COLLABORATIONS AND SOLUTIONS IN HIV, HCV AND STI RESEARCH

Quebec

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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Bonne nouvelle au Québec : un nouveau projet pilote accepté par les IRSC

La COCQ-SIDA, en collaboration avec la chercheure Christina Zarowsky (Université de Montréal) et une équipe de 19 chercheurs communautaires et partenaires sont fières de démarrer un nouveau projet pilote qui a reçu un financement du programme catalyseur en recherche communautaire sur le VIH/sida (2017) des Instituts de recherche en santé du Canada (IRSC). Ce projet porte sur l’accès aux soins et aux traitements antirétroviraux (TAR) pour les personnes vivant avec le VIH sans considérer le statut d’immigration.

Au Québec, des PVVIH éprouvent encore des difficultés complexes d’accès aux soins de santé et aux TAR à cause de leur statut d’immigration ou de l’absence de celui-ci. Pourtant les PVVIH sans recours aux TAR ont un risque très élevé de développer des problèmes de santé graves et de transmettre le virus. La prise quotidienne des TAR est également une stratégie de prévention (« indétectable=intransmissible»). De plus, ne pas avoir le droit ni l’accès aux soins de santé et aux traitements appropriés est contraire à la Déclaration universelle des droits de l’homme. Une couverture sanitaire universelle pour les PVVIH sans considérer le statut d’immigration répond aux objectifs de l’ONUSIDA (90-90-90) tout en venant combler les droits humains, en prévenant de nouvelles infections aux VIH et en contribuant à maintenir une société en santé.

Ce projet pilote regroupe une équipe intersectorielle et interdisciplinaire afin de baliser le « terrain » pour préparer un projet plus vaste afin de déterminer et de proposer une procédure réaliste de mise en place d’une couverture universelle au Québec pour toutes les PVVIH. Ce projet documentera l’information et l’expertise de l’ensemble des professionnels qui travaillent auprès de ces personnes afin de diffuser l’information aux intervenants communautaires et professionnels de santé  pour intervenir auprès des personnes dans cette situation en attendant un accès universel. À suivre!

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Mobilise! : des résultats de recherche pour optimiser l’accès aux services de prévention et de santé offerts aux HARSAH

L’équipe du projet Mobilise! était fière d’avoir présenté les données préliminaires de recherche lors de son Colloque, le 10 novembre 2017. Cet évènement faisait partie d’une série d’activités et de publications de transfert des connaissances déjà réalisées et à venir. Depuis 2015, ce projet de taille s’est penché sur la prévention des ITSS et du VIH chez les HARSAH et sur l’accès aux services de santé. Il avait également pour objectif de renforcer l’empowerment des membres de la communauté. Différentes méthodologies innovantes de collecte de données ont été utilisées, dont des focus group sous forme d’équipe citoyenne coordonnée par des leaders de la communauté, un questionnaire en ligne regroupant plus de 1000 participants et enfin, un scan environnemental pour recueillir des données sur l’accessibilité de plus de 100 services de prévention et de santé qui sont actuellement offerts au HARSAH dans la région de Montréal.

L’ensemble de ces données ont permis de mettre de l’avant la situation exceptionnelle de Montréal quant à la diversité de services de santé destinés aux HARSAH et la très bonne prise en charge des PVVIH. Pourtant, malgré cette diversité, la situation reste encore durablement préoccupante d’un point de vue épidémiologique (VIH, autres ITSS et autres problématiques de santé). De plus, des besoins en matière de santé sont encore non comblés, ou insuffisamment pris en charge, dont les services en dépendance, les services en santé mentale et l’accès à la PrEP et à la PPE. Les personnes trans constituent également un segment de ces communautés auquel il est nécessaire d’être particulièrement attentif en termes d’interventions ciblées et de surveillance. Ainsi, l’étude a permis de soulever les nécessités de maintenir une offre de service diversifiée et d’améliorer le caractère inclusif des services pour les HARSAH, en tenant compte des caractéristiques sociales et culturelles hétérogènes de chacun d’entre eux. Finalement, la nécessité de développer une meilleure coordination entre les services est ressortie comme un des enjeux prioritaires.

Ce projet d’envergure réalisé par l’ensemble des chercheurs communautaires et collaborateurs de Mobilise! a permis de rendre compte de plusieurs éléments clés pour optimiser l’accessibilité aux services de santé et de prévention chez les HARSAH. La prochaine étape du projet est maintenant en préparation afin de poursuivre le transfert des connaissances. Un processus d’accompagnement sera développé pour partager les résultats du scan environnemental avec les différents organismes répertoriés afin qu’ils puissent implanter des plans d’action visant à optimiser l’accessibilité de leurs services auprès des HARSAH.

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MOBILISE! news : a busy summer with KTE

20915637_1053996861403526_3822078460514067046_nThe MOBILISE! team took advantage of the summer to go out to meet communities and give them some results from the project, raise awareness about combination prevention methods and introduce current resources. This KTE was specifically adapted for summer season. Many diverse populations benefited from the project and the team’s expertise during several guided tours through the Village, the BBQ during the Montréal Pride, as well as the information booth during Pride Community day and direct interaction with people in the Village. Organised in collaboration with L’Astérisk, a community-based organisation, and initiated by Bruno Laprade, four tours gave an account of  the history of the community mobilization of the LGBT+ community in the Village by linking it with current information on the resources and prevention methods. In addition, project trainees dressed in MOBILISE! t-shirts have gone out to meet people in bars, coffee shops and public spaces and to bring discussion around different prevention methods. These discussions allowed the people to question their perceptions and to deconstruct prejudices about these methods. The MOBILISE! BBQ brought together participants, collaborators and supporters of the project in a friendly atmosphere by enjoying hot dogs and hamburgers. The public was able to discover the project’s results by reading various information boards and participating in games created by the team. The most experienced have tangled their legs playing MOBILISE! Twister. Each color represented a category of prevention and the aim of the game was to “combine strategies while having fun”, replied Gabriel Giroux, community project agent of MOBILISE!

Participants tested their knowledge and discovered the project’s research results with the MOBILISE! Wheel of Fortune. The Wheel was also a great success on the Community Day at the Montréal Pride. Indeed, the players came after one another during the whole day. In addition to winning small condom pouch, participants engaged in conversation on the issues about sexual health and different methods of prevention. Finally, the MOBILIZE! researchers have applied for a new grant to continue the project in the next five years. In short, a successful and well-filled summer!

You can consult the Facebook page and the MOBILSIE! website for more information.

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Design an intervention with, by and for women living with HIV and victims of domestic violence

Scientific literature has demonstrated links between HIV and violence against women. Women who are victims of domestic violence are at greater risk of contracting STI, including HIV, as they experience more difficulties negotiating condom use, for instance. In addition, a large number of women living with HIV experience more violence in their intimate relationship. Knowing this, are there services in Quebec that offer support for women caught in the intersection of HIV and violence? Community-based research led by sexology researcher Mylène Fernet (UQAM) notes that HIV organizations do not sufficiently deal with domestic violence issues. In addition, shelters for women who are victims of domestic violence rarely address the issue of HIV. The study’s objective is to build connections between these two sectors to create strong partnerships and interorganizational knowledge and expertise transfers.

The first stage of this project took place during a two-day event, June 28 and 29, where Executive Directors, stakeholders and service recipients from both HIV and domestic violence organisations met to share their respective realities and knowledge in group interviews and in joint discussion activities. It was also an opportunity for participants to enhance their knowledge about HIV and domestic violence through training and knowledge dissemination activities. At the end of these days, three avenues of action have been put forward and will be the subject of the next step of this community-based research project to elaborate these different actions. The need for collaboration between these organisations proved essential, and participants of this event have showed great interest in developing their partnership.

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A Francophone Summit on the Reduction of Drug-Related Risks in Montreal

May 13, 2017, the day before the Harm Reduction International Conference, the first French-language summit on harm reduction of drug-related was held in Montreal. Many Francophone countries are affected by the risks related to drugs, criminalization and stigmatization, and the need to sit down together seemed urgent. That day, many panelists from Europe and Quebec gathered together. However, the fact was raised that attendance from Africa was, unfortunately, very low.

The day was structured around roundtable discussions and other dialogue spaces where several organization representatives, community stakeholders and communities members were given the opportunity to speak from their various perspectives and viewpoints concerning risk reduction. Several innovative projects were presented, including the one by Cédric Fazan, director of Switzerland’s Foundation Le TREMPLIN, which works with people with addiction and/or great social insecurity. The project consists of having day centre users participate in a microbrewer’s operations to produce their own, better quality, alcoholic drink. In addition, this project allows them to take part in a daily activity of self-improvement and work integration.

The summit also provided an opportunity to share various points of view, notably on the sensitive issue of identity. In fact, people who use drugs are often reduced to “drug users,” a very prejudicial label. To remedy this negative identification, a much more positive one was proposed: “chemically enhanced man or woman,” expression in reference to physic or intellectual capacities enhance through new technologies. Finally, the day ended with a thought-provoking question: “Is risk reduction happening because of drug use or because of prohibition?” To be continued in 2018!

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Provider Perspectives on HIV Point-of-Care Testing: CAHR Poster

We wProvider Perspectives on delivering HIV POCTere excited to share our poster Provider Perpectives on HIV Point-of-Care Testing: Results of an International Scoping Review the Canadian Association for HIV Research conference that was held in Montréal! The poster inspired a lot of really interesting conversations, ranging from suggestions to a purely peer-delivered model of HIV testing, to discussions about the broadening scope of practice for pharmacists delivering testing. There were many conversations about the recommended contributors of success, (1) ensuring there is a strong champion, (2) clear and consistent training, and (3) ensuring there is an effective referral system and linkage to care. This last piece was emphasized by many of those who stopped to chat. While the test itself is critical as a diagnostic tool, it is important to ensure that the next steps for the patient are clear not only for them, but for the providers so that individuals may either engaged in treatment or learn useful harm reduction strategies.

 

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“Capacity-bridging”: Community-based research beyond “capacity building”

The term “expert” ofPanel 1 (9)ten refers to scholars of great universities, however experts also exist outside of academia. In the context of community-based research, community members act as experts in their field and teach researchers. This is referred to “capacity-bridging” rather than “capacity-building”, which is often use d in community-based research. This theme was the subject of a stimulating discussion at the Canadian Association for HIV Research (CAHR) Conference ancillary event, on Wednesday, April 5 2017. This event, titled “Capacity-building or capacity-bridging: re-envisioning community-based research” and organized by COCQ-SIDA and its collaboratPanel 2 (7) (2)ors, was an opportunity to present this concept and its context of implementation. It was illustrated by community-based research projects and a participatory evaluation methodology that put this concept into practice. “Capacity-Bridging” initiative, proposed by the Aboriginal HIV & AIDS Community-Based Research Collaborative Center (AHA Center), emphasizes building knowledge and capacity for everyone involved in the research. The Mobilize! and Mon BUZZ projects coordinators have put forward the active and essential involvement of community members in building research at every stage of the project. Finally, REACH’s Flipped WPanel 3 (1) (2)orkshops in Evaluation offers ongoing support and learnings for several community-based organizations who are evaluating their projects. These workshops are also good examples of capacity bridging where each stakeholder is an active participant in the process. With about forty participants and a dynamic discussion, let us say that this event was a success.

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Being Pragmatic in Getting to the 90-90-90 Targets in Canada

The OHTN, REACH 2.0, in collaboration with the Canadian Foundation for AIDS Research, and Canadian Institutes of Health Research Living with HIV Innovation Team, are hosting a lunch symposium at CAHR this Friday, April 7th from 12:30-14:00.

This program science plenary will showcase work underway in BC, Alberta, Manitoba, Ontario, and Quebec to build and scale-up monitoring of the HIV care cascade. Presenters will share information about the data platforms and systems evolving to monitor the cascade and about interventions being used to help people living with HIV stay connected to care. The session will engage participants in a discussion about ways to encourage and support cross-sectoral collaborations, and the coordination of efforts within and across provincial health and public health systems to achieve (and exceed) the 90-90-90 target goals.

Learning Objectives

  1. Highlight efforts and initiatives underway across the country to monitor the HIV Care Cascade and support people living with HIV to engage in and stay connected to care
  2. Review the data platforms and systems necessary to monitor the cascade, and innovative and pragmatic interventions getting underway to engage and retain people in care
  3. Describe contextual enabling / adaptive factors and barriers that can occur in building and scaling up these health system models of care in Canada, and possible solutions
  4. Gain insight into efforts needed to encourage and support cross-sectoral collaborations, and the coordination of efforts to support 90-90-90 goals

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