COLLABORATIONS AND SOLUTIONS IN HIV, HCV AND STI RESEARCH

Atlantic Canada

Mainline’s Peer Navigators Playing Vital Role in Harm Reduction

A community-based project led by Mainline is playing a vital role in harm reduction efforts and  helping to reach some of Halifax’s most marginalized people who use drugs (PWUD).  More than 20 PWUD have been trained as peer navigators and are working alongside Mainline’s peer staff in delivering various harm reduction services, including the distribution of clean equipment, the collection of used supplies, peer support, safer drug use education, as well as links to various health and ancillary support services. “The meaningful engagement of people who use drugs as peer navigators is so important,” says Mainline’s Director, Diane Bailey. “Peer navigators are critical to reducing the transmission of hepatitis C, HIV and the many other risks of drug use in our communities. Their experience provides a vital gateway and can bridge the gap between isolated PWUD and access to health and social support services.”

A demonstration project conducted last year by Mainline also highlighted the benefits of engaging as peer navigators on PWUD themselves. Testimonials revealed increases in knowledge, skills, confidence and empowerment, as well as hopefulness that they are inspiring their peers to also help in their communities. Through the expansion of services and increased visibility of the peer navigator “foot patrol” outreach, Mainline expects to  improve overall service delivery and the effectiveness of their harm reduction interventions in preventing hepatitis C, HIV, and other STBBIs. As stated by Diane Bailey, “Peer navigators have their pulse on the current drug using trends that can inform the policies and programs delivered by Mainline.”

Mainline will be hosting a peer-based education event in partnership with Direction 180 and HANDUP August 31st in honour of International Overdose Awareness Day and welcomes everyone to come meet their peer navigators and staff.

For some media and social media coverage on the project:

http://www.cbc.ca/news/canada/nova-scotia/medical-students-learn-about-dirty-needles-addictions-1.4650215
https://globalnews.ca/news/4370502/nova-scotia-hepatitis-c-research/
https://twitter.com/needleexchange2

 

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Moving Positively Together in Atlantic Canada

Moving Positively Together in Atlantic Canada was a one-day workshop for people living with HIV from Nova Scotia (14), Newfoundland and Labrador (6), New Brunswick (3), and PEI (3). It was part of a two-day weekend event co-hosted by AIRN and the Canadian Positive People Network (CPPN), where the first day included a regional symposium hosted by the CPPN to consult with people living with HIV and HIV co-infections around regional needs, gaps and priorities as well as to learn about U=U, the opioid crisis, and HIV criminalization.

The Moving Positively Together in Atlantic Canada workshop was held on the second day, hosted by AIRN, and made possible through funding from REACH for a 6-month foundational project, titled “Building Capacity for the Stigma Index Implementation in Atlantic Canada.” The workshop itself represents a relatively small component of the project and was intended primarily as a launch and momentum builder toward the project’s main objectives: (1) To connect/reconnect people living with HIV in the Atlantic Region; (2) To build a network of people living with HIV across the four Atlantic provinces; and (3) To build leadership capacity for the HIV Stigma Index implementation among people living with HIV in the Atlantic Region.

An anonymous survey was completed by all 26 participants immediately after the workshop to assess satisfaction and achievement of the various capacity building objectives. The feedback received was very positive, and a few of the highlights include:

  • 96% of participants reported being Very Satisfied (61%) or Satisfied (35%) with the workshop overall;
  • 91% – 100% were Very Satisfied or Satisfied with the networking and learning opportunities, as well as with all of the facilitated sessions;
  • Participants Strongly Agreed or Agreed that the event helped them: Connect/reconnect to PLWHIV (100%); learn about HIV-related stigma and its complexity (96%); understand the benefits of the Stigma Index (73%), and explore what we can do to move toward implementation (72%).

The findings around intentions are particularly encouraging, and underscore the workshop’s success in building momentum toward the actual implementation of the HIV Stigma Index in Atlantic Canada. The vast majority (77% – 100%) of participants reported intentions to stay in contact with other workshop participants, and to learn more about and become involved in an Atlantic Network of people living with HIV as well as the HIV Stigma Index. Stay tuned as the Atlantic region moves forward on this critical work!

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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
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* 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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Sounding the Alarm in New Brunswick

The first ever harm reduction symposium in New Brunswick was held March 23rd and 24th in Saint John. The event was launched on a Friday evening, where more than 200 provincial and municipal leaders, policymakers, administrators,  other stakeholders, and members of the general public heard from the provincial Minister of Health and Acting Chief Medical Officer of Health, as well as national and international harm reduction experts, Dr. Marilou Gagnon and Mr. Don MacPherson.

The day-long “Sounding the Alarm” Saturday event was also filled to capacity, with more than 200 healthcare workers and trainees from various sectors gathered to share, learn and inspire. Elder Michael Paul welcomed participants to Wolastoquey Territory with a sweetgrass smudging ceremony and prayer. Marilou Gagnon then provided a very comprehensive keynote presentation on the current state of harm reduction nationally. The day continued with excellent sessions, including: addiction and trauma-informed care; the needle exchange experience on the Elsipogtog First Nation; a video and heartfelt discussion with HANDUP (Halifax Area Network of Drug Using People); a panel discussion on opioid substitution therapy, pharmacists on the front lines, and prescription drug monitoring; and infectious disease complications among people who use drugs. Donald MacPherson, Director of the Canadian Drug Policy Coalition, provided the final keynote session, highlighting the number of toxicity deaths and the urgency of taking action on Canada’s ineffective drug policy.

The evaluation of the event was extremely positive, indicating that stakeholders from all over New Brunswick are hungry for more information and requesting another similar symposium consisting of an extra day. A glance at the social media comments provide some indication of the event’s success.

  • The #SoundingtheAlarm symposium gave me hope ! It was amazing to see leaders from ALL sectors coming together to talk about harm reduction. This rarely happens !
  • The #SoundingtheAlarm organizers set formidable examples for academic meetings: hired a local social enterprise for (healthy) catering, donated speakers’ honoraria to local shelters, acknowledged unceded territories, involved Indigenous speakers and persons with lived experience.
  • Halifax Area Network of Drug Using People (HANDUP) screen their film at #SoundingTheAlarm Harm Reduction Symposium. Their inspiring Q&A panel received a standing ovation. Thanks for the work you do!

For more information:

 

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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.

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  • 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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