Appendix B (research projects): Population-specific HIV/AIDS status report: HIV/AIDS and other sexually transmitted and blood borne infections among youth in Canada

Appendix B – Research Projects Focusing on HIV/AIDS among Youth

Project R1

Title: A CBR approach to enhancing Toronto HIV prevention services for newcomer youth
Principal investigator: Roxana Salehi
Co-investigator: Sarah Flicker
Abstract: The early teen years are the period where first sexual encounters occur and risk for HIV emerges. Current HIV prevention services have been deficient given the increasing rates of STIs among youth, coupled with an alarming decrease in their knowledge of HIV/AIDS. Newcomer youth immigrants, refugees, or Non-Status youth who have lived in Canada for five years or less are some of the fastest-growing populations affected by HIV/AIDS in Ontario. We know very little about their unique health needs. To fill this gap, my PhD work explores the accessibility and effectiveness of Toronto HIV/AIDS prevention services for newcomer youth aged 13-19 as a basis for reducing the existing racial and ethnic disparities in health outcomes. My work is nested within a community-based project called Toronto Teen Survey. My focus within the larger project is specifically on newcomer youth. Many newcomer youth encounter immigration-related factors that can put them at risk of marginalization, including poverty, and cultural/ linguistic barriers to accessing services. Thus, effective HIV preventive services should be sensitive to the unique vulnerabilities of this group. Newcomers, however, are not a homogeneous group. Individual and interpersonal differences, such as gender, race, substance use or family dynamics, differentially expose youth to HIV transmission. Traditional HIV/AIDS research has paid inadequate attention to: i) larger structural factors, such as racism or sexism, that affect HIV risk, and ii) to the variations in sex, gender, and sexual orientation that represent lived experiences of youth. I will work towards compiling a theoretical model that explores diversity and the larger social context. I will use both survey and focus group data to generate theories and disseminate practical knowledge for enhanced programming and service delivery. This work should create better HIV prevention programs and contribute to the global movement to eliminate HIV/AIDS.
Dates: May 2009-April 2011
Funding program: CIHR Doctoral Research Awards-HIV/AIDS Community-Based Research-General Stream
Source: CIHR database

Project R2

Title: A developmental CBR study to investigate factors leading to pregnancy and HIV risk among female street youth in Toronto
Principal investigator: Allison Scott
Abstract: not available
Dates: February 2007-January 2009
Funding program: OHTN Operating Grant
Sources: OHTN & CAHR databases

Project R3

Title: Adolescents infected through vertical transmission: Analysis of their developmental trajectory
Principal investigator: Mylène Fernet

Abstract: The profile of the pediatric epidemic has changed and is now characterized by the emergence of a high number of young people who have lived with HIV infection since birth; some are on the threshold of adolescence while others have reached the age of majority. Although many studies have been conducted in the adult HIV population, few have examined the situation of pre-adolescents and adolescents infected at birth through vertical transmission (Battles and Wiener, 2002; Fielden, 2005; Mialky, Vagnoni and Rutsein, 2001). As they enter adolescence, these young people are faced with the question of disclosing their HIV status (Fielden, 2005), along with the various issues associated with treatment management and the many changes that accompany puberty (Fielden, 2005; Hoffman, Futterman and Myerson, 1999; Trocmé et al., 2002). Results: An initial study funded by the CIHR (2004-2006) recruited from among the CMIS mother-child cohort at CHU Sainte-Justine a total of 30 pre-adolescents and adolescents who were infected at birth (participation rate of more than 88%) and identified the key areas in which child development appears to have been comprised. Objectives: The purpose of this renewal application is to illustrate the developmental trajectory of adolescents in the following areas: (1) health management and modes of treatment appropriation (side effects, treatment compliance, etc.); (2) the types of interactions adolescents establish with their environment, particularly with respect to disclosure of their HIV status; (3) the feelings of isolation that are frequently associated with a burdensome secret that is difficult to share; and (4) adolescents’ relationships with others and with their sexuality, as well as the prevention issues with which they are faced. Research plan: This qualitative study is informed by the theory of symbolic interactionism (Blumer, 1969; Le Breton, 2004). It involves conducting a second qualitative data collection exercise with the same 30 youths (15 girls and 15 boys, average age 14.5 years) 24 months after the first series of interviews. Non-directive individual interviews of approximately two hours duration will be conducted at the CMIS, CHU Ste-Justine. An interview grid derived from that of the Children’s and Women’s Health Centre of British Columbia (2000) and informed by the interview data obtained in the course of the first study will be used. Once it has been matched on a case-by-case basis with the first set of interviews, the data collected in the present study will be subjected to chronological analysis (Miles and Huberman, 2005), with an emphasis on grounded theory procedures (Fernet, 2005). Benefits: Given the scarcity of Canadian studies that deal with these issues and the specificity of a study that examines the first generation of adolescents to have lived with HIV infection from birth, this study clearly addresses an immediate need and will contribute to the advancement of knowledge in this area. The study will begin by establishing the developmental characteristics of adolescents living with a chronic disease that affects not only their health but also their personal and sexual interactions. From a methodological standpoint, this study is highly innovative in that it proposes to qualitatively analyse the developmental trajectories of these adolescents from a chronological (longitudinal) perspective. To our knowledge, only one quantitative longitudinal study has focused on this unique population. The results of this study will be used to establish an education and prevention program that takes into account the developmental issues facing these adolescents; they may also serve as a model for studies and intervention programs in other places where vertical transmission is still taking place, both in Canada and in Europe.
Dates: January 2007–January 2009
Funding programs: Fonds québécois de la recherche sur la société et la culture (FQRSC)-Operating Grant and Fonds de la recherche en santé du Québec (FRSQ)-Operating Grant
Source: OHTN database

Project R4

Title: A longitudinal examination of child sexual abuse and motivations for sex as predictors of sexual risk behaviours and poor sexual health outcomes among adolescents in the child welfare system
Principal investigator: Carolyn A. James
Co-investigator: Jennifer S. Mills
Abstract: Youth in the child welfare system are a greatly at-risk, yet relatively understudied population. Those who have experienced childhood sexual abuse (CSA) may be at particular risk for engaging in maladaptive health behaviours, including various risky sexual behaviours. However, the pathways leading from CSA to maladaptive sexual health behaviours are poorly understood among this population. Motivations for sex, or reasons for engaging in sexual behaviour, have been found to be related to various sexual risk behaviours. As such, motivations for sex might be important in explaining the relationship between CSA and later sexual risk behaviours. Additionally, some research has suggested that the degree to which CSA is associated with negative outcomes is related to the severity and chronicity of such abuse. The proposed study will examine how CSA and motivations for sex are related to changes in sexual risk behaviours over time (baseline, one-year and two-year follow-ups) among child welfare youth. Understanding the mechanisms by which CSA leads to maladaptive health behaviours is necessary for the development of interventions to break the cycle of maltreatment and adverse health outcomes.
Dates: September 2006-February 2010
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Doctoral Award
Source: CIHR database

Project R5

Title: An investigation of injection drug use and HIV infection among drug using youth
Principal investigator: Thomas H. Kerr
Abstract: not available
Dates: July 2006-June 2011
Funding program: CIHR New Investigator
Source: CIHR database

Project R6

Title: An investigation of the impact of crystal methamphetamine use on sexual and injection-related risk behaviour among street youth and injection drug users
Principal investigator: Brandon D. Marshall
Co-investigators: Thomas H. Kerr; Jean A. Shoveller
Abstract: Illicit drug use remains a major public health concern throughout Canada. The health and social consequences of injection drug use are particularly severe and include high rates of blood borne disease transmission, including HIV and Hepatitis C. Additionally, in Vancouver and elsewhere in Canada, there is concern regarding escalating rates of crystal methamphetamine (CM) use. The prevalence of CM use is rising in other settings internationally and has been associated with unsafe sexual and injecting practices among specific subpopulations at risk for HIV. However, the potential associations between CM use and sexual and injection-related risk behaviour among marginalized populations in Vancouver have not been fully investigated. A fundamental aim of the proposed research is to improve our understanding of the interactions between CM use and sexual and injection-related risk behaviour that concomitantly result in increased vulnerability to HIV and other sexually transmitted infections among street youth and injection drug users. The specific objective of this project is to examine a number of factors that predict frequent CM use and engagement in sexual and injection-related risk behaviour. The primary hypothesis is that social disadvantage, impoverished living conditions, intensified law enforcement, and poor access to health-related services will be associated with higher frequency and intensity of CM use. The secondary hypothesis is that CM use will mediate sexual and injection-related risk behaviour in specific ways across different subpopulations (e.g., youth and IDU who do not identify as heterosexual, are homeless, or are currently involved in sex work). Given the growing concerns related to CM use and the scarcity of evidence to inform related health and social policy, this research is urgently needed to develop effective public health interventions that reduce and prevent HIV and STI transmission within marginalized populations in our country.
Dates: 2007 and 2008 and September 2008-March 2011
Funding programs: MSFHR Research Trainee Award, Junior Graduate Studentship and MSFHR Research Trainee Award, Senior Graduate Studentship and CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Doctoral Award
Sources: MSFHR and CIHR databases

Project R7

Title: An investigation of the impact of trauma and crystal methamphetamine use on injection drug use and HIV infection among drug using youth
Principal investigator: Jo-Anne M. Stoltz
Co-investigators: Robert S. Hogg; Evan Wood
Abstract: This study examines the ongoing impact of childhood trauma on injection drug use and HIV infection among illicit drug-using youth. Although a link has been established between childhood abuse and drug use in adolescence, there remains a lack of understanding of how abuse leads to drug use. In an effort to fill this gap, this study will sub-divide trauma into sexual/physical/emotional abuse and neglect, and explore each type of trauma in terms of its ability to predict HIV risk behaviour, HIV incidence, and initiation of injection drug use. This study also will examine the impact of crystal methamphetamine use on injection drug use and HIV infection among drug-using youth. Specifically, this research will explore the influence of crystal methamphetamine use on HIV risk behaviour, HIV incidence, and initiation of injection drug use among youth. Five hundred street-involved youth in downtown Vancouver, British Columbia, will be followed for five years. Participants will complete the Childhood Trauma Questionnaire at baseline, and an interviewer-administered questionnaire and blood testing for HIV and hepatitis C at baseline and every six months. The study is part of a larger, CIHR funded research project on the natural history of injection drug use.
Dates: July 2006-June 2009
Funding program: CIHR HIV/AIDS IPPH-Public Health Agency of Canada Fellowship
Source: CIHR database

Project R8

Title: Building capacity to conduct community based research on evaluating youth sexual health peer education programs
Principal investigators: June A. Larkin; Denise W. Jaworsky Co-investigators: Sarah Flicker; Susan Flynn; Jesse M. Janssen
Abstract: Many youth organizations and community groups have responded to the HIV epidemic and growing incidence among youth by implementing peer education programs; however these organizations often have limited capacity to properly evaluate the efficacy of these programs. The need for scientifically proven program evaluation methods is long overdue in the field of sexual health education as the current level of knowledge is insufficient to allow for policy decisions to be based on scientific data. The purpose of this application is to build the capacity of the youth-run organization, Children's AIDS Health Program, to evaluate youth sexual health peer education programs so that future research on the efficacy of youth peer education may be conducted. This project will be carried out as a collaboration between academic researchers in the fields of health promotion and health psychology and youth-focused HIV and sexual health community organizations. This project aims to review existing literature on levels of sexual health education among Canadian youth and on current evaluation methods for peer education programs. The next objective will be to develop and pilot a method of evaluating the efficacy of youth-peer education programs. Finally, a key component will be knowledge translation where the findings will be disseminated to community groups and youth organizations.
Dates: April 2008-March 2009
Funding program: CIHR HIV/AIDS Community Based Research Program-General-Catalyst Grant
Source: CIHR database

Project R9

Title: Analyse d'implantation du Chî kayeh : application des connaissances auprès des communautés cries (Chî kayeh implementation analysis: Applying knowledge in Cree communities)
Principal investigator: Joanne Otis
Co-investigators: Thérèse M. Bouchez; Françoise Caron; Isabelle Duguay; Manon Dugas; Marlène Beaulieu; Gaston Godin; Joseph J. Lévy Abstract: In 2005, following several consultations, Cree government authorities decided to adapt the theoretically anchored program Express Protection, which was found to be effective in Montérégie. That is how the innovative Chî kayeh program came to be developed with a view to respecting the needs and cultural distinctness of Cree youth and in accordance with 2005 data on students’ beliefs, thus ensuring extremely valid program content. In 45 lessons, the program aims to promote sexual health and to prevent STD and HIV infections and unplanned pregnancies among youth attending school. Implementation of the program was analyzed from 2006 to 2008. The next crucial step is a collaborative process for applying the knowledge acquired during analysis of the implementation, so that the findings can be validated and a basic implementation guide based on the recommendations made by those concerned during implementation of the program can be developed. The overall objective of the proposed process will therefore be to facilitate implementation of the findings of the Chî kayeh implementation analysis among those involved in the implementation. The specific objectives are as follows: (1) synthesize the findings and recommendations arising from the Chî kayeh project implementation analysis; (2) mobilize those involved in the Chî kayeh program implementation; (3) submit the implementation analysis findings to those involved; (4) discuss the research findings and the recommendations put forward by the researchers; (5) obtain a consensus on the Chî kayeh implementation recommendations and the program’s durability.
Dates: April 2006-March 2009 and September 2009-August 2010
Funding programs: CIHR-Operating Grant and CIHR Meetings, Planning and Dissemination Grant-Knowledge Translation Supplement
Sources: CAHR and CIHR databases

Project R10

Title: Recherche-action évaluative du processus d'appropriation du programme "Chî kayeh iyaakwaamiih" implanté dans le milieu scolaire autochtone des Terres-Cries-de-la-Baie-James (Evaluation action research on the process of taking ownership of the "Chî kayeh iyaakwaamiih" program in the Aboriginal educational environment of Terres-Cries-de-la-Baie-James)
Principal investigator: Joanne Otis
Co-investigators: Martin Blais; Sarah Flicker; Joseph J. Lévy; Jill E. Torrie
Abstract: To respond to Cree communities’ concerns about the sexual health of their young people, the Chî kayeh program was developed and incorporated into the school curriculum of two Cree communities in 2006-2007. From 2006 to 2009, an implementation study was done on the program, with the focus on the program itself (validation) and the factors influencing the process of taking ownership of the program, primarily by the teachers. The study results gave rise to a new version of the program, Chî kayeh iyaakwaamiih, which is more culturally adapted and sensitive to the realities and ways of living and learning of Cree youth. The program has been implemented in nine Cree communities since September 2009. This evaluative action research is being proposed with the ultimate goal of fostering program sustainability in these nine communities and building capacity among community members to implement it. The research will answer the following questions: What strategies will be used to ensure the sustainability of Chî kayeh iyaakwaamiih from one community to another and how will each community adapt the program to its own situation? What effects does the program have on students, and their school, family and community environment? To answer these questions, two goals have been set: 1) support and document the process of taking ownership and ensuring the sustainability of Chî kayeh iyaakwaamiih in each of the communities; 2) document the program’s effects in terms of the achievement of its goals, according to the indicators that the community considers significant. Multiple data collection methods will be used to achieve these goals, as well as a self-administered questionnaire for students three times before and after their participation in the program. 
Dates: October 2010-September 2011
Funding program: CIHR Operating Grant Priority Announcement: First Nations, Inuit and/or Métis Health
Source: CIHR database

Project R11

Title: Child sexual abuse as a predictor of sexual risk behaviour in adolescent youth in the Canadian child welfare system
Principal investigator: Tiziana Fulco
Co-investigator: Sandra Clare Paivio
Abstract: not available
Dates: 2007-2009
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Master Award
Source: CIHR database

Project R12

Title: Analyse chronologique des trajectoires amoureuses et sexuelles des adolescents vivant avec le VIH/SIDA depuis la naissance (Chronological analysis of the affective/sexual trajectories of adolescents living with HIV/AIDS since birth)
Principal Investigator: Kimberly H.Y. Wong
Abstract: not available
Date: 2008
Funding program: Canada Graduate Scholarships Program-Master Award
Source: SSHRC database

Project R13

Title: Cognitive beliefs and social attitudes as predictors of sexual risk behaviours among adolescents and young adults
Principal investigator: Michael Lima
Co-investigator: Steven R. Bray
Abstract: not available
Dates: September 2009-August 2010
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Master Award
Source: CIHR database

Project R14

Title: Colliding worlds: Looking behind HIV/AIDS discourse in public health campaigns and among Aboriginal youth
Principal investigator: Jorge Laucirica
Abstract: not available
Dates: January 2006-January 2009
Funding program: SSHRC Student Award
Source: CAHR database

Project R15

Title: Comprehensive intervention strategies with young HIV-positive women in Canada: Individual, social, and cultural factors that make sexual health promotion programs successful
Principal investigator: Sarah J. Fielden
Co-investigators: Jean A. Shoveller; Joanne Otis Abstract: Despite extensive global efforts to combat HIV/AIDS through prevention, treatment and care services, HIV infection rates continue to rise and approximately 25% of new infections are among young people. Young women are especially vulnerable to infection due to developmental, biological, social and cultural factors contributing to the feminization of the pandemic. Research that extends beyond behavioural models of sexual health promotion is urgently needed to help curb the spread of HIV and provide support and care for those already living with HIV/AIDS. This proposed research is Pan-Canadian and aims to both develop and evaluate innovative sexual health interventions with HIV-positive young women. Given evidence of the multiplicity of factors impacting on health and wellness outcomes for women living with HIV, the objectives of the study include examining social and community influences. As a qualitative program of research, this work will enhance the understanding of developing successful interventions with groups of marginalized young women through using qualitative and community-based methodologies. This will involve combining various qualitative methods including naturalistic observation and in-depth interviews with young women and other key stakeholders such as family members and service providers. It will use intervention mapping, a step-wise systematic method of determining relevant stakeholders, community needs, program directions and evaluation. The proposed research explores and addresses support and service needs of young women living with HIV in various geographic and cultural communities as it relates to their sexual health. In addition to the development of theoretically and empirically-based interventions, the project will serve to elicit cultural knowledge including understandings about the daily experiences of these young women in relation to their medical institutions, community-based services and family systems.
Dates: June 2009-May 2012
Funding program: CIHR Fellowships in Priority Announcement-In the Area of Health Services/Population Health HIV/AIDS Research
Source: CIHR database

Project R16

Title: Coping with the effects of cultural dislocation: Young Aboriginal People, the perils of injection drug initiation and the associations of HIV incidence
Principal investigator: Caroline Miller
Co-investigator: John D. O'Neil
Abstract: not available
Dates: January 2007-August 2008
Funding program: CIHR Fellowships in Priority Announcement-In the Area of Health Services/Population Health HIV/AIDS Research
Source: CIHR database

Project R17

Title: Critical approaches to youth HIV prevention, support and community based research
Principal investigator: Sarah Flicker
Abstract: not available
Date: 2008
Funding program: OHTN Grants
Source: OHTN database

Project R18

Title: Determinants of HIV-risk behaviour among South Asians, and evaluation of a brief HIV-risk prevention intervention
Principal investigator: Amrita Ghai
Co-investigators: Joel D. Katz; Trevor A. Hart
Abstract: HIV prevention remains an important challenge given stable rates of new infections per year. Considering the multicultural makeup of Canada, it is important that the prevention needs of particular cultural/ethnic groups be fully examined. Among cultural groups, South Asians in North America have not been adequately represented in HIV prevention efforts and literature. The proposed research program will investigate how particular cultural factors may impact individual risk factors and sexual risk behaviours in a sample of 400 South Asians, aged 18-35, in Toronto. Participants in the study will answer questions about their sexual risk behaviours (e.g., inconsistent condom use, unprotected sex), cultural variables (e.g. the extent to which they identify with their ancestral culture or the culture of majority, perceived support from their cultural community, perceived discrimination) and individual risk variables (negative attitudes towards using condoms, depression). The study will also evaluate an HIV-prevention video that is specifically targeted for a South Asian audience. This video was developed by a local AIDS service organization (The Alliance for South Asian AIDS Prevention), and depicts South Asian actors encouraging condom use. The study will assess how well the sample understands the video, how often they have seen it and how important they believe its message to be. It will also examine whether exposure to the video predicts sexual risk behaviour after six months. This information collected will help elucidate the role of cultural and individual risk factors on sexual risk behaviours. It will also help in the development of effective HIV prevention and educational campaigns that address the particular needs of the growing South Asian community.
Dates: September 2008-August 2011
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Doctoral Award
Source: CIHR database

Project R19

Title: Engaging newcomer communities in sexual health research: Understanding cultural factors for HIV risk reduction amongst immigrant and refugee ethno-racial youth in western Canada
Principal investigator: Susan E. Frohlick
Abstract: The main aim of this project is to build a unique and innovative collaboration of African immigrant and refugee youth, community organizations and university researchers across three cities to develop a process for a community-based research team involving youth as peer researchers. This project is the outgrowth of a community-university partnership in Winnipeg, partly funded by a CIHR MPD Grant that facilitated an exchange of knowledge about sexuality, sexual health and sexually transmitted infections with African newcomer youth grappling with cultural norms from their African heritage and Canadian society in the negotiation of safe sex practices. A clear message from these exchanges was that a public discourse around sex and sexuality was missing within these communities and that knowledge about culturally-sensitive strategies was sorely wanted in order to reduce their vulnerability to HIV infection related to linked factors of poverty, race, cultural gender and sexual norms, and stigma associated with sex and HIV. It was also clear that to be effective, intervention needs to engage the community at all levels of research and implementation including the research process, from design to data collection to youth-focused delivery of the messaging. Given the lack of information on youth and sexuality and HIV in ethnic minority immigrant populations in Canada, this project seeks to expand the scope of community-research partnerships to three cities in western Canada and the number of youth participants in order to develop a multi-year project using community-based research principles. The strength of the project lies in the multi-disciplinary regional team approach to CBR for HIV risk reduction targeted at and engaging marginalized and under-represented youth in African newcomer communities in identifying cultural factors that put them at risk. The team will generate a larger research proposal as the final outcome of activities outlined for this catalyst project
Dates: October 2010-September 2011
Funding program: CIHR Catalyst Grant-HIV/AIDS Community-Based Research Program-General Stream
Source: CIHR database

Project R20

Title: Engaging young women in online STI testing: The role of social context
Principal investigator: Wendy M. Davis
Co-investigator: Jean A. Shoveller
Abstract: New interventions, such as British Columbia's Online Sexual Health Services Program (OSHSP), are being launched to complement existing face-to-face clinical services, in the hopes that they may improve young women's participation in STI/HIV testing. Seeking STI testing remains a deeply stigmatized behaviour for many young women, a reality that is unlikely to be fully remedied by online services (e.g. face-to-face enactments of gendered stereotypes can also be represented online through a text-based medium). Unfortunately, we do not yet fully appreciate how important social factors (e.g. social norms; stereotypes women's responsibilities for sexual health) affect experiences with online STI testing (particularly within vulnerable subgroups of young women). Thus, the proposed study will seek to better understand young women's perspectives on the ways in which important aspects of their social contexts (e.g. stigma; gendered stereotypes) affect their engagement in this and other sexual health promotion activities. Multiple data collection and analysis techniques will be used (e.g. focus groups and individual in-depth interviews; a Youth Roundtable to refine analysis from focus groups and individual interviews and a Youth Working Group will be formed to provide insights into the development and design of the look, feel and content of website. The proposed study will be conducted in Greater Vancouver, and will adopt participatory approaches. Ultimately, the new information gathered during this study will help inform the development and design of an online STI testing service in British Columbia.
Dates: September 2010-August 2011
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Master Award
Source: CIHR database

Project R21

Title: Examining structural vulnerabilities to injection drug use and HIV infection among marginalized young people: An approach using complex systems modeling and social epidemiology
Principal investigator: Brandon D. Marshall
Co-investigators: Sandro Galea; Evan Wood
Abstract: Injection drug use among young people is a growing national and international health problem. Given that injection drug use is a primary mode of HIV transmission and is responsible for many other health and social harms, preventing youth from initiating injecting is a major public health priority. However, there exists little scientific evidence to guide effective HIV and injection drug use prevention measures among at-risk youth. This research will address these urgent challenges and will provide necessary information to inform appropriate and effective responses to this health crisis nationally and internationally. The primary goal of this research is to use complex systems modeling (a form of mathematical modeling) to understand how rates of injection initiation and HIV infection are affected by social, environmental, and political factors - and are essential for the development of effective interventions. Specifically, new mathematical modeling techniques will be used to test the potential effectiveness of several interventions to prevent transitions to injection and reduce HIV risk among young drug users. Interventions to be examined include the expansion of addiction treatment programs for drug-dependent youth and the provision of safe housing options for homeless young people. The proposed research has important implications for a segment of the Canadian population that experiences considerable health-related harms and contributes substantially to societal and health costs. Given the growing concerns related to the initiation of injecting and the complexities of the interventions required to reduce HIV infections and other harms, the proposed research will generate valuable insights that can be applied by public health agencies and other decision makers to implement evidence-based programs and policies to address this important health issue.
Dates: January 2011-December 2013
Funding program: Fellowship-Priority Announcement-Health Services/Population Health HIV/AIDS Research
Source: CIHR database

Project R22

Title: Exploring and addressing the determinants of health in older children with perinatally acquired HIV-1 in British Columbia in partnership with families and communities
Principal investigator: Sarah J. Fielden
Co-investigators: Christabelle Sethna; Peter S. Tugwell
Abstract: With the advent of effective antiretroviral therapies, children with pediatric HIV are now maturing into adolescence and young adulthood. As they experience these transitions, additional age-appropriate services are needed to support their positive development. This research explores the health and wellbeing of older children with perinatally acquired HIV in British Columbia through three phases with the aim of laying the foundation for future health promotion interventions with this population of children. The first phase involves children, their family members and their healthcare and community service providers, and explores the needs of this cohort of children through a community-based, participatory, consultative process using qualitative inquiry. Based on findings from the first phase, a program model will be created which will combine empirical knowledge gained from the various stakeholders with theoretical models in the areas of health promotion, HIV/AIDS, and child and youth development. A third study will add a contextual, quantitative component to the research through a retrospective cohort study describing the mortality rates, drug treatment trends and demographic profiles of children with pediatric HIV in British Columbia.
Dates: September 2005-August 2008
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Doctoral Award
Source: CIHR database

Project R23

Title: Guys un-limited: Young men speak out about health services
Principal investigator: Elizabeth Marie Saewyc
Abstract: Sexually exploited and at-risk teen males often experience serious health issues. Recent research in British Columbia has shown as many as one in three street youth have been sexually exploited, males at equal rates as females. However, services to help sexually exploited youth are often focused on girls and young women, and use female-centred approaches that may not be supportive for young men. While young men in general access help less often than young women, sexually exploited teens experience stigma that may make them even more reluctant to access services they need. This study will explore sexually exploited and at-risk young men's experiences of health and social services, how their views and ideals about masculinity influence their decisions to access services and ways health care can be delivered using male-friendly approaches for this marginalized population.
Dates: April 2009-March 2011
Funding program: CIHR Operational Grant
Source: CIHR database

Project R24

Title: Impact of policy decisions and service delivery models on HIV/AIDS prevention: Ensuring comprehensiveness and accessibility for female adolescents
Principal investigator: Charlene P. Cook
Abstract: not available
Dates: 2006-2009
Funding program: SSHRC Doctoral Fellowships
Source: SSHRC database

Project R25

Title: Interventions utilisant les TIC pour la promotion de la SSR: partage d'expériences internationales (Interventions using ICT to promote SRH: Sharing of international experiences)
Principal investigator: Marie-Pierre Gagnon
Co-investigators: Françoise Coté; José Coté
Abstract: The situation of adolescents and young adults with respect to sexuality is a matter of concern despite multiple interventions aimed at this segment of the population. The younger generation’s familiarity with technology makes ICT a promising option for promoting sexual and reproductive health, including STD/HIV/AIDS prevention in adolescents and young adults, referred to herein as SRH. However, developing effective interventions using ICT requires solid scientific evidence. The purpose of the proposed project is to stimulate knowledge sharing among researchers with complementary expertise, policy makers and national and international stakeholders to create a solid, ongoing partnership. The subject of the first workshop will be a review of SRH interventions and strategies. Experts will share their experiences and explain the indicators used to evaluate the projects carried out so far by their respective institutions and the evaluation results. The purpose of the second workshop will be to develop an evaluation grid for studies on interventions using ICT to promote SRH. The main speakers at the workshop will be researchers who will present existing knowledge on the use of ICT to promote SRH. A discussion will follow to identify the intervention strategies, indicators and results to be validated in the studies included in the projected knowledge synthesis. The resulting grid will be used to examine the studies that meet the eligibility criteria established for the systematic review. This partnership among domestic and international players holds the potential for greater collaboration to improve strategies and the results of interventions to promote SHR.
Dates: October 2010-September 2011
Funding program: CIHR Planning Grants - Priority Announcement: HIV/AIDS (biomedical/clinical research and health services/population)
Source: CIHR database

 

Project R26

Title: Investigating and addressing injection drug use and other harms among street-involved youth: The ARYS project
Principal investigator: Evan Wood
Co-investigators: Jane Buxton; Scott E. Hadland; Richard P. Harrigan; Thomas H. Kerr; Brandon D. Marshall; Julio S. Montaner; Thomas L. Patterson; Élise Roy; Kate Shannon; Jean A. Shoveller; Steffanie A. Strathdee; Mark W. Tyndall Abstract: This research will address the urgent challenge of illicit drug use among street-involved youth. By studying a large group of street-involved youth in Vancouver, we will acquire the evidence-based information necessary to inform appropriate responses to this health crisis locally, nationally and internationally. Specifically, the project will examine patterns of illicit drug use and the risk environment in which they are used, and evaluate their effects on initiation of injection drug use, sexual risk behaviour, and incidence of hepatitis C and HIV among a cohort of 500 street-involved youth from 14 to 24 years of age. The study will investigate not only individual circumstances but also social, structural and environmental influences on risk behaviour. For instance, the study will assess specific factors such as homelessness and sex-trade involvement on sexual and drug risk-taking and infectious disease incidence, with the aim of informing pragmatic intervention strategies. The study will be carried out by inviting youth to conduct a standardized survey every six months for five years. The knowledge gained through this research should prove useful in guiding HIV and hepatitis C prevention measures, as well as initiatives to prevent the initiation of injection drug use among youth. Street youth represent one of the most vulnerable populations in Canada, and research to determine how to reduce harm among this population will be of benefit to all Canadians.
Dates: April 2010-March 2015
Funding program: CIHR Operating Grant
Source: CIHR database

Project R27

Title: Investigating determinants of injection drug use initiation among street youth in Vancouver
Principal investigator: Daniel M. Werb
Co-investigators: Evan Wood; Jane Buxton Abstract: While significant resources have been devoted to reducing the size and scope of illicit drug markets, recent data suggests that drug use and other drug-related behaviours such as drug dealing continue to occur at high rates in areas where these markets are located. Because HIV and other blood borne diseases are transmitted through injection drug use, research has focused on preventing the initiation of such behaviours. Of particular concern, then, is that research suggests that proximity to a drug market may increase the risk of initiation of illicit drug use and the initiation of drug dealing among vulnerable populations such as street youth. The proposed research project consists of an investigation of the factors that make individuals in vulnerable populations such as street youth more likely to engage in drug dealing. As well, this project will also investigate the factors that influence individuals entrenched in a drug market scene to cease both drug dealing and injection drug use. This investigation will use data collected among illicit drug users and street youth in Vancouver over three years. By focusing on initiation into drug dealing and cessation of drug dealing, it is hoped that this research will allow for the development of effective interventions aimed at preventing drug market involvement. Further, by focusing on the factors that affect cessation of drug use and drug market involvement, this investigation will also provide a framework within which to develop interventions targeted towards entrenched drug market participants. Given the intimate relationship between drug dealing and drug use at the street level in Vancouver and other Canadian urban areas, a project investigating both of these phenomena, and the way that they interact, will provide important findings that have implications for the development and implementation of a wide range of public health interventions.
Dates: September 2010-August 2013
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Doctoral Award
Source: CIHR database

Project R28

Title: Investigating population-level interventions to improve youth sexual health
Principal investigator: Jean A. Shoveller
Co-investigators: Mark P. Gilbert; Thomas H. Kerr; Marc Levine; Gina S. Ogilvie; John L. Oliffe; Kate Shannon; Judith A. Soon; Jessica Yee Abstract: The proposed research program focuses on investigating population-level interventions affecting youth sexual health (ages 12-24) within and outside of the health sector. Across Canada, many young people experience serious health and social problems related to sexually transmitted infections (STIs) and unwanted pregnancies. Despite public health efforts, STI rates among youth are high and rising; and, while teen pregnancy rates are levelling off within the population in general, the health and social impacts of these problems manifest disproportionately among vulnerable populations. Moreover, as sexual health inequities grow, conventional interventions appear to be increasingly disconnected from youth's primary prevention needs, especially the needs of vulnerable sub-groups of youth. Our research program is integrated within a set of established and growing partnerships amongst researchers (UBC; BC Centre for Excellence in HIV/AIDS) and our collaborative linkages with: (a) the public health system (e.g. BC Centre for Disease Control; Regional Health Authorities); (b) decision-makers in sectors other than health (e.g. education; social services; employment; housing); and (c) relevant NGOs and youth-led organizations (e.g. OPTions for Sexual Health BC; YouthCO AIDS Society; Native Youth Sexual Health Network). Together, we will launch multiple studies that are conceptually linked and will be implemented over the next five years, with the components of our proposed studies necessarily (and beneficially) informing one another to: 1) identify the mechanisms through which population-level interventions enhance or detract from youth sexual health; 2) describe how population-level interventions can be scaled up effectively to avoid exacerbating existing sexual health inequities, particularly amongst vulnerable sub-groups of youth; 3) assess the relative impacts on youth sexual health of population-level interventions within and beyond the health sector.
Dates: November 2010-March 2011
Funding program: CIHR-Operating Grant-Programmatic Grants to tackle health and health equity
Source: CIHR database

Project R29

Title: Learning from the voices of youth: A participatory research study exploring the HIV and HCV prevention needs of youth who smoke crack
Principal investigator: Lynne E. Leonard
Abstract: This research is driven by the expressed need of community partners for age-specific data relating to the HIV- and HCV-related prevention needs of youth who smoke crack. The lack of targeted health care and HIV and HCV prevention support services for people who smoke crack is particularly concerning considering the epidemiologic evidence demonstrating escalating engagement in crack smoking and virologic evidence documenting the HIV- and HCV-related risks associated with this practice. Street-involved youth are particularly vulnerable to crack use initiation. In Ottawa, 64% of street-involved youth reported using crack and/or cocaine without injecting. Youth engagement is an essential component of this project, as it is through the knowledge provided by youth that we will create the research tools, develop effective recruitment strategies, appropriately understand the research findings and design a targeted plan for the dissemination of findings. As such, youth under 25 who have experience with crack (direct or indirect) will be recruited to join the Project Team, which will serve as a working group to inform the research process and ordering of priorities. As a component of each Project Team meeting, youth will participate in a guided debriefing session in order to provide them with a safe space to share their feelings, reflect on their experiences in the meetings and make suggestions for ways of improving the process. This study will employ a sequential mixed methods design. We will use qualitative interviews to gather the perspectives of youth who have been identified as holding insight into the particular risk environments occupied by certain groups of youth who smoke crack. This data will inform the development of the quantitative analysis plan and survey tool. We will then carry out a quantitative survey to document engagement in HIV- and HCV-related risk behaviours and practices that may place youth who smoke crack at risk of HIV and HCV infection.
Dates: April 2011-March 2014
Funding program: CIHR Operating Grant-HIV/AIDS CBR Program-General
Source: CIHR database

Project R30

Title: Place and experiences of risk among young drug users in downtown Vancouver
Principal investigator: Danya Fast
Co-investigator: Thomas H. Kerr Abstract: Illicit drug use is associated with severe harms among youth. In Vancouver, recent epidemiological research has revealed alarming rates of mortality as well as HIV and HCV incidence among drug using youth. These problems persist despite the recent establishment of an array of youth services, including various harm reduction programs. While there is growing recognition that contextual factors play a central role in determining high-risk drug using behaviour, there exist few in-depth investigations of drug using contexts or 'scenes' that focus on the perspectives of young drug users. Such an approach is critical to the development of meaningful policy and program interventions that seek to address the severe and preventable suffering among drug-using youth. The proposed study will employ qualitative ethnographic methodology to explore young people's understandings of the structural, social and physical landscape of the downtown Vancouver drug scene, and how this environment shapes experiences of safety and risk among drug using youth. Although new lines of inquiry are likely to emerge as the research progresses, the primary objectives of this study are: 1) to examine how young drug users are initiated into and come to understand the downtown Vancouver drug scene; 2) to examine how this landscape shapes experiences of risk (including HIV risk behaviour, drug-related harms and physical violence) among young people, and alternatively, how it facilitates situations of safety; and 3) to examine the effects of spatial exclusion as a result of urban revitalization and gentrification on experiences and understandings of safety and risk. By exploring each of these objectives, this study aims to identify those aspects of this 'risk environment' that mediate harm among young drug users, and are therefore relevant to policy and program intervention.
Dates: September 2009-August 2012
Funding program: CIHR Vanier Canada Graduate Scholarships
Source: CIHR database

Project R31

Title: Primary HIV prevention research in marginalized communities
Principal investigator: Neil Andersson
Co-investigators: Chris P. Archibald; J. K. Barlow; Douglas A. Coyle; Nancy L. Gibson; Beverley J. Shea Abstract: Primary HIV prevention involves reduction of risk factors for HIV prevention in the first place. This Centre will develop research methods and capacity for primary HIV prevention, focussing particularly on resilience in Aboriginal youth and in marginal communities. It will develop primary prevention interventions for these settings, test and implement decision aids to support translation of primary HIV prevention research into effective prevention policies.
Dates: September 2008-December 2008
Funding program: CIHR HIV/AIDS Population Health and Health Services
Source: CIHR database

Project R32

Title: La promotion de la santé sexuelle et reproductive, incluant la prévention du VIH-sida, soutenue par les technologies de l'information et des communications: une étude de faisabilité chez les Premières Nations (Promotion of sexual and reproductive health, including HIV/AIDS prevention, supported by information and communications technologies: A feasibility study among First Nations)
Principal investigator: Roy Bernard
Co-investigators: Marie-Pierre Gagnon, Nancy Gros-Louis
Abstract: There is great inequality in the distribution of prevalence rates of sexually transmitted diseases (STDs) and HIV/AIDS in Canada. Such rates can be up to 10 times higher among First Nations than in the population as a whole. This is why STDs and HIV/AIDS are a priority for the Quebec First Nations Health and Social Services Blueprint 2007-2017. The approach and interventions seem to focus more on adherence to antiretroviral treatment on the part of persons living with HIV, and secondary rather than primary prevention. However, the situation of adolescents and young adults with respect to sexuality is a concern despite the many interventions aimed at this segment of the population. The younger generation’s familiarity with information and communications technologies, or ICT, provides a highly promising opportunity in the area of sexual and reproductive health promotion, including STD/HIV/AIDS prevention in First Nations adolescents and young adults. However, developing effective interventions using ICT requires solid scientific evidence. To reduce the above-mentioned inequalities, the project will involve planning and conducting a feasibility study in close collaboration with the First Nations of Quebec and Labrador Health and Social Services Commission. In this initial phase of the partnership, the needs of the organization will be evaluated, and it will be prepared and supported in developing interventions using ICT to promote sexual and reproductive health and preventing HIV/AIDS among adolescents and young adults in Quebec and Labrador First Nations communities.  
Dates: March 2011-February 2012
Funding program: CIHR Catalyst Grant: HIV/AIDS Community Based Research Program - Aboriginal Stream
Source: CIHR database

Project R33

Title: Online STI testing and youth
Principal investigator: Jean Shoveller
Co-investigators: Mark P. Gilbert; Gina S. Ogilvie; John L. Oliffe
Abstract: New interventions, such as British Columbia's Online Sexual Health Services Program (OSHSP), are being launched to complement existing face-to-face clinical services, in the hopes that they may improve youth participation in STI/HIV testing. Seeking STI testing remains a deeply stigmatized behaviour, a reality that is unlikely to be fully remedied by online services (e.g. face-to-face enactments of gendered stereotypes can also be represented online through a text-based medium). Unfortunately, we do not yet fully appreciate how important social factors (e.g. social norms; stereotypes about men's and women's responsibilities for sexual health) affect experiences with online STI testing (particularly within vulnerable subgroups of youth). Thus, the proposed study will seek to better understand youth's perspectives on the ways in which important aspects of their social contexts (e.g. stigma; gendered stereotypes) affect their engagement in this and other sexual health promotion activities. Multiple data collection and analysis techniques will be used (e.g. focus groups and individual in-depth interviews; a Youth Roundtable to refine analysis from focus groups and individual interviews and a Youth Working Group will be formed to provide insights into the development and design of the look, feel and content of website). Throughout the project, a series of "Reality Checks" with youth also will be used to obtain feedback on emerging versions of the website, with a particular emphasis on checking in with vulnerable subgroups of youth. The proposed two-year study will be conducted in Greater Vancouver, and will adopt participatory approaches. Together, we will use new information gathered during our study inform the development and design of an online STI testing service in British Columbia.
Dates: October 2010-September 2012
Funding program: CIHR Operating Grant
Source: CIHR database

Project R34

Title: Protective factors associated with preventing injection drug use initiation among at-risk youth in Vancouver, British Columbia
Principal investigator: Catharine Chambers
Abstract: Street youth – 15- to 24-year-olds without a permanent residence – are at considerable risk for acquiring HIV and hepatitis C due to participation in high-risk activities such as injection drug use (IDU) and sex trade work. In comparison to their older counterparts, street youth who use injection drugs are at greater risk for blood borne infections because of their lack of experience: they are more likely to share needles and other drug equipment, and they are more likely to initially require a friend or acquaintance to inject them, decreasing their control over the use of clean equipment. In addition to the risk for HIV and hepatitis C infection, initiation of IDU at a young age is associated with participation in sex trade work, binge drug use events, criminal activity, and long-term injection drug use. While most research concerned with IDU in street youth populations examines high-risk behaviours for HIV and hepatitis C infection, few studies have investigated factors that prevent street youth from initiating IDU. Catharine Chambers’ research aims to determine why certain street youth are resilient to IDU initiation and, for those youth who have experimented with injection drugs, why they initiated IDU and what can potentially prevent them from transitioning into regular users. She hypothesizes that stable relationships with primary caregivers, social support networks separate from the street community, and absence of criminal activity may provide resilience from IDU initiation. Chambers’ findings will inform the development and implementation of prevention programs to reduce initiation of injection drug use among Vancouver's street youth. Ultimately, this could reduce the prevalence of blood borne infections, HIV and hepatitis C, in these high-risk groups.
Dates: 2008 and September 2008-August 2009
Funding programs: MSFHR Research Trainee Award, Junior Graduate Studentship and CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Master Award
Sources: MSFHR and CIHR databases

Project R35

Title: Research for injection drug use prevention: Exploring risk and resiliency among adolescent Aboriginal women who use drugs in British Columbia Principal investigator: Caroline Miller
Co-investigators: Wayne M. Christian; John D. O’Neil; Margo E. Pearce; Chris G. Richardson; Martin T. Schechter; Patricia M. Spittal
Abstract: Recent groundbreaking work in Canada has shown that, among young Aboriginal people, vulnerability to HIV, HCV and injection drug use rests among young women. Moreover, epidemiological evidence regarding vulnerability to these three conditions among young Aboriginal women suggests that historical traumas may be colluding with more recent traumas including homelessness, sexual abuse and survival sex work. However, there remains a dearth of evidence regarding effective drug prevention programs and policies for adolescents generally, and much less for young women who may be coping with multi-layered traumas. The proposed research seeks to address the paucity of young Aboriginal women's voices in drug use prevention by building on a unique and strong Aboriginal research partnership in British Columbia, Canada to contribute new evidence regarding risk and resiliency to injection drug use among at-risk (defined as using illicit drugs in the previous month other than marijuana) Aboriginal adolescent (aged 14-19 years) women. To accomplish this we will utilize ethnographic methods to qualitatively explore the following four objectives: investigate the relationships between trauma, resiliency and transitioning to injection drug use; examine the intersection between cultural safety and harm reduction; explore the role of specific drugs and their respective transition trajectories; and synthesize the evidence to develop a framework for action towards the prevention of injection drug use for at-risk adolescent Aboriginal women. This research will generate much needed evidence to inform drug prevention policy targeted towards those most at risk in Canada.
Dates: March 2011-February 2012
Funding program: CIHR Operating Grant-Priority Announcement-Gender, Sex and Health Research
Source: CIHR database

Project R36

Title: Safe n Sexy: Use of sexual health services by street-involved youth in Hamilton, Ontario
Principal investigators: Sandra Bullock; Adrian Betts
Abstract: not available
Date: 2009
Funding program: OHTN Grants
Source: OHTN database

Project R37

Title: Sexual health matters: Concerns of HIV+ adolescents and young adults
Principal investigator: Tamara Landry
Co-investigator: William Fisher
Abstract: Background: HIV+ youth face vulnerabilities such as stigma, emotional or sexual disturbance, compromised immune systems, alcohol/substance use and risk of sexually transmitted infections. A number of these vulnerabilities may be enhanced by the very act of self-disclosure of HIV. Few Canadian studies have explored HIV+ youths’ experience with disclosure of HIV status, or compared the experience of youth infected at birth to youth infected during adolescence. In Canada there are no existing health promotion guidelines or “disclosure scripts” on how to assist HIV+ youth to disclose (or not) their HIV status. Objectives: This study explores: a) the experience of disclosure of HIV+ status of a diverse group of Canadian HIV+ youth infected at birth or during adolescence; b) the impact of disclosure on their sexual health; c) their access to available support services. It compares HIV disclosure experience of HIV+ youth infected at birth or infected during adolescence to identify key distinctions. Methodology: In June 2010, a youth advisory committee identified key themes, and helped develop interview questions. Up to 48 HIV+ youth from London, Toronto and Vancouver, 14-29 years of age, will be participating in in-depth interviews with ethics clearance from the University of Western Ontario.  Using a phenomenological approach, data analysis will describe and catalogue the lived experience of the participants. Themes and patterns will be compared across all transcripts to describe individual and collective experiences. Relevance and potential impact: This research is intended to advance knowledge to help create and implement education, support and prevention programs tailored specifically to the sexual health and health status disclosure concerns of HIV+ youth, as well as minimize the risk of HIV transmission and protect the health of HIV+ and HIV- individuals. Education programs designed with the assistance of HIV+ youth can help to facilitate an approach to disclosure with which they can feel comfortable to discuss their health status with health care providers, intimate friends and partners.
Dates: 2009-2010
Funding program: OHTN Studentship Award
Source: OHTN database

Project R38

Title: Social exclusion and the health and wellbeing of gender and sexual minorities
Principal investigator: Robb Travers
Abstract: HIV has been shown to disproportionately affect groups that experience social exclusion, and in Canada, a strong case has been made to understand HIV in its social context. The Canadian Public Health Association notes that poverty, homelessness, stigma, addiction, violence, untreated mental health problems, lack of employment opportunities, powerlessness, lack of choice, lack of legal status and lack of social support create environments in which HIV and other illnesses flourish and spread. Very little Canadian health research has focussed on understanding the health issues and health care needs of two marginalized populations: transgendered and transsexual individuals as well as lesbian, gay, bisexual and transgender youth. Drawing on a social-determinants-of-health framework, this five- year program of research will focus on exploring the role that social exclusion plays in shaping health outcomes, and healthcare access barriers for gender and sexual minorities. Given the dearth of information addressing the needs of these populations in the Canadian context, a significant emphasis of this research program will be on identifying factors that will: 1) lead to improved health outcomes; 2) help to ameliorate service access barriers; and 3) help to overcome vulnerability by fostering personal resiliency. The program of research will be community-based and collaborative, involving a number of community agencies and service providers as partners. In addition, this research program will include significant opportunities for student mentoring. This will help to support the development of a new generation of researchers in Ontario able to work collaboratively with community partners and other stakeholders to impact this epidemic. A key goal of the research program will be to prioritize knowledge transfer and exchange initiatives that get data into the hands of decision makers who need them.
Dates: July 2011-June 2016
Funding program: New Investigator Award-Priority Announcement-HIV/AIDS Services/Population Health Research
Source: CIHR database

Project R39

Title: Socio-cultural and individual determinants of accessing sexual health services among young adults
Principal investigator: Bojana Petrovic
Co-investigators: Farah Ahmad; Trevor A. Hart Abstract: Worldwide, young adults between the ages of 15 to 24 account for 45% of new HIV infections each year (UNAIDS, 2008). Among young adults in Canada between the ages of 15 to 19, women comprise more than half of the new HIV positive cases (Public Health Agency of Canada, 2007). Previous research evidence has demonstrated that members of ethnic and religious minority groups and immigrants experience barriers to accessing sexual health services. This study will examine how psychological and cultural factors affect access to appropriate services among a sample of undergraduate students, and whether these barriers are associated with gender.
Dates: September 2010-August 2011
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Master Award
Source: CIHR database

Project R40

Title: Strengthening community-based approaches to HIV/AIDS education, screening, and treatment among Canadian Inuit youth
Principal investigators: Jeanette Doucet; Jacqueline C. Gahagan; Aideen F. Reynolds; Audrey Steenbeek
Co-investigators: Chris P. Archibald; Pitsulala S. Lyta Abstract: This project will begin to explore the complex interplay between culture, youth health and gender empowerment regarding HIV/AIDS risk within Inuit communities, and determine research priorities for a multi-year study. There is an urgent need for a clearer picture of the dynamics and epidemiology of HIV risk among Inuit in Canada. Current Inuit HIV data tends to get lost among Aboriginal or broader Canadian statistics and underrepresents the true situation for Inuit in Canada. This research seeks to contribute to this understanding and hopes to guide the development of sustainable community-based participatory options for HIV/AIDS interventions that are sensitive to the challenges of health promotion and health care provision in Northern communities. The project employs a community-based research methodology involving direct participation from Inuit organizations and community members. Moreover, on account of the barriers related to testing in small remote communities (lack of anonymity, stigma and discrimination, lack of access to care upon receipt of a positive test, lack of AIDS Service Organizations in the North), this community-based research methodology provides an important opportunity to build capacity for health care providers and to improve access to education, testing (anonymous testing with pre- and post-test counselling), diagnosis, care, treatment and support.
Dates: April 2007-March 2008
Funding program: CIHR HIV/AIDS Community-Based Research Program-Aboriginal-Catalyst Grant
Source: CIHR database

Project R41

Title: Taking Action: Using arts-based approaches to developing Aboriginal youth leadership in HIV prevention
Principal investigator: Sarah Flicker
Co-investigators: Jeanette Doucet; Randy Jackson; June A. Larkin; Claudia Mitchell; Tracey Prentice; Jean-Paul Restoule; Melanie M. Rivers
Abstract: Aboriginal youth are overrepresented in the Canadian HIV epidemic. Arts-based approaches to engaging youth in health promotion activism have been effective locally and globally. With this in mind, several community partners and academic researchers have collaboratively developed this research grant application. The goal of this study is to engage Aboriginal youth in HIV prevention leadership using art-based approaches. Specific objectives include: (1) to explore how Aboriginal youth link structural inequalities with individual risk, HIV and Aboriginal culture(s) using art-based methodologies; (2) to investigate the efficacy of art-based methods models of engagement (e.g. hip-hop, video/photographic documentary, popular theatre, music and/or dance, etc.); (3) to build youth capacity to address HIV issues in their local communities; (4) to develop and disseminate community-specific "by youth for youth" HIV prevention and support materials; and (5) to create a national digital repository of "by youth for youth" HIV prevention materials. Embedded and underlying each of these goals and objectives, is respect for the principles of Ownership, Control, Access and Possession (OCAP). The research team will partner with six local communities in different regions of the country to co-sponsor "Taking Action" workshops. These will each have HIV educational and cultural production components where participants will be afforded opportunities to develop projects that unpack the links between structural inequalities, individual HIV risk, and Aboriginal culture(s). Post-workshop, participating youth will be interviewed individually and asked to reflect on key knowledge gained and how their artistic productions are embedded in structural realities. Interviews and media will be qualitatively analyzed for thematic content. Results will be disseminated in academic and community-accessible formats.
Dates: April 2008-March 2011
Funding programs: CIHR HIV/AIDS Community Based Research Program-Aboriginal-Operating Grant and OHTN Grants
Sources: CIHR and OHTN databases

Project R42

Title: Taking Action II: Fostering Aboriginal leadership in HIV prevention using arts-based methods
Principal investigator: Sarah Flicker
Co-investigators: Jessica Yee; Randy Jackson; June A. Larkin; Claudia Mitchell; Vanessa J. Oliver; Tracey Prentice; Jean-Paul Restoule
Abstract: OBJECTIVES: (1) to understand what inspires some young people to become active around HIV prevention in their communities; (2) to explore digital storytelling as a strategy for increasing Aboriginal youth activism in HIV prevention; (3) to develop and disseminate community-specific "by youth for youth" HIV prevention and support materials. METHODS: Stage 1: We will invite Aboriginal youth from across Canada to apply to "tell their stories" about HIV leadership, activism and engagement. We will select youth (n=20; ages 16-25) to ensure representation from all regions of the country. These youth will be welcomed to a week-long workshop at which they will be taught digital storytelling skills and provided assistance to create short (3-5 minute) films that tell their unique stories (in their own words and languages) about how and why they became involved and engaged in HIV prevention. Following the creation of these stories, each youth will be interviewed about their film and why they became HIV leaders and activists. Stage 2: Each youth leader/film maker will be asked to organize a screening of their film in their own community with other youth, elders and community members. Following the film, a facilitated discussion will ensue about the impact of HIV on Aboriginal communities, why it is so difficult to talk about and what might inspire others to become leaders. ANALYSIS: We will analyze all of the digital stories collected, and all of the interviews and facilitated discussions. DISSEMINATION: In addition to disseminating findings through traditional academic media, youth productions will also be shared online. We will create community-friendly packages with a copy of the DVD that has all the stories, a manual and a discussion guide for others seeking to screen the stories.
Dates: April 2011-March 2014
Funding program: CIHR Operating Grant-HIV/AIDS CBR Program-Aboriginal
Source: CIHR database

Project R43

Title: Teens resisting urban transphobia and homophobia (TRUTH)
Principal investigator: Heidi H. Newton
Co-investigator: Robb Travers
Abstract: not available
Dates: September 2009-August 2011
Funding program: HIV/AIDS Community Based Research Program-General-Master Award
Source: CIHR database

Project R44

Title: The Cedar Project: A comparison of the sexual vulnerabilities of young Aboriginal men and women surviving drug use and sex work in Prince George and Vancouver
Principal investigator: Negar Chavoshi
Co-investigator: Patricia M. Spittal
Abstract: This research will be conducted in collaboration with the Cedar Project; an ongoing prospective cohort study involving at-risk Aboriginal young people aged 14-30 who reside in Vancouver and Prince George, British Columbia, who either smoke or inject illicit drugs. For the PhD program, I propose to utilize time-series analyses to investigate predictors of transitioning to positive hepatitis C (HCV) status, becoming HIV positive and barriers to HIV/AIDS treatment access over time among the Cedar cohort. Appropriate time series models will adjust for significant predictors to determine which risk factors are independently associated with HIV seroconversion. The equivalent modeling will be conducted for all participants who seroconverted to HCV. The Cedar Project addresses a paucity of information on sexual vulnerabilities among Aboriginal young people. My study findings will be brought back to the affected Aboriginal communities and federal/provincial authorities including Chief and Councils. Project partners will have the leading role in developing recommendations for programming and policy to reduce HIV and HCV infection risks. These will be derived from study evidence regarding the determinants of sexual and drug use vulnerabilities to meet the needs of the at-risk Aboriginal young people and their communities. Future studies will deliver meaningful research for the Aboriginal councils who use the findings for general planning of services and evaluating the efficacy of programs. My work for the Cedar Project will contribute to the capacity for Aboriginal service providers to raise awareness, identify needs, advocate for adequate resources, and develop an HIV/AIDS strategy that respects and integrates traditional and cultural values and beliefs of individuals, families and communities with mainstream HIV and HCV prevention and treatment, while taking into account determinants of health vulnerabilities of the cohort.
Dates: 2008-April 2009 and September 2009-August 2012
Funding programs: CIHR HIV/AIDS Community Based Research Program-Aboriginal-Master Award and CIHR Doctoral Research Award-HIV/AIDS Community Based Research-Aboriginal Stream
Source: CIHR database

Project R45

Title: The Cedar Project: Exploring HIV and hepatitis C vulnerabilities among young Aboriginal drug users in three Canadian cities
Principal investigators: Patricia M. Spittal; Martin T. Schechter
Co-investigators: Catherine P. Baylis; Russell C. Callaghan; Wayne M. Christian; Kevin J. Craib; Patricia A. Janssen; David C. Marsh; Akm Moniruzzaman; Christopher H. Sherlock; Mary P. Teegee; Eric M. Yoshida; Reinhard M. Krausz; Caroline Miller; Eugenia Oviedo-Joekes; Chris G. Richardson
Abstract: During the past decade the number of Aboriginal people diagnosed with HIV in Canada has grown more than any other ethnicity. Although Aboriginal people comprise only 4% of British Columbia's population, they represent more than 13% of all positive tests. Whereas the majority of infections are related to injection drug use, factors that explain elevated risk and transmission of HIV among Aboriginal young people who use illicit drugs are not well understood. The Cedar Project is an observational study addressing HIV and HCV related vulnerabilities of Aboriginal young people living in Vancouver, Kamloops and Prince George, British Columbia. We have recently identified concerning rates of both HCV and HIV infection, transition to injection and crystal methamphetamine use. Having an established cohort designed and implemented with Aboriginal partners and investigators now allows us the opportunity to expand our work to include identification of resiliency and protective factors from the perspectives of Aboriginal young people and focus in particular on a case management intervention aimed at increasing utilization of HIV care among HIV positive Cedar participants.
Dates: July 2005-June 2010 and October 2006-September 2009 and April 2009-March 2012
Funding programs: CIHR New Investigator in the Area of Gender and Health Research and CIHR Operating Grant; HIV/AIDS Research Initiative-Health Services/Population Health Stream and CIHR Operating Grant
Source: CIHR database

Project R46

Title: The Cedar Project: Exploring resiliency and its influence on HIV vulnerability among young Aboriginal people who use drugs in two Canadian cities
Principal investigator: Brittany L. Bingham
Co-investigator: Julian Somers
Abstract: The increasing rates of HIV among young Aboriginal people in British Columbia are deeply concerning. Few studies have investigated the role that historical trauma plays in HIV vulnerability of young Aboriginal people who use drugs. A holistic resiliency approach is a critical component of re-building healthy families and communities that have been heavily impacted by the effects of colonization, including multigenerational trauma. It is unknown how Aboriginal young people who use drugs define resilience for themselves. The Cedar Project is a cohort study of Aboriginal young people who use drugs in two Canadian cities. The proposed study will utilize mixed methods to investigate the impact of resiliency on HIV vulnerability among Aboriginal young people who use drugs. Through quantitative and qualitative inquiry the influence of structural factors, age, gender and trauma on young people’s perceptions of resilience will be explored. It is hypothesized that structural factors, trauma, resiliency, age and gender are significant determinants of HIV vulnerability for Aboriginal young people. Through ethnographic interviews of Cedar Project participants the relationship between protective-resiliency and risk factors for HIV will be investigated. The proposed study aims to provide recommendations for fostering resiliency and preventing HIV vulnerability among Aboriginal young people who use drugs.
Dates: January 2011-December 2013
Funding program: CIHR Doctoral Research Award-HIV/AIDS Community Based Research-Aboriginal Stream
Source: CIHR database

Project R47

Title: The Cedar Project Leadership Forum: Acknowledging the pain of our children
Principal investigator: Patricia M. Spittal
Abstract: The Cedar Project is an ongoing initiative addressing HIV and HCV vulnerability young Aboriginal people who use drugs in three Canadian cities. It is the first and only study of its kind in North America. One of the most disastrous outcomes of the legacy of historical trauma among Aboriginal people has been a higher rate of HIV and other infectious diseases among young Aboriginal people who use drugs. Since the study's inception, an Aboriginal partnership has led the Cedar Project. The Partnership has been planning The Cedar Project Leadership Forum: acknowledging the pain of our children. Using funding from a CIHR-Institute of Aboriginal People's Health Meetings, Planning and Dissemination grant, this event will provide an opportunity for translating Cedar Project information and dialogue on the subject of healing multigenerational trauma among young Aboriginal people. Leadership involved in the Partnership has committed to seek additional funding for the Forum. The Partnership has also emphasized the necessity of holding a preliminary meeting for knowledge transfer, planning, preparing and organizing the Cedar Project Leadership Forum. Part of the grant will be used to carry out this meeting. Meeting 1: Preparatory Gathering With support from the grant, Cedar Project partnership and investigators will gather in Vancouver in September 2008. This preliminary meeting will allow the partnership to carry out important organizational tasks in preparation for the Forum. Meeting 2: The Cedar Project Leadership Forum In addition to funds raised by the partnership, the remainder of the grant will go toward the forum taking place in Vancouver, February 2009. This event will include voices of Aboriginal and non-Aboriginal leadership, Aboriginal youth delegates, law enforcement and justice, child welfare representatives, Aboriginal HIV/AIDS and health service organizations, health research scientists and other academics.
Dates: September 2008-August 2009
Funding program: CIHR Meetings, Planning and Dissemination Grant-Knowledge Translation
Source: CIHR database

Project R48

Title: The Cedar Project: Your voice making a difference
Principal investigator: Patricia M. Spittal
Abstract: It is the aim of Cedar Project studies to provide an evidence base for Aboriginal communities, service providers, leaders and decision makers who support healthy community responses to healing and reconciliation. A critically important outcome of this research is to meaningfully translate knowledge gained from the research process and in turn to receive wisdom from the Partnership that will inform data interpretation and recommendations. In addition, an increasingly important part of Cedar Project knowledge transfer is the facilitation of the involvement of young Aboriginal people and elders in the sharing and discussion of study results. Finally, the Partnership has brought attention to the need for a newsletter that disseminates Cedar Project study findings and related community action, political discourse and media attention generated by the study. The newsletter would not only be a useful tool for translating Cedar Project findings to communities but also to let the young Aboriginal Cedar Project participants know that their voice is making a difference.  With support from the CIHR Meetings, Planning and Dissemination Grant: Knowledge Translation Supplement, Cedar Project Partnership members, other Aboriginal social and health service organizations and Cedar Project scientific investigators will gather for a program of four meetings in The Cedar Project: Your Voice Making a Difference. The anticipated timeframe for the meetings is between May 2011 and January 2012.  The proposed agendas and budgets for the meetings are attached to this grant application proposal. Additionally, a key deliverable of The Cedar Project: Your Voice Making a Difference program will be the development of Cedar Project newsletter. The newsletter will aid in the transfer and dissemination of results, community-based responses and media attention on Cedar Project research.
Dates: February 2011-January 2012
Funding program: CIHR Knowledge Translation Supplement
Source: CIHR database

Project R49

Title: Understanding the influence of early childhood sexual trauma and protective factors on incidence of HIV infection and other negative health outcomes among young Aboriginal people who use drugs in British Columbia
Principal investigator: Margo E. Pearce
Co-investigator: Patricia M. Spittal
Abstract: OBJECTIVES: 1) to analyze gender differences of over time health outcomes related to antecedent sexual abuse, including incidences of social, physical and mental health issues, risk behaviours and HIV/hepatitis C infection (HCV), among young Aboriginal people who use drugs and participate in the Cedar Project; 2) to gain better understanding of what protective factors prevent greater negative health outcomes among Cedar Project participants who have experienced sexual trauma, such as injection drug use and sex work; 3) to address sexual trauma and protective factors within a global public health policy perspective that contributes to the health-determinants model of understanding young Indigenous people's health. HYPOTHESES: 1) trauma and resiliency are significant determinants of HIV and HCV seroconversion among young Aboriginal women and men participating in the Cedar Project; 2) young female participants who have experienced sexual abuse will be at greater risk for initiating sex work, injection opiate use and attempted suicide; 3) young male participants who have experienced sexual abuse will be at greater risk for incidence of incarceration, crystal methamphetamine and solvent use; 4) historical trauma among young Indigenous peoples must be addressed using a multidimensional approach at the individual, family, organizational, community and policy levels. METHODS: I will utilize data from the Cedar Project, an ongoing CIHR funded initiative that monitors HIV and HCV among over 600 young Aboriginal people aged 14-30 who use injection and non injection drugs in Vancouver, Prince George and Kamloops. Since 2003 the study has assessed demographic characteristics, historical and lifetime traumatic events, drug use patterns and sexual vulnerabilities among participants every six months. Quantitative and ethnographic methods will identify both risk and protective factors for harms associated with sexual abuse among male and female participants.
Dates: 2009 and September 2009-August 2012
Funding programs: MSFHR Research Trainee Award, Senior Graduate Studentship and CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Doctoral Award
Sources: MSFHR and CIHR databases

Project R50

Title: The social and structural contexts of HIV/STIs among women and youth working in the sex industry in Canada
Principal investigator: Kate Shannon
Abstract: This new investigator award application aims to investigate the social (violence, work conditions) and structural (laws, regulations, urban renewal) contexts of HIV/STIs among youth and women working in the sex industry in Vancouver, British Columbia. The persistently high rates of health-related harms, violence and mortality among sex workers both in Canada and globally highlight a desperate need for renewed public health interventions targeting the reduction of harms in the sex industry. Building on international guidelines and the CIHR priorities for sex- and gender-based analyses, we will aim to evaluate longitudinally the broader risk environment that shapes gendered negotiation of partner-level risk and HIV/STI acquisition among youth and adult women in sex industry work. To meet these objectives, the proposed research will be based upon the assembly and follow up of a real cohort consisting of: 1) 500 existing and new adult women working in both the street and indoor sex industry in the AESHA (An Evaluation of Sex Workers' Health Access) I cohort; and 2) 500 female youth aged 14-20 years who have exchanged sex for money, drugs, gifts, shelter or other commodities in the previous 30 days in the AESHA II cohort (youth arm). The novel integration of individual mapping data and neighborhood environment data from publicly available data sources (such as housing, violence) will increase the potential for directly informing interventions to reduce harm. To our knowledge this study is among the first prospective studies of sex work in North America. The team I have assembled brings a wealth of expertise in observational and intervention research, policy and sex work, and as such, is uniquely positioned to conduct this study, which aims to directly improve the health of some of the most marginalized youth and women in Canadian society.
Dates: July 2011-July 2016
Funding program: CIHR New Investigator
Source: CIHR database

Project R51

Title: The Vancouver injection drug users study: A programme of study of HIV and hepatitis C and other harms related to injection drug use
Principal investigator: Evan Wood
Co-investigators: Patricia M. Spittal; Robert S. Hogg; Thomas H. Kerr; Julio S. Montaner; David M. Patrick; Martin T. Schechter; Mark W. Tyndall Abstract: It is estimated that approximately 100,000 people inject illicit drugs in Canada and are experiencing an epidemic of drug-related harms. Fatal and non-fatal overdoses and assaults are extremely common. The prevalence of hepatitis C has reached in the order of 80% to 90% and HIV continues to spread. Moreover, it appears that specific vulnerable subgroups such as women, Aboriginal people and homeless people may be at even higher risk. The spread of HIV in drug users is the first step in a chain which leads to increasing HIV infection among injection drug users and their sexual partners. Strategies aimed at preventing these harms are the subject of considerable international attention. This study program will follow large numbers of people who inject drugs, and youth at risk of starting to inject drugs. This programmatic operating grant is to support a population-based prospective cohort study that will examine the impact of prevention, treatment, enforcement, and harm reduction strategies on rates of initiation into injection drug use among high-risk youth, and examine the impact of risk behaviours and service use activities on HIV and Hepatitis C infection and overdose mortality rates among active injection drug users. Only when we understand how this happens, can we design interventions that prevent injection drug use among young people who have not yet started to inject and that can stop and reverse the epidemic of harms among those who have.
Dates: April 2004-March 2009
Funding program: CIHR Operating Grant-Priority Announcement-HIV/AIDS Research Initiative-Health Services/Population Health Stream
Source: CIHR database

Project R52

Title: Understanding sexuality and sexual health among adolescents with physical disabilities: A narrative ethnography
Principal investigator: Lauri East Co-investigator: Treena R. Orchard
Abstract: Sexuality and physical disability is an aspect of health that is often overlooked, particularly when it comes to adolescents. While the research available in this area is limited, studies have shown that due to societal misconceptions and stigma, youth with physical disabilities show considerably lower levels of sexual knowledge compared to their able bodied peers. This lack of information and inadequate sex education puts these youth at a very high risk for sexual abuse, sexually transmitted infections, teen pregnancy and HIV/AIDS. This study will employ qualitative research methods, specifically narrative ethnography, in order to explore adolescent sexuality and disability. Narrative ethnography is guided by several different modes of data collection in order to examine a topic at both the individual and societal level. This is a particularly useful approach to discern locally constructed meanings, values, and discourses and is especially useful when exploring sensitive issues such as those under investigation. Currently, there is little qualitative research being undertaken on sexuality and disability within Canada; thus this project will provide vital base-line data for future research and program development in this area. The information generated by project will be of direct relevance to the development of resources that can improve education and communication strategies for discussing sexuality issues with youth who have a disability. These types of resources may include the development of curriculum guidelines for sex education, discussion guides for parents and teachers, policy recommendations, courses for health professionals and interactive, web-based resources for youth. By focusing on the perspectives of a marginalized group like adolescents with disabilities, this research also contributes to the empowerment of these youth as they struggle to obtain the knowledge and skills necessary to have safe, healthy and fulfilling relationships.
Date: September 2010
Funding program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships-Master Award
Source: CIHR database

Project R53

Title: Toronto Teen Survey: A community-based survey to assess sexual health services among diverse urban youth and develop a city-wide youth sexual health services access strategy
Principal investigator: Sarah Flicker
Abstract: Canadian youth lack comprehensive knowledge of the risk factors associated with unprotected sexual activity and the necessary prevention skills required. Sexually transmitted infections (STI), including HIV/AIDS, pose a significant threat to the health and wellbeing of young people and improved youth access to information and appropriate prevention strategies are needed. The goal of the Toronto Teen Survey (TTS) is to increase health outcomes for youth aged 13-17 years by ensuring that services meet the needs of diverse communities living in Toronto. A Community-Based Research (CBR) model was used to engage teens in finding solutions to barriers they experience in accessing non-judgmental and relevant sexual health services. Diverse youth completed 1,216 surveys exploring access to sexual health services. There have also been 13 focus groups conducted with 90 service providers from 55 agencies to discuss preliminary findings, and 14 focus groups with 108 youth to explore survey findings in greater depth. This is the largest and most diverse (85% of the sample is non-White) survey of its kind in Canada. TTS findings demonstrate that systemic barriers to youth access and uptake of sexual health services are experienced differently by age, gender, language, race and ethnicity, sexual orientation, immigrant/refugee status, socio-economic status and community membership. Community stakeholders have been engaged throughout the research process resulting in increased levels of project awareness and support from all stakeholders. A Youth Advisory Committee (YAC) of 20 youth received training to facilitate the 90 survey gathering and sexual health information sessions. Service providers have been engaged in analysis of preliminary data and community organizations will collaborate in the development of community specific bulletins to share in community forum settings. TTS findings will have an impact on communities at risk in the HIV epidemic and will include specific HIV/AIDS related recommendations. The TTS will contribute to HIV prevention efforts by promoting knowledge and exchange among key stakeholders involved in the fight against HIV. The OHTN has a significant interest in ensuring that research findings are shared and exchanged with stakeholders in ways that encourage networking, partnership, mobilization, action and change. Several of the 'research community bulletins' will be launched in partnership with local ASOs, targeting many of the communities vulnerable to HIV, as identified in the Ontario AIDS Strategy (including African and Caribbean youth, young MSM, and newcomers). The TTS team is committed to ensuring that findings have a direct and immediate impact on HIV and sexual health policy and programming and will implement a multi-faceted KTE plan between June 2009 and March 2010.
Dates: 2006-2008
Funding program: OHTN Grants
Source: OHTN database

Project R54

Title: KTE of the Toronto Teen Survey
Principal investigators: Susan Flynn; Sarah Flicker; Robb Travers
Abstract: not available
Date: 2009
Funding program: OHTN Grants
Source: OHTN database

Project R55

Title: Winnipeg African refugee/immigrant youth and sexual health, sexually transmitted infections and HIV
Principal investigator: Susan E. Frohlick
Co-investigators: Katie J. Dutfield; Paula Migliardi; Janice L. Ristock
Abstract: This project is aimed at exploring some of the issues affecting African immigrant and refugee male youth living in Winnipeg between the ages of 18 to 30. Specifically this research team hopes to facilitate a number of discussions around sexual health, STIs and HIV/AIDS for an underrepresented and socially and economically marginalized group living in urban Canada. We are interested in what effect, if any, social stigma, discrimination and racism have in the lives of this population and how it might impact how vulnerable to sexual health, STIs and HIV/AIDS they might be. It has come to the attention of this research team that in Winnipeg there is a lack of messaging, especially when it comes to HIV/AIDS. In Africa issues around sexual health, STIs and particularly HIV/AIDS are openly discussed. On the African continent where the prevalence of HIV/AIDS and STIs is so exceptional, the messaging around awareness, risk behaviour and treatment are all extremely visible. We are requesting these funds to help finance a series of four meetings that will help us ascertain a much better understanding of some of these issues within this population. Focussed discussions with the targeted research community will ensure that there is a collaborative and participatory methodology at work from the outset. A final online report and oral presentations will be used to disseminate the information as widely as possible. This research has far-reaching implications as no work has been done with this group in this field here in Winnipeg. In addition, possible research may be gathered that could be used to better target future public health campaigns or methods of treatment and care.
Dates: September 2009-August 2010
Funding program: CIHR Meetings, Planning and Dissemination Grant-Planning Grant-Priority Announcement-Institute of Infection and Immunity
Source: CIHR database

Project R56

Title: Young men and online STI/HIV testing services
Principal investigator: Rodney E. Knight
Co-investigator: Jean A. Shoveller
Abstract: Rates of sexually transmitted infections (STI) and HIV are high among young people in Canada. However, young men's engagement with STI/HIV testing remains disproportionately low. The British Columbia Centre for Disease Control's (BC CDC) new Online Sexual Health Services Program (OSHSP) is developing online STI/HIV testing services in the hopes that it will improve young men's participation in STI/HIV testing. Understanding the processes by which the OSHSP can create new opportunities to meaningfully engage men in accessing STI/HIV testing services is therefore the fundamental aim of the proposed study. The findings from the proposed study will provide recommendations for tailoring the OSHSP to meet the needs of young men in British Columbia to improve young men's sexual health services. This study will: (1) examine young men's perspectives on the saliency, credibility and value of the emerging OSHSP; (2) describe and examine how men are represented (e.g. gender norms; sexuality) within the OSHSP; (3) use these perspectives to facilitate the development of recommendations for tailoring the OSHSP to accommodate the needs of young men; and (4) explore the differential effects of the OSHSP across potentially vulnerable subgroups of men and use this information to respond to their needs. The study will use a purposive sampling strategy to recruit participants (men ages 15-24) from a variety of socio-cultural backgrounds to ensure a wide variety of perspectives. There will be a particular emphasis recruiting young men who may be most vulnerable to the health and social impacts of STIs/HIV (e.g. economically disadvantaged; men who have sex with men). A variety of qualitative data collection techniques will be used, including: in-depth, qualitative interviews (n=40); focus groups (4 groups with n=5 men); and a one-day participatory planning summit (n=12 men).
Dates: September 2011-August 2014
Funding program: CIHR-Doctoral Research Award-Priority Announcement-HIV Research
Source: CIHR database

Project R57

Title: Young people living with HIV: Resiliency factors and HIV-related stigma
Principal investigator: Alexander L. McClelland
Co-investigator: Sarah Flicker
Abstract: This Community-Based Research (CBR) project with Positive Youth Outreach, the AIDS Committee of Toronto and York University aims to explore what factors enable an environment for healthy decision making and resiliency in the context of HIV-related stigma for young people living with HIV. The project seeks to better understand the individual, community, social and structural level factors that enable resiliency and healthy decision making among young people living with HIV in the context of significant HIV-related stigma. HIV-related stigma has significant and adverse effects on the health, quality of life, wellbeing and social support of young people living with HIV. The realities and fears of HIV-related stigma are felt intensely by young people living with HIV. HIV-related stigma has also been shown to impact access to services and adherence to antiretroviral therapy among young people living with HIV, as well as affecting self-esteem and depression levels. Better understanding how young people living with HIV respond to unique challenges and various forms of HIV-related stigma can assist in the development of relevant and effective interventions to address these factors. Using an asset-based, resiliency approach, a modified form of 'body mapping' methodology will be used to engage youth in identifying individual, community and institutional assets that enable resiliency in the face of HIV-related stigma. Body mapping is a process whereby people living with HIV are facilitated through a creative process of tracing, drawing and painting to depict pictures relating to their health, their history, their points of personal power and their life goals. Each resulting map tells a unique story that illustrates the impact of HIV on the body and the soul. Research outcomes will inform ongoing program development at PYO and other programs working with young people living with HIV.
Dates: September 2010-October 2011
Funding program: CIHR Master's Award-HIV/AIDS Community-Based Research-General Stream
Source: CIHR database

Project R58

Title: Youth, disability, HIV vulnerability and prevention
Principal investigator: Sarah Flicker Co-investigators: Marcia Rioux; Stephanie Nixion; Trevor A. Hart; June Larkin; Denise Nepveux; Robb Travers
Abstract: not available
Dates: 2007-2008
Funding program: CANFAR HIV/AIDS Research Grants
Source: CANFAR database

Project R59

Title: Youth HIV and sexual health education health programs in Canada: What's needed to enhance evaluation capacity?
Principal investigators: June Larkin; Denise Jaworsky
Co-investigators: Jerri Clout; Sarah Flicker; Trevor Hart; Jesse Janssen; Alicia Jarvis; Henry Luyombya; Sarah Switzer
Abstract: not available
Dates: 2009-2010
Funding program: CANFAR HIV/AIDS Research Grants
Source: CANFAR database

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