nécessite de leur fournir un soutien approprié – et il n’y a pas d’approche uniforme à toutes les situations pour le faire. Pour en savoir plus, restez à l’affût : nous publierons un lien donnant accès au rapport de l’atelier. Pour lire nos principes de la RC, cliquez ici.

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