Appendix B (research projects): Population-Specific HIV/AIDS Status Report: People living with HIV/AIDS

Appendix B

Research Projects Focussing on People Living with HIV/AIDS

Project R1:

Title: 1st Annual Symposium on HIV, Law and Human Rights: "From Evidence and Principle to Policy and Practice"

Principal Investigator: Richard Elliot

Abstract: The Canadian HIV/AIDS Legal Network proposes to hold a one-and-a-half day educational symposium on HIV/AIDS, law and human rights that will engage multiple audiences. The aim of the symposium is to stimulate new learning and knowledge exchange between researchers, policy-makers, service providers, people living with HIV/AIDS (PHAs), legal professionals and ASOs/CBOs. The symposium will open on the evening of Friday, June 12th, 2009 with a keynote address by the Hon. Justice Edwin Cameron, a judge of the Constitutional Court of South Africa and an internationally renowned human rights advocate openly living with HIV. Over the course of the following day, four panel discussions and three skills-building workshops will bring together lawyers, judges, health researchers, ASOs/CBOs and PHAs to discuss and debate, from various perspectives, key legal developments related to HIV and relevant research, and their implications for policy and practice in four different areas: global access to AIDS medicines and Canada's Access to Medicines Regime; drug policy developments and the impact on HIV prevention and care among people who use drugs; prisoners' rights to information and services for HIV prevention and care; the criminalization of HIV transmission/exposure. All of these issues are ones on which there is a need for greater exchange between researchers, lawyers and policy-makers in order to advance policy that is evidence-based and human rights-based.

Dates: May 2009 - April 2010

Funding Program: Canadian Institutes of Health Research (CIHR) Meetings, Planning and Dissemination Grant: Knowledge Translation

Source: CIHR database

Project R2:

Title: 2nd Annual Symposium on HIV, Law and Human Rights: "From Evidence and Principle to Policy & Practice"

Principal Investigator: Richard Elliot

Abstract: The symposium will open on Thursday, June 10th, 2010 with a day-long skills-building workshop on media training focussed on the issue of the criminalization of HIV transmission and exposure. The following day, Friday June 11th, the Symposium program will consist of three plenary presentations that will bring together lawyers, judges, health researchers, students, ASOs/CBOs, and PHAs to discuss and debate, from various perspectives, key legal developments related to HIV and relevant research. Possible topics currently under discussion include, but are not limited to: criminalization and HIV non-disclosure;  HIV-related travel restrictions and immigration policies; housing rights and HIV-related vulnerability; women's rights: an international and comparative assessment of legal issues; and developments in Canadian prostitution laws. The day will close with an evening lecture, open to the public, presented by a high-profile keynote speaker addressing the audience on an HIV-related legal/human rights issue. At the moment, we are approaching such potential speakers as Dr. Michel Kazatchkine (Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria); Dr. Mary Robinson, (past President of Ireland and former UN High Commissioner of Human Rights); Dr. Louise Arbour (former Justice of the Supreme Court of Canada and former UN High Commissioner for Human Rights); Justice Rosalie Abella of the Supreme Court of Canada. The evening will also be the occasion of announcing the Canadian and international recipients of the 2010 Awards for Action on HIV/AIDS and Human Rights, awarded jointly by the Legal Network and Human Rights Watch. A cocktail reception will conclude the evening. The first half of Saturday June 12th, 2010 will close the Symposium. There will be one final panel session, followed by the Legal Network's 2010 Annual General Meeting and closing remarks by a keynote speaker.

Dates: January 2010 - December 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant: Knowledge Translation

Source: CIHR database

Project R3:

Title: A collaborative approach to understanding and improving Aboriginal people's access to HIV services in Northern BC

Principal Investigator: Dr. Lesley Cerny

Abstract: Scholars attribute the additional burden of illness among Aboriginal people to the legacy of colonialism and history of social marginalization. In a recent study Aboriginal women reported experiencing encounters with health providers as invalidating, which discouraged them from seeking health services. While colonialism continues to shape relationships between health providers and Aboriginal patients, we know little about how this legacy affects the delivery of HIV services. Specifically, how are differences in power experienced and negotiated in patient-provider relationships; how do Aboriginal people with HIV and their health providers experience the delivery of these services; and how can an understanding of Aboriginal people's experiences contribute to improvements in HIV policies and practices? This study uses ethnographic methods of participant observation, interviews and focus groups to examine these questions in the relationships between health providers and Aboriginal people with HIV. Patient-provider relationships will be observed during provision of HIV services. Parties will also be interviewed separately with attention to the experiences of Aboriginal women, youth and IV drug users. Participants will be engaged in discussing factors identified as barriers in accessing HIV services - to increase understanding between patients and providers. Development of a collaborative methodology will extend conventional approaches to participatory research by involving parties in analysis of data and in knowledge translation activities. Building on lived experiences of those most at risk for HIV, and those providing HIV services, this research will identify innovative new strategies for improving HIV policy and practice and for increasing access to HIV prevention, treatment and support services.

Dates: September 2007 - August 2012

Funding Program: CIHR Operating Grant

Source: The Canadian Association of HIV Research (CAHR) database

Project R4:

Title: A feasibility study of chemotherapy and mandatory combination antiretroviral therapy (cART) for management of acquired immunodeficiency syndrome (AIDS)-related lymphoma

Principal Investigators: Dr. Kathleen I. Pritchard and Dr. Matthew C. Cheung

Co-Investigators: Dr. Kevin R. Imrie, Dr. Mona R. Loutfy, and Dr. Elizabeth J. Phillips

Abstract: People who live with human immunodeficiency virus (HIV) infection are at an increased risk of developing certain cancers, including lymphoma, a cancer of the immune system. Treatment for this HIV complication typically includes multiple anti-cancer drugs known as chemotherapy; however, the ideal combination of chemotherapy drugs is unknown. As well, although drugs that combat the HIV itself (antiretrovirals) are ultimately used in all patients, it is unclear whether these treatments should be given at the same time as chemotherapy or immediately after cancer treatment. Some experts advocate withholding anti-HIV drugs based on concerns about the ability of patients to consistently take these treatments while experiencing side effects of chemotherapy. Other experts argue that both the lymphoma and HIV may be more effectively controlled if anti-viral treatment is given at the same time as chemotherapy. This study aims to address the controversy of whether patients are able to consistently stay on their anti-viral drugs while receiving chemotherapy. Patients will receive a specific chemotherapy combination (EPOCH-R) and mandatory antiretroviral therapy to test the feasibility of co-administering these drugs, as measured by a patient's ability to take all prescribed doses. The overall benefit of the treatment strategy will be reflected by the response of the lymphoma to treatment. Finally, chemotherapy blood levels will be measured to determine whether combining the drug classes influence the way the body handles these treatments. If the anti-virals can be safely given during chemotherapy, this trial will re-define practice for physicians who currently withhold these therapies due to concerns of non-adherence. This study will also provide important information on drug class interactions for currently used chemotherapies and antiretrovirals. The ultimate goal is to define the best treatment combination for patients with HIV infection and lymphoma.

Dates: April 2006 - March 2010

Funding Program: CIHR - Operating Grant

Source: CIHR database

Project R5:

Title: A gathering of support: Developing an Aboriginal grassroots research network on HIV/AIDS

Principal Investigators: Margaret L. Akan and Carrie A. Bourassa

Co-Investigators: Roxanne Boekelder, Mary R. Hampton, Ron S. Horsefall, Randy Jackson, and Kim McKay-McNabb

Abstract: All Nations Hope AIDS Network is the only Aboriginal AIDS Service Organization in the province of Saskatchewan; yet, Saskatchewan has one of the highest urban Aboriginal populations in Canada. Within this urban Aboriginal population rates of HIV/AIDS are significant, 48.9% of positive HIV test reports in 2004-2005 are of Aboriginal ancestry. (Saskatchewan Health, 2005). Some research has been done to identify the population size and demographics of this group, but no long-term, comprehensive studies have been undertaken at this time. Further, these data do not offer guidance in terms of programming and outreach, and also do not highlight, explore, or speculate on the relationships between substance use and HIV/AIDS. Given the incidence and prevalence of substance use within the province an informal network has been working collaboratively to determine how they might best unite their efforts to address local issues, and this group is interested in moving forward with a community-based research approach to more closely examine Aboriginal peoples' experiences with substance use and HIV/AIDS in Saskatchewan. Presently, there are some informal networks developing that include members from academic institutions, health service providers, AIDS service organizations, and Aboriginal people living with HIV/AIDS (APHAs). Currently, it seems appropriate to attempt to bring these informal networks together to determine if it is possible to formalize partnerships and begin working toward establishing a research direction and approach to explore and identify better ways of addressing the issues. However, at this time, no formal partnerships or commitments have been established and, therefore, the purpose of this development application is to facilitate the establishment of the formal partnerships necessary to develop a community-based research project, which addresses community identified needs as they relate to Aboriginal people, substance use, and HIV/AIDS.

Dates: April 2008 - March 2009

Funding Program: HIV/AIDS Community-Based Research Program - Aboriginal - Catalyst Grant

Source: CIHR database

Project R6:

Title: A qualitative investigation of the social, structural and environmental determinants of highly active antiretroviral therapy access, discontinuation and adherence among injection drug users

Principal Investigator: Andrea B. Krusi

Co-Investigator: Thomas H. Kerr

Abstract: Recent advances in HIV/AIDS treatment have given rise to a remarkable increase in life expectancy and quality of life for people living with HIV. Unfortunately, individuals with a history of drug use have not benefited from these advances to the same extent as other people living with HIV/AIDS. Previous research has found fewer HIV-positive drug users are accessing HIV treatment compared to other HIV-positive individuals. Furthermore, approximately half of the drug users who start HIV treatment do not follow through with it and among those drug users who remain on treatment, 60% do not follow the treatment as prescribed by their doctor. To date, research on factors influencing HIV treatment access and maintenance among individuals with a history of drug use has focused mainly on risk factors that are related to a person's behaviour or to their psychological state. Examples of risk factors for reduced therapeutic success of HIV treatment that have been identified previously include, continued substance use, depression and anxiety. To date, a more complete understanding of the broader influences on access to and maintenance of HIV/AIDS treatment among drug users, such as stigma and discrimination, housing stability and the way healthcare services are organized, is still sorely lacking. In order to gain a better understanding of these broader social and structural influences on HIV treatment among drug users, we will systematically analyze the perspectives of HIV-positive drug users and service providers on the challenges of accessing and maintaining HIV treatment. The ultimate goal is that findings of the proposed study will contribute to the implementation of policies and programs that support drug users' access to HIV treatment and care.

Dates: September 2009 - August 2012

Funding Program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships - Doctoral Award

Source: CIHR database

Project R7:

Title: A Small-Group Intervention to Reduce HIV Sexual Transmission Risk Behaviour Among HIV-Positive Men Who Have Sex With Men

Principal Investigators: Trevor A. Hart and Barry D. Adam

Co-investigators: Herbert Co, David E. Hoe, Robert C. Leahy, Mona R. Loutfy, Robert A. MacKay, and Eleanor Maticka-Tyndale

Abstract: The primary objective of this project is to develop, implement, and provide an evaluation of an HIV prevention program for HIV-positive gay and bisexual men in a sexual health and community-based research framework. This collaboration between the Positive Prevention Working Group and researchers comes at a time when HIV rates have begun to rise among men who have sex with men, and when rates of unprotected sex have been rising among HIV-positive men. The project will build on evidence-based HIV prevention programs reported in the research literature, consult with leading developers and practitioners of prevention programs directed toward HIV-positive men across North America, and engage local men to find the kind of program they would find attractive and effective. A small-scale series of workshops will be mounted for four groups of a dozen men who have a recent history of unprotected sex. Workshop participants will subsequently be followed to discover the degree to which the intervention has a sustained effect on risk behaviour. Findings from this study will provide the foundation for a subsequent effective, evidence-based, large-scale intervention.

Dates: April 2009 - March 2011

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Operating Grant

Source: CIHR database

Project R8:

Title: A Smoking Cessation Program for PHAs: Pharmacologic, Immunologic, Cardiovascular and Socio-Behavioural Outcomes

Principal Investigators: Paul MacPherson and Louise Balfour

Co-Investigators: Gary Garber, William Cameron, Jonathan Angel, Craig Lee, Curtis Cooper, Giorgio Tasca, Charles LaPorte, Kimberley Corace, Daniella Sandre, Andrew Pike, and Robert Reid

Abstract: New treatments for HIV have generated both new hope and new challenges for people living with HIV (PHAs). Cardiovascular disease (CVD) has now replaced AIDS as the leading cause of morbidity and mortality among PHAs. Even after controlling for a history of pre-existing disease, cigarette smoking is still the most significant predictor of CVD among PHAs. These results are of great concern given that an alarming proportion of PHAs (40%-70%) smoke cigarettes, three times higher than in the general Canadian population (19%). Despite these very high rates of smoking, smoking cessation programs are rarely delivered in routine HIV clinical care. Our goal is to develop, implement, and evaluate the first "HIV Quit Smoking Program" specifically tailored to the unique needs of PHAs. The University of Ottawa Heart Institute (UOHI) has developed a smoking cessation program widely recognized for its national standard of excellence ("Ottawa Model for Smoking Cessation"; Reid, Pipe, et al, 2003). Our HIV Quit Smoking Program builds upon the success of the Ottawa Model by tailoring it to the unique needs of PHAs. In particular, depression, which occurs in 40%-60% of PHAs, needs to be addressed in order to optimize smoking cessation efforts in PHAs. Further, key issues such as changes in immune system functioning, and side-effects of antiretroviral medications (ART) also need to be assessed and monitored among PHAs who quit smoking. The HIV Quit Smoking Program combines the Ottawa Model smoking cessation strategies (nicotine replacement therapy and behavioural strategies for managing nicotine cravings), with treatment of depression, immune system monitoring, and assessment of ART side effects. The synergy between the smoking cessation experts at UOHI and the Behavioural and Infectious Diseases Specialists from the Ottawa Hospital Immunodeficiency Clinic provide the combined expertise to ensure successful development and implementation of this much needed and innovative HIV Quit Smoking Program. A standardized treatment manual is currently being developed in both English and French that outlines the process of delivering the HIV Quit Smoking Program. The goal is to disseminate this manual to HIV outpatient clinics and primary care facilities across Canada so that the HIV Quit Smoking Program becomes part of standard of care for HIV+ individuals.

Dates: 2009 - 2010

Funding Program: Grants Awarded, Cycle 22 (2009-2010), Canadian Foundation for AIDS Research (CANFAR)

Source: CANFAR database

Project R9:

Title: A Study of an HPV VLP Vaccine in a Cohort of HIV-Positive Girls and Women

Principal Investigator: Deborah M. Money

Co-Investigators: Sean A. Bitnun, Hélène Coté, François Coutlée, Simon R. Dobson, John C. Forbes, Marina B. Klein, Tobias R. Kollman, Mel Krajden, Mona R. Loutfy, Gina S. Ogilvie, Martin Petric, Neora Pick, Janet M. Raboud, Anita R. Rachlis, Fiona M. Smaill. Gavin C. Stuart, Julianne E. Van Schalkwyk; Sharon L. Walmsley; and Wendy L. Wobeser

Abstract: In 2006, the first vaccine to protect against Human Papillomavirus (HPV) was approved in Canada. This vaccine protects against the virus (HPV) which is the known cause of cervical cancer and genital warts. HIV positive women have higher rates of HPV infection which progresses faster in them to cervical cancer. While HPV vaccine has been well studied in healthy young women, it is not known how well it will work in girls or women with HIV infection. This study will evaluate the HPV vaccine response in HIV positive females from across Canada providing important data on immune responses, side effects and long-term protection against HPV in this group of women. This data is necessary to inform appropriate vaccination programs in Canada for this vulnerable group. In turn, the information from this study will also be valuable towards implementing HPV vaccine programs in the developing world where HIV infection is widespread. Although, most cases of cervical cancer in Canada are prevented by early detection via Pap smear screening, this is not the case in the developing world where access to Pap screening is limited. This vaccine has great promise to prevent both HPV infection and its serious consequences in Canada and can be life saving on a much larger scale in the developing world where cervical cancer is a leading cause of death among women.

Dates: April 2008 - March 2013

Funding Program: CIHR - Operating Grant

Source: CIHR database

Project R10:

Title: A systematic review of evidence linking sexual violence and HIV/AIDS

Principal Investigator: Beverley J. Shea

Co-investigators: Neil Andersson, Candyce Hamel, Ari Ho-Foster, Tara Horvath, Gail Kennedy, Jessie McGowan, Deb Milne; Steven P. Mitchell, and George A. Wells

Abstract: Despite the growing knowledge of evidence on HIV/AIDS very little is known about the relationship between interventions for the prevention of sexual violence and HIV/AIDS. Individuals who are HIV+ report experiencing violence directly attributable to their being sero-positive. To date there is no published high quality systematic review summarizing this body of knowledge. This project will 1) systematically review and meta-analyze all studies conducted on interventions for the prevention of sexual violence and HIV/AIDS, 2) translate the findings and develop recommendations for their use by integrating decision makers into the review process and 3) develop materials based on the findings for policy making and for front line HIV/AIDS and sexual violence prevention. Research Plan: The title for this review is registered with the Cochrane Review Group on HIV/AIDS of the Cochrane Collaboration. We will follow the methods established by the Cochrane Collaborative Review Group on HIV Infection and provided by Cochrane Collaboration Handbook for Systematic Reviews of Interventions. A protocol for the review will be submitted defining a priori the search strategy and data sources, the selection criteria, the methods of analysis. Integrated throughout the research, beginning with formulating the research problem, are decision makers from the Public Health Agency of Canada and the Canadian Aboriginal AIDS Network who will: help shape the review by providing guidance on the policy relevance, political context of the review, the inclusion criteria, and prioritizing outcomes for analysis; assist with interpreting the findings for use by addressing the strength and the applicability of the evidence, considerations such as costs and current practice, and clarification of any trade-offs between the expected benefits, harm and cost of intervention; develop and implement an end-of-grant translation plan to ensure the findings are accessible and useful.

Dates: October 2008 - September 2009

Funding Program: CIHR Knowledge Synthesis Grant

Source: CIHR database

Project R11:

Title: Adherence to HAART in HIV populations: A meta analysis

Principal Investigator: Dr. Edward J. Mills

Co-investigator: Dr. Curtis L. Cooper

Abstract: Highly active antiretroviral therapy (HAART) has dramatically affected the course of HIV disease, producing reductions in AIDS-related morbidity and mortality. HAART has, however, been described as the most rigorously demanding oral medication regimen ever offered. Treatment often requires that patients take numerous pills several times a day, and medications are often taken at odd intervals in accordance with strict dietary guidelines. Furthermore, side effects are common and often severe. Optimism concerning HAART has been tempered by concerns that viral suppression requires high levels of medication adherence and that drug-resistant strains of HIV may develop and be transmitted when adherence is suboptimal. Accurate assessment of medication adherence is therefore critical to the assessment of clinical efficacy, side effects and risks associated with HAART. Presently, there is no "gold standard" for assessing adherence, and while several measures are in use, each measures only a subset of adherence behaviours. Our previous work comparing adherence to HAART therapy in Sub-Saharan Africa to a relatively wealthier North American setting found adherence in Sub-Saharan Africa to be statistically superior to North America - a finding at odds with popular beliefs and important to many agencies mandated to fight HIV. We propose to conduct a series of meta-analyses examining adherence within specific populations, including: gay males; intravenous drug users; Aboriginal groups in developed nations and immigrant populations. This analysis will require extensive systematic searching and advanced meta-analytic techniques. The findings of this meta-analysis will be shared with policy makers in HIV and will have had profound effects on antiretroviral delivery and management in the developing world.

Dates: February 2008 - January 2009

Funding Program: CIHR- Operating Grant

Source: CAHR database

Project R12:

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 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 Program: Fonds Québecois 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:  Ontario HIV Treatment Network (OHTN) database

Project R13:

Title: Advancing HIV services research: Expanding Andersen's health service utilization framework

Principal Investigator: Dr. Catherine Anne Worthington

Abstract: HIV services research and evaluation have shown that in order to be effective, HIV services need to be tailored to the specific contexts, cultures and locales of populations infected and at risk for infection to HIV through collaborative research endeavours, particularly since many of these populations are vulnerable or marginalized. The goal of this five-year program of research, supported by a CIHR New Investigator Award, is to conduct a series of collaborative and interdisciplinary research projects to improve HIV health services for specific groups. Two projects focus on services for those living with HIV, and two projects focus on services for vulnerable populations. The first project (funded by CIHR for 2003-2005) will provide rehabilitation and HIV professionals with information on the ways in which rehabilitation services could improve health care for those living with HIV. The second project (funded by SSHRC for 2003-2006) will provide HIV clinicians with information on ways to improve clinical research practices for HIV patients. The third research project (submitted to CIHR) will provide information to Aboriginal and HIV service providers on the knowledge, attitudes, experiences, and beliefs of Ontario Aboriginal women about HIV and HIV risks to assist in services development for this vulnerable population. The fourth research project will provide a team of HIV and street youth agencies with information on the spectrum of street-youth in Calgary, their HIV and health risks, strengths, coping mechanisms, and service needs. All of these projects are collaborative in nature with direct participation of service providers and/or members of the populations under study to ensure knowledge exchange and timely uptake of research results.

Dates: July 2005 - June 2010

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R14:

Title: AHFMR Population Health Investigator: HIV Services Research

Principal Investigator: Dr. Catherine Anne Worthington

Abstract: The goal of this three year program of research, supported by an AHFMR Population Health Investigator salary award, is to conduct a series of collaborative and interdisciplinary research projects to improve HIV health services for specific groups. One study will provide a team of HIV and street youth agencies with information on the spectrum of street youth in Calgary, their HIV and health risks, strengths, coping mechanisms, and service needs. The second will investigate HIV prevention and care needs of newcomers to Calgary from HIV endemic countries in sub-Saharan Africa. Both studies are collaborative in nature with direct participation of service providers and members of the populations under study to ensure knowledge exchange and timely uptake of research results.

Dates: July 2005 - June 2017

Funding Program: Alberta Heritage Foundation for Medical Research (AHFMR) Career Scientist Award

Source: CAHR database

Project R15:

Title: AIDS Committee of Durham Region KTE Day

Principal Investigator: Peter Richtig

Abstract: Not available

Date: 2009

Funding Program: n/a

Source: OHTN database

Project R16:

Title: AIDS in the 21st century or efforts at decoding a pandemic

Principal Investigator: Jason T Szabo

Co-investigators: Didier Fassin and Norbert J. Gilmore

Abstract: In recent memory, few illnesses have enjoyed as high a profile as AIDS. Even as scientists and clinicians have struggled to understand this disease, social scientists have explored its personal, social, economic, and political impact on different communities and societies. Yet probably because of the complexity and breadth of AIDS, there have been no recent comprehensive studies of its history. My clinical experience and historical training have led me to want write a series of papers exploring the relationships between the AIDS pandemic and the social and scientific structures of the late twentieth century. Among the topics that will be addressed are: the history of antiviral drug development, marketing, and distribution; the responses of different constituencies to dying AIDS patients; the complex and evolving relationship between public health initiatives and AIDS; and finally, the decisive role that AIDS has played in the creation of a modern discourse on health rights and the development of trans-national activist communities. Examining what we have already 'been through' will permit better understanding of medicine while helping us judge what strategies have best dealt with this devastating problem.

Dates: April 2006 - March 2009

Funding Program: CIHR Fellowships in Priority Announcement: In the Area of Health Services/Population Health HIV/AIDS Research

Source: CIHR database

Project R17:

Title: Alcohol Use by Aboriginal Persons Living with HIV/AIDS and its Association with Access to Care and Treatment

Principal Investigators: Renée Masching and Colleen A. Dell

Co-Principal Investigators: John Egan; Nancy Gros-Louis, David L. Lee, Tracey Prentice, and Lyanna Storm

Abstract: This proposal has been written to support the Canadian Aboriginal AIDS Network's (CAAN) comprehensive research agenda which includes inquiring into health service delivery merits and issues regarding Aboriginal people with HIV/AIDS (APHAs) who use alcohol or are perceived to be using alcohol. Since 1997, CAAN has completed several research projects, many of which have been funded by the CIHR. In Canadian Aboriginal People Living with HIV/AIDS: Care, Treatment and Support Issues (Jackson & Reimer, 2005), prejudice was found to be prevalent among primary healthcare providers where APHAs are concerned. Recommendations by APHA participants point directly to ways in which access to and delivery of services can be improved. Therefore, the purpose of this grant proposal is to undertake research to determine the association between alcohol use and access to services from the perspectives of Aboriginal persons living with HIV/AIDS and service providers using a mixed methodology approach. In turn, these research findings, analysis and conclusions will be used to influence health service delivery including cultural competency training for healthcare practitioners.

Dates: April 2008 - March 2011

Funding Program: CIHR HIV/AIDS Community-Based Research Program - Aboriginal - Operating Grant

Source: CIHR database

Project R18:

Title: An IHPREG Pilot Study: Feasibility of the Ontario HIV Pre-conception Cohort Study

Principal Investigator: Mona R. Loutfy

Co-investigators: Jonathan B. Angel, Ahmed M. Bayoumi, Sean A. Bitnun, Jason C. Brophy, Adriana Carvalhal, Saara Greene, Shari L Margolese, Khatundi I. Masinde, Kellie E. Murphy, Trent S Newmeyer, Janet M. Raboud, Kenneth L. Rosenthal, Lena Serghides, Fiona M Smaill, and Mark H. Yudin

Abstract: The decrease in death rates due to HIV drug therapy has led to decreases in transmission of HIV from mother to child. In addition, the increasing proportion of HIV-positive Canadians being women of child-bearing age, have led many HIV-positive Canadians to consider planning pregnancies. As a result, increasing pregnancies amongst HIV-positive women lends itself to a tremendous opportunity for multiple areas of research in all the stages of pregnancy including in labour and delivery and after childbirth to accompany the research before the childbirth stage. One of the main goals of this catalyst grant is to develop a research project of HIV-positive individuals and couples who are planning pregnancies in Ontario and to test the research documents and feasibility. The other main goal of this catalyst grant is to foster and form the team which will involve: 1) organizing regular group meetings, finalizing terms of reference, preparing a summary of meeting discussions, creating newsletters, as well as assisting team researchers to communicate with study sites and the community; and 2) creating a community advisory board that will advise on the various team research projects. The proposed research project is directly aligned with two of the CIHR HIV/AIDS Research Initiative's priorities: 1) health systems, services and policy; and 2) resilience, vulnerability and determinants of health. The project is also aligned with the Initiative's Health Service and Population Health Funding Stream as it seeks to: 1) assess and maximize the fertility health services for HIV-positive individuals living in Ontario, 2) inform policy in the area of fertility and HIV, 3) assess the population of HIV-positive individuals interested in planning pregnancies and 4) build capacity in the area of fertility research, service and health promotion; all aimed to improve Ontarians' lives and care.

Dates: March 2010 - February 2011

Funding Program: Catalyst Grant: Infection and Immunity - HIV/AIDS Research Initiative - Health Services/Population Health Stream

Source: CIHR database

Project R19:

Title: BC Centre for Excellence in HIV/AIDS

Principal Investigator: Julio Montaner

Abstract: Not available.

Dates: 2009 - 2010

Funding Program: CIHR Knowledge Translation Award

Source: BC Centre for Excellence (BCCfE) database

Project R20:

Title: Chronological analysis of the affective/sexual trajectories of adolescents living with HIV/AIDS since birth

Principal Investigator: Kimberly H.Y. Wong

Abstract: Not available.

Dates: 2008

Funding Program: Canada Graduate Scholarships Program - Master's Awards

Source: Social Sciences and Humanities Research Council of Canada (SSHRC)

Project R21:

Title: Angiogenesis and adverse pregnancy outcomes in women with HIV, a pilot study

Principal Investigator: Lena Serghides

Co-investigators: Mona R. Loutfy, Kellie E. Murphy, and Mark H. Yudin

Abstract: With HIV increasingly becoming a manageable chronic disease, having a family has become a possibility and an issue of great importance to HIV-positive women. However, HIV-positive women have a higher risk for having pregnancy complications including pre-term labour and low birth weight babies, both of which can endanger the health of the baby. Very little research has focused on understanding why this is so. Our research will try to determine if HIV infection affects the development of the placenta and the blood supply system to the baby. We will do this by monitoring the levels of certain factors called angiogenic factors that are involved in the development of blood vessels. Our work may be useful in developing diagnostic tests to identify women that are at risk of developing pregnancy complications early in their pregnancy, so they can receive appropriate attention to ensure the best outcome for the baby.

Dates: 2009 and March 2010 - February 2011

Funding Program: Catalyst Grant: Infection and Immunity - New Investigator Catalyst Grant

Source: CIHR database

Project R22:

Title: Assessing the impact of food insecurity and malnutrition on HIV treatment outcomes

Principal Investigator: Aranka Anema

Co-investigators: Julio S. Montaner and Robert S. Hogg

Abstract: Current HIV treatment, known as antiretroviral therapy, has successfully reduced illness and death among HIV-infected individuals for over one decade. However, an increasing body of evidence suggests that food insecurity and malnutrition may have a significant adverse impact on HIV patient treatment outcomes. Few studies have been conducted on this topic worldwide. In order to ensure that patient outcomes are optimized in Canada and internationally, there is an urgent need to understand the effect of food insecurity and malnutrition on HIV progression and mortality. The British Columbia Centre for Excellence in HIV/AIDS (BC-CfE) is one of Canada's leading clinical, laboratory and epidemiological research centres. It manages the procurement and distribution of anti-HIV drugs for all HIV-positive people in the province. The proposed research aims to assess the impact of food insecurity and malnutrition on survival, immunological status and virological change among patients receiving HIV treatment in BC. The research will draw upon the BC-CfE's expertise in molecular biology, clinical care, statistic and epidemiological analysis. It will be conducted in close collaboration with HIV-related community-based organizations. Findings from this study will be widely disseminated to academic audiences through publication in peer-reviewed journals; to clinical and policy audiences through publication in the BC-CfE's monthly newsletter; and to community groups through stakeholder meetings. Study findings from the proposed project will be relevant to public health managers and clinicians throughout Canada. It will contribute to the Canadian government's aim of promoting evidence-based medicine and of providing optimal treatment and support to people living with HIV/AIDS.

Dates: May 2009 - August 2012

Funding Program: CIHR Vanier Canada Graduate Scholarships

Source: CIHR Database

Project R23:

Title: Assessment of pain, pain-related treatment needs and barriers to care among individuals living with HIV/AIDS

Principal Investigator: Dr. Lorraine Overduin

Abstract: Not available.

Dates: March 2008 - October 2008

Funding Program: Ontario HIV Treatment Network

Source: CAHR database

Project R24:

Title: Best Practices in the Meaningful Involvement of People with HIV/AIDS who are Users of Illicit Drugs

Principal Investigators: Barbara L Paterson, Julie A. Dingwell, Monique Y. Fong, and Lois A. Jackson

Co-investigators: Richard Elliott; Leslie A. Jeffrey, Ralf Jurgens, Joannah M. Lang, Gayle M. MacDonald, and Christine Porter

Abstract: Meaningful involvement is the inclusion of service users in the development, adoption and/or evaluation of programs and policies in non-profit community organizations that serve them. Governments and community organizations alike have acknowledged that people with HIV/AIDS who use illicit drugs (henceforth called "the population of interest") have a great deal to contribute to the planning, adoption and evaluation of programs, research and policies that affect them; however, in much of Canada, this rhetoric has not achieved practical application, largely because there is a lack of evidence to guide such involvement. The seed grant will support the team of academic and community researchers in developing a proposal for future submission to CIHR as a community-based research project to answer the following research question: What can we learn from recent and emerging community practice within a small city of rural Atlantic Canada, and from the insights of service users and providers, about effective strategies to ensure the meaningful involvement of people with HIV/AIDS and users of illicit drugs in community organizations that serve them? The setting of the research will be the "community" of HIV/AIDS community organizations in Atlantic Canada.

Dates: November 2008 - October 2011

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Catalyst Grant

Source: CIHR database

Project R25:

Title: Building International Research Partnerships in HIV & Rehabilitation: Bridging Practice and Research

Principal Investigators: Kelly K. O'Brien and Patricia E. Solomon

Co-investigators: William J. Chegwidden, Chloë M. Orkin, Catherine A. Worthington, and Elisse Zack

Abstract: Our goal for this proposed meeting is to develop an international collaborative research agenda that will address research priorities in HIV and rehabilitation by establishing sustainable partnerships with researchers, clinicians, and community organizations in Canada and the United Kingdom (UK). Specific objectives for the three-day meeting are: 1) To facilitate knowledge transfer and exchange (KTE) among researchers and clinicians on HIV and rehabilitation research, clinical practice, and service delivery in Canada and the UK; 2) To determine the cross applicability (e.g. similarities and differences) of research and clinical practice in HIV and rehabilitation and formulate recommendations to advance programs and policies to enhance care, treatment and support for people living with HIV in the UK and Canada; 3) To develop a plan for a collaborative international research proposal that will address at least one of the six research priorities in HIV and rehabilitation for adults living with HIV recently identified by a national scoping study; and 4) To develop a collaborative research team of UK and Canadian researchers, clinicians, policy makers, and people living with HIV that will generate an international HIV and rehabilitation research agenda. This will be a sustainable collaboration that will build on existing areas of expertise and formally enhance linkages between UK and Canadian researchers termed the Canada-UK HIV and Rehabilitation Research Collaborative.

Dates: May 2009 - April 2010

Funding Program: CIHRMeetings, Planning and Dissemination Grant: Knowledge Translation

Source: CIHR database

Project R26:

Title: Building Partnerships and Increasing Community Capacity for Conducting HIV/AIDS, Health and Housing Instability

Principal Investigators: Saara Greene and Clemon George

Co-investigators: Steve Byers, David C. Este, Josephine B. Etowa, Jacqueline C. Gahagan, Winston C. Husbands, Stephen W. Hwang, Randy Jackson, Jay Koornstra, Erica S. Lawson, Jessica F. Leech, Laverne E Monette, Sean B. Rourke, Ruthann Tucker, and Catherine A. Worthington

Abstract: The proposed partnership is aimed at building strong and sustainable relationships between academics, community based researchers, health and social services, and community members who have a shared interest in the health and well-being of people living with HIV/AIDS from African and Caribbean communities in Canada. This partnership will succeed in building the research capacity of our community partners, advisory committee and peer researchers from African and Caribbean communities. We also aim to build partnerships that reflect a shared commitment to applied research and to increase the research capacity of the African and Caribbean HIV positive community in Canada. To this end, this project will lead to the development of a research plan and proposal in the area of HIV/AIDS, health and housing instability in Canada's African and Caribbean Communities. The partnership will enable us to highlight the housing experiences and needs of African and Caribbean communities and to address specific concerns including: high rates of housing instability; stigma and racial discrimination; and barriers to health and social services for PHAs who lack supportive and/or stable housing. Moreover, the research partnership will also support a process of identifying those communities within the larger African and Caribbean communities (e.g. women, families, MSM) who are the greatest risk of homelessness and housing instability.

Dates: April 2008 - March 2009

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Catalyst Grant

Source: CIHR database

Project R27:

Title: Capacity Building through Enhanced Operating Grants in HIV/AIDS

Principal Investigator: Robert S. Hogg

Co-investigators: Thomas H. Kerr, Julio S. Montane, and Evan Wood

Abstract: The primary objective is to establish a new population-based cohort of 500 HIV-infected men and women accessing antiretroviral therapy via the BC HIV/AIDS Drug Treatment Program in order to evaluate the impact of supportive health service (like methadone treatment, MAT/DOT, physician care, pharmacy supervision, and addiction services) and ancillary services (quarterly CD4 and viral load test, and drug resistance testing as required) on adherence and response to antiretroviral therapy.

Dates: July 2006 - March 2009

Funding Program: CIHR Capacity Building through Enhanced Operating Grants in HIV/AIDS

Source: CIHR database

Project R28:

Title: Care and Management of Persons Living with HIV

Principal Investigator: Dr. Sharon Walmsley

Abstract: My focus on research includes:

  1. optimal use of ARV
  2. coinfections with herpes and HIV
  3. adverse effects of ARV therapy, primarily lipodystrophy
  4. bone disease and HIV
  5. HIV and women, including HPV, fertility, pregnancy, response to therapy

Dates: April 2006 - March 2011

Funding Program: OHTN

Source: CAHR database

Project R29:

Title: CIHR Centre for REACH in HIV/AIDS (Research Evidence into Action for Community Health) / Centre des IRSC d'action sur le VIH/sida (Mise en pratique des résultats de la recherche en santé communautaire)

Principal Investigators: Sean B. Rourke, Barry D. Adam, Ahmed M. Bayoumi, Jacqueline C Gahagan, Robert S. Hogg, Ana Johnson, Rosemary J. Jolly, Susan A, Kirkland, Marina B. Klein, Gerry J. Mugford, Eric Mykhalovskiy, Stephanie A. Nixon, Michael Orsini, Joanne Otis, and Janice L. Ristock.

Co-investigators: Chris P. Archibald, Jean Bacon, Louise C. Balfour, Greta R. Bauer, Martin Blais, David Brennan, Donna E. Bulman, Roy Cain, John Cairney, Peter C. Coyte, Natasha S. Crowcroft, Margaret C. Dykeman, Laurie Edmiston, Richard Elliott; Sarah Flicker, Sandra L. Gardner, Saara Greene, Gregory E. Harris, Trevor A Hart, Winston C Husbands, Lois A. Jackson, Randy Jackson, Michel R. Joffres, Barbara L Johnston, Jeff Karabanow, Rupert Kaul, Rick A. Kennedy, Jay Koornstra, Hartmut Krentz, Lynne E. Leonard, Alan T. Li, Mona R. Loutfy, Jo-Ann M. MacDonald, Victor J. Maddalena, Muhammad Mamdani, Frank McGee, Caroline Miller, Edward J. Mills, Margaret E. Millson, Nicole Mittman, Samuel Noh, Kelly K. O'Brien, Patricia O'Campo, John D. O'Neil, Cynthia K. Patton, Anita R. Rachlis, Kate Shannon, Paul A. Shuper, Ingrid S. Sketris, Michael Sobata, Carol J. Strike, Wangari E. Tharao, Robb Travers, and Ruthann Tucker.

Abstract: The proposed CIHR Centre for REACH in HIV/AIDS is a collaborative, national partnership among leading health researchers in Canada in a wide array of disciplines from over 20 academic institutions, people living with HIV, front-line service providers, knowledge translation and exchange (KTE) specialists, and federal, provincial and regional policy makers. Our vision is to bring together critical practice, research, and policy skills as well as the lived experience of people with HIV to enhance the health of individuals and communities disproportionately affected by HIV. Our mission is to provide the core infrastructure support required to: engage community, policy-makers and researchers in interdisciplinary teams; break down geographical, theoretical, and conceptual barriers; and solve problems in the use, uptake and implementation of research evidence. Our work will strengthen policy, programs and practices, and make a measurable difference in the health and well being of people with HIV and communities most vulnerable to HIV. Using an interdisciplinary approach and working collaboratively at the intersections of social science, population health and health services research, the Centre will use an interdisciplinary approach to focus on three thematic areas: (1) Understanding the problems and factors driving the epidemic  by reaching beyond individual behaviour to explore the impact of broader structural and cultural factors as well as the social determinants of health (i.e., poverty, stigma, discrimination, racism and gender inequality) on risk, resilience, behaviour and access to health services within communities; (2) Finding innovative and practical solutions by taking an integrated approach to prevention and treatment, developing evidence-based interventions and strategies; and (3) Moving research evidence into action by developing effective KTE strategies, relationships and networks and having a measurable impact on policy and practice.

Dates: June 2009 - May 2014

Funding Program: CIHR HIV/AIDS Population Health and Health Services

Source: CIHR database

Project R30:

Title: CIHR Clinical Trials Network in HIV/AIDS

Principal Investigators: Martin T. Schechter, Aslam H. Anis, and Julio S. Montaner

Co-investigators: Jonathan B. Angel, D. W. Cameron, Curtis L. Cooper, Michael J. Gill, Marianne Harris, Marina B. Klein, Richard R. Lalonde, Mona R. Loutfy, Jean-Pierre Routy, Rafick-Pierre Sekaly, Mark A. Wainberg, and Sharon L. Walmsley

Abstract: For nearly two decades, the Canadian HIV Trials Network (CTN) has been central to Canada's research response to HIV/AIDS. The CTN is proud to have created an organization that encourages and facilitates high quality investigator-driven research, while linking or connecting resources and expertise from across Canada. And the need for reliable and well-structured trials has not diminished in the current context. While research alone has tremendous value, its worth compounds when it translates into new knowledge, better treatments and improved services and public policies. The CTN has developed a plan for its next funding cycle (2008-2013) that includes five strategic priorities and the actions needed to realize them. Critiques from past external reviews, recommendations from the CTN's operational review conducted in 2006, and ideas garnered from CIHR's RFA planning session in May in Ottawa, have all been taken into consideration in setting the Network's 5-year agenda, These five strategic priorities create a framework for action and continuous improvement: 1. Deliver on the value of a Canadian clinical trials network for HIV/AIDS research. 2. Ensure the CTN is a high-performance, service-oriented and accountable organization that supports researchers and scientific excellence. 3. Enable scientific excellence by facilitating HIV/AIDS clinical trials in Canada and beyond. 4. Translate and transfer scientific knowledge into action. 5. Position the CTN to be an integral player in The Federal Initiative to Address HIV/AIDS in Canada (FI).

Dates: April 2008 - March 2013

Funding Program: CIHR Clinical Trials Network in HIV/AIDS

Source: CIHR database

Project R31:

Title: CIHR Team Grant in Co-occurring polysubstance abuse, psychosis and viral infection

Principal Investigator: William G. Honer

Co-investigators: Alasdair M Barr, Reinhard M. Krausz, Julio S. Montaner, and Allen E. Thornton

Abstract: Polysubstance abuse and serious mental illnesses such as psychosis are linked with high prevalence rates for hepatitis C virus (HCV) and human immunodeficiency virus (HIV). This proposal concerns the opportunity to shape the future of clinical research in these co-occurring disorders by changing the paradigm of research. We propose a fully integrated, life history strategy for simultaneous investigation of polysubstance abuse, psychosis, and viral infections. This approach will emphasize assessment of risk factors related to good or poor outcomes for co-occurring disorders' resolution versus persistence of psychosis, and the extent of adherence with highly active antiretroviral treatment for reduction of HIV load. The results of the project will have significant implications for the delivery of health services to those affected by polysubstance abuse, psychosis, and viral infection.

Dates: July 2008 - June 2009

Funding Program: CIHR Team Grant: Substance Abuse Prevention and Treatment - LOI

Source: CIHR database

Project R32:

Title: CIHR Team in HIV therapy and aging

Principal Investigators: Dr. Hélène Côté, Dr. David Burdge, Dr. Peter Lansdorp, and Dr. Deborah Money

Co-investigators: Dr. Ariane Alimenti, Dr. Marianne Harris, and Dr. Patricia Janssen

Abstract: Globally, there are ~18 million women living with HIV. The vast majority of these women are of child-bearing age and ~3 million give birth annually. Treatment of HIV-infected pregnant women with antiretrovirals (ARV) reduces the rate of perinatal transmission from ~25% to <1% and is critical for the health of women who are at risk for serious opportunistic infections and/or death. Current treatment guidelines recommend combination ARV therapy for all pregnant women infected with HIV. The international community is rapidly scaling up the accessibility of ARVs in the developing world and millions of infants will be soon born having had in utero ARV exposure. While it is clear that ARVs are very effective at preventing HIV transmission, very little is known about the potential adverse effects of exposing developing fetuses and infants to these drugs. HIV ARVs may have an adverse effect on the developing embryo, fetus or infant. Any potential effects of the drugs are expected to be greatest when exposure occurs during rapid development and growth. Consequently, it is of particular importance to investigate the impacts of ARV on these children. In humans, we already know that HIV ARV can cause DNA molecular changes that are strikingly similar to those occurring with aging, and that are associated with genetic diseases or conditions whose prevalence increases with age, such as degenerative illnesses and heart diseases. The goal of this Emerging Team proposal is to develop a research program focused on the potential effect of HIV ARVs in modulating aging-related biological phenomena in the pediatric population, namely HIV-uninfected infants exposed to HIV drugs perinatally (before and after birth) and of HIV-infected children receiving ARV therapy. To our knowledge, ours is the only group in Canada working on issues related to the toxicity of perinatal and pediatric HIV ARV exposure and is uniquely positioned to undertake the research program supported by this Team grant.

Dates: October 2007 - September 2012

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R33:

Title: CIHR Team in HIV Treatment Outcomes: The Canadian Observational Cohort (CANOC) Collaboration

Principal Investigators: Robert S. Hogg, Marina B. Klein, Nimâ N. Machouf, Sean B. Rourke, and Christos M. Tsoukas

Co-investigators: Gloria R. Aykroyd, Louise C. Balfour, Ahmed M. Bayoumi, John Cairney, Liviana Calzavara, Curtis L. Cooper, Kevin A. Gough, Silvia A. Guillemi, Richard P. Harrigan, Marianne Harris, George E. Hatzakis, Donald L. Kilby, Viviane D. Lima, Mona R. Loutfy, Edward J. Mills, Margaret E. Millson, Julio S. Montaner, David M. Moore, Janet M. Raboud, Anita R. Rachlis, Stanley E. Read, Irving E. Salit, Marek J. Smieja, Benoit Trottier, Sharon L. Walmsley, and Wendy L. Wobeser

Abstract: Our application for an emerging team grant proposes an integrated research, mentoring, education and knowledge translation program to undertake policy-relevant research regarding treatment and management practices for person with HIV/AIDS in Canada. This program will evaluate the impact of antiretroviral care on the health and well-being of persons infected with HIV/AIDS in various regions of Canada, will assist in the training of new health practitioners and researchers, and will disseminate research findings in ways that will improve current practice guidelines for treatment and care. Through these three objectives, we hope to foster research collaborations between interested Canadian researchers, to enhance existing research and training opportunities for graduate students, post-doctoral fellows and clinicians in the country, and to inform clinicians and persons living with HIV/AIDS in all regions of the country about our findings that may affect current treatment and management practices.

Dates: October 2007 - September 2012

Funding Program: CIHR Emerging Team Grant Program - HIV/AIDS

Source: CIHR database

Project R34

Title: CIHR Team in HIV/HCV Co-infection

Principal Investigators: Dr. Babita Agrawal, Dr. Rakesh Kumar, and Dr. Christopher Richardson

Co-investigators: Dr. Christopher Powell and Dr. D. Lorne J. Tyrrell

Abstract: Human immunodeficiency virus (HIV) causes devastating viral infection culminating in acquired immune deficiency syndrome (AIDS). Despite significant progress in treatment and prevention initiatives, the worldwide incidence of HIV infection continues to increase. Among HIV infected people, hepatitis C virus (HCV) frequently causes co-infection due to shared routes of transmission. The implications of HIV-HCV co-infection are severe on the health, quality of life, and treatment options leading to high mortality of the afflicted patients. This research proposal outlines new approaches to the study of this very important issue in HIV/AIDS. The focus of this proposal is to understand complexity of mechanisms underlying the disease, study immunological and neurological interactions in HIV-HCV co-infection, develop novel animal models to study the pathogenesis in co-infections, and investigate novel preventive and therapeutic strategies to improve the treatment and quality of life, and increase the life expectancy of HIV infected people in Canada and worldwide. The innovative animal models will provide an opportunity for Canadian scientists to make unique contributions to the study of these diseases and to collaborate with leading scientists worldwide. This project will also contribute significantly to the knowledge and the development of immunotherapy and vaccine candidates for the treatment of HIV-HCV infection. Our multidisciplinary approach combining various expertises will increase the potential for success in fighting this dreaded disease.

Dates: October 2007 - September 2012

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R35:

Title: CIHR Team in the Study of Acute HIV Infection in Gay Men

Principal Investigators: Michael L. Rekart and Babak Pourbohloul

Co-investigators: Daniel Coombs, Benedikt Fischer, Mark P. Gilbert, Mel Krajden, Gina S. Ogilvie, Valencia Remple, and Terrence A. Trussler

Abstract: People newly infected with HIV are at their most infectious phase but mostly unaware of their infection status at this time. This is because routine tests for HIV infection are unable to identify persons in this phase as being infected. Fortunately, new laboratory testing methods can now identify HIV infection at a much earlier stage. This makes it possible to offer programs to these early infected individuals, including support to prevent transmission of HIV to others. An exciting new team of researchers has been formed to work with the gay community in British Columbia to strengthen prevention programs for persons with new infections from this community. The team members are from the biomedical sciences, public health, the social sciences, and researchers based in the community itself. The program will investigate gay men's understanding of HIV testing, their motivations and challenges in taking an HIV test, and the impacts of new testing technologies that are able to identify very infectious persons, on their testing practices. This information will be used to design messages to encourage gay men in BC to be tested for HIV. People diagnosed with early HIV infection will be offered enhanced prevention programs, which will be designed with gay community organizations and prevention experts. Gay men identified with early infections will also be interviewed to better understand their needs to fine tune the prevention programs. An important aspect of this program will be to investigate how to follow up with the sexual partners of those infected in the most efficient manner so that these partners can be offered access to prevention and follow up programs as soon as possible. A key aspect of the research will involve the evaluation of these new programs so that they can be continually improved. The results of this research program will also be used to promote similar programs for people with new HIV infections from other communities in BC and Canada.

Dates: October 2007 - September 2012

Funding Program: CIHR Emerging Team Grant Program - HIV/AIDS

Source: CIHR database

Project R36:

Title: Community-University Exposition

Principal Investigator: Budd L. Hall

Abstract: CUexpo 2008 is a gathering of community and university researchers who work together in a partnership mode. The May 4-7 event will be the largest such gathering in Canadian history. The conference brings together interdisciplinary and multi-sectoral teams together working on complex health, social, sustainability and economic issues. One of the CUexpo core sponsors is the Community-Campus partnerships for Health. Community Research teams will be presenting on the themes of HIV/AIDS, Health, Housing and Homelessness, Social Determinants of Health, Population Health and related areas. The focus is on the process of partnership development, ethics, methods and knowledge synthesis and dissemination.

Dates: May 2008 - April 2009

Funding Program: CIHR Meetings, Planning and Dissemination Grant: Partnerships and Citizen Engagement

Source: CIHR database

Project R37:

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 and 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 illicit 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 R38:

Title: Conceptualizing HIV-related stigma within communities of gay and bisexual men

Principal Investigator: Dr. Marney McDiarmid

Abstract: Not available.

Dates: June 2008 - May 2010

Funding Program: Ontario HIV Treatment Network (OHTN) Student Award

Source: CAHR

Project R39:

Title: Contextual factors affecting HIV/AIDS treatment and prevention amongst recent immigrants from endemic countries

Principal Investigator: Tam T. Donnelly

Co-investigators: Katharina A. Kovacs Burns, Daniel W. Lai, Paul Schnee, and Catherine A. Worthington

Abstract: Over the past few years, Alberta has had an increase in the number of immigrants with HIV or AIDS, who came from countries with high numbers of people with HIV/AIDS. We need to find ways to help these people take care of their health and HIV/AIDS, as well as stop the spread of HIV. The purpose of this study is to (a) find out how recent immigrants living in small towns in Alberta seek help to manage their HIV/AIDS, prevent the spread of HIV, and deal with social stigma; and (b) find out how to be effective in meeting the needs of recent immigrants living with HIV/AIDS, and in promoting the use of HIV prevention activities. There are five questions which this study will ask related to the purpose, as well to what kinds of things influence how recent immigrants access health care and social support services, and what or who encourages them to seek the right kinds of help for their HIV/AIDS and prevent its spread. We will address these research questions from both the immigrant and the healthcare provider's perspectives using interviews. We want to recommend ways to strengthen Alberta's health delivery system and create supportive environments for recent immigrants to seek care and to prevent HIV/AIDS.

Dates: April 2007 - March 2009

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R40:

Title: Cordon sanitaire or healthy policy?: Documenting and evaluating impacts of Canada's HIV screening of immigrants and refugees as a population health intervention strategy

Principal Investigator: Laura M. Bisaillon

Co-investigators: Ronald Labonté and Dave Holmes

Abstract: That Canada's mandatory HIV testing of immigrant applicants and refugees is problematic from ethical, moral, human rights, health equity, and immigration law perspectives is supported by a burgeoning literature. Like Canada, the U.K., Australia and New Zealand introduced mandatory HIV testing of newcomers after 2000. The preliminary literature review shows that none of these countries has evaluated the impacts of mandatory HIV testing from the points of view of those tested. The central research question is: What are the impacts of the mandatory HIV screening policy that applies to all immigrant applicants and refugees to Canada since 2002? This project will 1) generate a new knowledge base on, and systematically document, the implications of testing on immigrants and refugees which has never been done before so as to inform and improve Canadian health policy decision-making; and 2) to assess the implications of mandatory HIV testing as a prerequisite for admission to Canada, setting these within broader discourses on social justice, political economy of health, globalization and human mobility, human security, and social and immigration policy. The preliminary groundwork for this bilingual research has been laid. This study is the first systematic documentation and critical appraisal of the consequences of the mandatory testing on immigrants to Canada and is directed to a range of audiences, including community, policy makers, researchers, educators, advocacy groups, and immigrants and refugees.

Dates: May 2005 - April 2011

Funding Program: CIHR Doctoral Research Award Area of Health Services/Pop. Heath HIV/AIDS Research

Source: CIHR database

Project R41:

Title: Current and future burden of illness for treating HIV/AIDS in British Columbia

Principal Investigator: Dr. Adrian Levy

Co-Investigators: Dr. Richard P. Harrigan, Dr. Robert Hogg, and Dr. Douglas James

Abstract: This research proposal aims to (a) estimate the current annual direct cost of treating HIV-infected persons in British Columbia (BC), (b) project this burden of illness over the patients' lifetime, and (c) develop a simulation model in which decision and health policy makers can estimate current and future annual treatment costs and evaluate the impact on costs of alternative prevention and treatment strategies. Since the advent of highly active antiretroviral therapy for treating HIV in 1996, persons infected with HIV/AIDS have experienced an increase in life expectancy. In addition, the incidence of new HIV cases in BC and throughout Canada has been stable or increasing for a number of years. Increasing life expectancy and increasing incidence each independently contribute to an increasing prevalence of HIV/AIDS in BC and Canada. With a growing prevalent population, there is a need among health planners for more accurate estimates of annual and lifetime direct medical costs for treating persons infected with HIV/AIDS. We propose to build a computer simulation tool that will compute estimates of these costs, as well as predict how they would change under various assumptions regarding treatment protocol, total number of persons infected, and demographic structure of the prevalent population. Our work will focus on Vancouver, BC, due to our access to high-quality population-based data from this area, as well as the fact that a disproportionately large number of Canadian persons infected with HIV/AIDS reside in Vancouver. However, our planning tool will be applicable to other jurisdictions with a single payer for health care.

Dates: October 2007 - September 2010

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R42:

Title: Current issues facing the treatment of patients with non-B subtypes of HIV

Principal Investigator: Vinh-Kim Nguyen

Co-investigator: Cécile L. Tremblay

Abstract: Millions of dollars are being poured into programs supporting the rapid scale-up of antiretroviral treatment (ART) in Africa. Yet, as this much needed support is dramatically increasing the number of people receiving life-saving treatment, substantial concern is emerging over the sustainability of such programs. One of the major reasons for this anxiety is the development of drug resistance that compromises treatment options for both individuals and populations. Over the course of the HIV/AIDS pandemic, HIV has evolved into various subtypes. One of the scientific community's greatest knowledge gaps around ART resistance is how the genetic variability of HIV may influence the development and transmission of resistant strains of the virus, especially in non sub-type B HIV strains. This is because most research on HIV resistance has occurred in North American and European settings where sub-type B is the predominant form of the virus, even though other subtypes, particularly C, are more prevalent in Africa. Various genetic subtypes of HIV may have differing resistance profiles, such that patients with certain subtypes may be more susceptible to developing drug resistance than patients of another subtype. Consequently, we increasingly feel that current prescribing practices may not be optimal for patients harbouring non-B strains. The objective of the meeting would be to review the evidence concerning ART resistance in non-B subtypes and to discuss ART treatment options with prescribing clinicians. As a result, we propose a workshop that will bring together expertise on non-B subtypes and ART resistance from three continents in order to consolidate our knowledge on the subject and identify priority research areas. A subsequent public talk will facilitate knowledge dissemination and translation by presenting the results of the workshop to practicing clinicians, researchers, and students.

Dates: September 2008 - August 2009

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R43:

Title: Desire, Place, Stigma, and Unsafe Sex: Understanding the Subculture of Men who use Gay Internet Cruise Sites

Principal Investigators: Patrick O'Byrne and Dave Holmes

Abstract: In Canada, men who have sex with men (MSM) represent the largest proportion of new HIV infections, and sexual partnerships that are arranged via the Internet are described as contributing to this elevated infection rate. However, a review of the research that correlates the Internet and HIV-transmission revealed that it often excluded the perspective of MSM who live with HIV/AIDS (MSMHA). Consequently, many HIV advocacy groups have criticized researchers of further marginalizing an already stigmatized illness/group. In response to this, the first step of this project was to seek the guidance of Ontario's "Poz Prevention Group" in order to diminish these ethical/scientific issues. With such input, and the results of two previous CIHR funded studies in bathhouses and circuit parties, the objective of this project is to qualitatively explore the role and sequence of 'desire, place, stigma, and unsafe sex' as it relates to MSMHA who meet sexual partners via the Internet. The importance of this is that it incorporates the psychosocial nature of human sexuality by acknowledging that unsafe sexual practices are not always the outcome of simple decision-making processes that follow the rules of doing what is best for one's health. This research aims at exploring this sequence in an effort to gain a better understanding of the motivations of MSMHA so as to develop more culturally sensitive HIV prevention initiatives. In other words, the goal of this project is to better understand how desire helps guide the selection of specific sexual practices and places, and how this process is also guided by public and personal perceptions of stigma. Qualitative methods will be used to explore these four dimensions as they relate to MSMHA who arrange sexual contacts via the Internet. More specifically, this will involve analysis of the websites which are used to arrange sexual contacts, in addition to 45 in-depth qualitative interviews with men in Montréal, Ottawa, and Toronto.

Dates: March 2010 - February 2011

Funding Program: CIHR HIV/AIDS Bridge Funding - Biomedical/Clinical Stream

Source: CIHR database

Project R44:

Title: Development of a conceptual framework to enhance labour force participation for people living with HIV in Canada

Principal Investigator: Catherine A Worthington

Co-investigators: Eileen J. McKee, Kelly K. O'Brien, and Elisse Zack

Abstract: Labour force participation and income support issues have been identified by people living with HIV (PHAs) and HIV specialists as one of the most pressing issues facing PHAs in Canada. While the links between health and labour force participation are complex, it is clear that labour force participation is an important social determinant of health. Labour force participation provides a means not only to income, but can also increase psychological health and quality of life through daily life structure and social linkages for adults living with HIV. However, barriers to work are numerous for PHAs, and development of labour force initiatives that promote increased opportunities for PHAs to participate in the labour force will require collaborative efforts of PHAs, rehabilitation healthcare professionals, policy makers, employers, and social program researchers. This study will lay the foundation for a planned program of research to develop and test a national labour force intervention for PHAs. The overall purpose of this study is to develop a conceptual framework of labour force participation for people living with HIV to inform the development of an innovative income support and labour force intervention aimed to enhance social participation for PHAs. To create this framework, we will conduct a literature (scoping) review of existing literature on return to work and labour force participation for PHAs, followed by a series of interviews and focus groups with PHAs, employers, insurers and policy makers to present findings from the literature, obtain data to develop a preliminary framework, attain feedback, and develop consensus on the conceptual framework. The results from this study will help shape the development of new programs and policies that will enhance the successful social participation for PHAs in Canada.

Dates: October 2007 - September 2009

Funding Program: CIHR Operating Grant - Priority Announcement: HIV/AIDS Research Initiative - Health Services/Population Health Stream

Source: CIHR database

Project R45:

Title: Development of new models for the delivery of antiretroviral therapy to injection drug users on the Downtown East Side of Vancouver.

Principal Investigator: Dr. Haroutioun Krikor Tossonian

Co-investigator: Dr. Brian Conway

Abstract: The treatment of HIV-infected injection drug users (IDUs) presents multiple challenges, including problems of adherence to therapy and access to care. Adherence is predictive of successful virologic suppression by highly active antiretroviral therapy (HAART), and may be more difficult to achieve in IDUs. Directly observed therapy (DOT) is one strategy that has been proposed and implemented for increasing adherence to HAART and monitoring the multiple health issues associated with IDUs. However, the employment of certain strategies are still necessary a) to characterize patients that are not achieving virologic suppression, b) to improve the selection of patients entering treatment, c) to enhance the adherence of patients receiving treatment, and d) to demonstrate the long-term cost effectiveness of such strategies. By developing new models for the delivery of antiretroviral therapy to IDUs on the Downtown East Side of Vancouver, refinement and optimization of therapeutic approaches to HIV-infected IDUs enrolled in a methadone program could be achieved.

Dates: September 2005 - August 2008

Funding Program: CIHR Operating Grant

Source: CAHR

Project R46:

Title: Disability in the Context of HIV: Building a Foundation for an Instrument to Describe "Disability" Experienced by Adults Living with HIV

Principal Investigator: Ms. Kelly O'Brien

Co-investigators: Dr. Aileen Mary Davis and Dr. Ahmed Mohamed Bayoumi

Abstract: Because of this, HIV may be considered a chronic disease containing fluctuating periods of wellness and illness. In addition, there may be a greater number of people living with the day-to-day health-related challenges of HIV and its treatments. A term that may be used to label these health-related challenges is "disability". Measuring the occurrence of "disability" with a questionnaire is important because it could promote a better understanding of these experiences, and help to improve the health of people living with HIV. But, healthcare providers currently cannot measure "disability" because the types of challenges that persons living with HIV experience are complex and not well understood. A better understanding of the meaning and experience of living with HIV is first needed to help healthcare providers know what type of questions should be included in a questionnaire to measure the health-related challenges of HIV. This study investigates the day-to-day health-related challenges (or "disability") that adults living with HIV face as a result of HIV and its associated treatments. Results of this study will include recommendations to help develop a questionnaire to measure these experiences. The experience of living with HIV will be investigated through focus groups and interviews with persons living with the disease. These results will be used to assess how well existing questionnaires used in the healthcare setting capture these experiences. Based on these results, recommendations will be made as to whether a new questionnaire needs to be developed, or whether an existing questionnaire can be modified so that healthcare providers can adequately measure "disability" for adults living with HIV.

Dates: September 2004 - May 2009 and September 2008 - August 2011

Funding Program: CIHR Operating Grant and Fellowships in Priority Announcement: In the Area of Health Services/Population Health HIV/AIDS Research

Source: CAHR

Project R47:

Title: Double Discrimination: Refugees and Refugee claimants with AIDS/HIV+ in Canada

Principal Investigator: Akm A. Ullah

Co-investigators: Ronald Labonté and Kevin Pottie

Abstract: Allowing HIV+ refugees to settle in Canada has become a concern amongst public health professionals and government officials, as it risks putting increasing strain on public health systems that are already under enormous pressure. These persons become 'refugees' within refugee communities, potentially facing a sort of double discrimination that can imperil their own and other people's health. At present, however, little is known empirically or even anecdotally about the extent of this risk. Primarily this research will seek to identify the ways in which refugee claimants may be discriminated against both generally and in relation to their known or feared HIV+ status, and their perceptions of and experienced health and social impacts of that discrimination. It will compare this experience against their descriptions of stigma faced in their countries of origin. Finally, it will attempt to determine the health care and treatment regimen for HIV/AIDS known to, and accessed by, refugee claimants in Canada, including treatments offered by their own ethnic communities; and their understanding of human rights relating to HIV/AIDS issues in Canada. The research questions and arguments will be addressed by applying appropriate research techniques (which would be determined after a reconnaissance or as research progresses). Anticipated methods include primary reliance on in-depth interviews, using ethnographic techniques to elicit refugee claimants' life histories (pre and post-migration). This research will be conducted in full partnerships with community organizations working with refugee claimants and HIV/AIDS in Ottawa and in Montréal. Extensive review of relevant and existing literature and databases to consider mortality morbidity will precede field research. This research will fill a significant vacuum in knowledge about the experiences in handling stigma, health regimen, and awareness on human rights issues about HIV/AIDS amongst Canadian refugee claimants.

Dates: September 2008 - August 2011

Funding Program: Fellowships in Priority Announcement: In the Area of Health Services/Population Health HIV/AIDS Research

Source: CIHR database

Project R48:

Title: Dynamic models incorporating drug resistance and compliance to describe long term therapy in HIV patients

Principal Investigator: Line Labbé

Abstract: Not available.

Dates: July 2005 - June 2010

Funding Program: CIHR - Rx&D - HRF/CIHR Career Awards in Health Research

Source: CIHR database

Project R49:

Title: Employment and Health Outcomes in HIV/AIDS: A Prospective Mixed Methods Cohort Study

Principal Investigators: Sean B. Rourke, Murray G. Jose, Alan T. Li, Lori Lucier, and Sergio Rueda

Co-investigators: Barry D. Adam, Jean Bacon, John Cairney, Winston C. Husbands, Margaret E. Millson, Nicole Mittmann, Kelly K. O'Brien, Anita R. Rachlis, Patricia E. Solomon; Robb Travers, and Michael G. Wilson

Abstract: With the significant improvements in survival and capacity to manage HIV-related complications with the availability of HAART, HIV/AIDS is increasingly being viewed as a chronic and long-term condition as opposed to a progressive terminal illness. Objectives: (1) What is the impact of employment on health-related quality of life? (2) Do differences (and changes) in impairments, activity limitations and in key social determinants of health predict employment stability? (3) How people living with HIV understand and perceive their disablement (impairments, activity limitations and participation restrictions) over time and how experiences with disablement influences employment trajectories and health-related quality of life over time. Methods: The proposed study will employ a mixed methods approach that combines quantitative and qualitative methods. The quantitative portion of the study consists of a prospective cohort design that will follow 500 people living with HIV in Ontario over two years with six-month data collection periods for a total of 5 visits. The qualitative portion of the study consists of a prospective qualitative study that will follow 30 people with HIV over 3 measurement times (separated by 6 months). Relevance: This project will provide critically needed data and human perspectives, which will inform both decision-makers by providing evidence for policy debates (e.g., how to create a more flexible / adaptable work environment) and front-line community-based agencies by helping them develop strategies and support services for people living with HIV who are in different employment situations.

Dates: April 2008 - March 2011

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Operating Grant

Source: CIHR database

Project R50:

Title: Enhancing uptake and sustainability of HIV care and antiretroviral therapy among survival sex workers

Principal Investigator: Dr. Mark W. Tyndall

Co-investigators: Ms. Vicki Bright, Dr. Kate Gibson, Mr. Francisco Ibanez-Carrasco, Dr. Thomas H. Kerr, Dr. Treena Rae Orchard, Ms. Anita Palepu, Dr. Cynthia Kay Patton, Ms. Kate Shannon, and Dr. Evan Wood

Abstract: The introduction of highly active antiretroviral therapy (HAART) has dramatically changed the clinical course of HIV infection for many thousands of Canadians. It has been nearly a decade since effective medications have been available, and current treatment is highly effective, well tolerated, and has manageable toxicities. The benefits of these impressive treatment gains however have not been shown among marginalized populations, including sex workers and illicit drug users, who increasingly are feeling the impact of HIV. The uneven distribution of antiretroviral therapy to eligible HIV positive people represents one of the largest disparities in Canadian health care. Although this situation presents a major challenge for health care providers and policy makers, it also provides an opportunity to develop, implement and evaluate a comprehensive program in HIV care and treatment that can greatly improve the health of this population and decrease HIV transmission. The lessons learned from this project have the potential to go beyond Vancouver's Downtown Eastside community, to become a model for other urban communities where HIV treatment is under-utilized.

Dates: July 2005 - March 2009

Funding Program: CIHR Operating Grant

Source: CAHR

Project R51:

Title: Environmental Scan of HIV+ Smokers in British Columbia

Principal Investigators: J. Craig Phillips and John L. Oliffe

Co-investigators: Joan L Bottorff, Mary H. Ensom, Milan Khara, and Glyn A. Townson

Abstract: Smoking is common among persons living with HIV (PLWH) with estimates suggesting prevalence as high as 70%. New drug regimens have yielded significant health benefits for many PLWH, but those who smoke have increased risk for other serious complications. Significant knowledge gaps exist about the smoking patterns of PLWH and what might constitute effective targeted strategies for tobacco reduction (TR) among diverse sub-populations of PLWH. In British Columbia (BC), as in other settings, PLWH are a diverse group with complex psychosocial issues. However, few studies address tobacco related issues for PLWH who smoke or describe population specific TR interventions. Pathways to healthcare services for PLWH who smoke are also poorly understood, and consensus prevails among healthcare providers that TR efforts require focused attention. The purpose of the proposed catalyst grant is to conduct an environmental scan to better understand the distribution of various sub-populations in assessing the feasibility of accessing and supporting the TR efforts of PLWH who smoke and to describe the tobacco related issues for men and women living with HIV and their healthcare providers. Based on the findings drawn from our environmental scan, we will conduct qualitative interviews with a sample of men and women smokers with HIV to begin to understand some of the issues related to tobacco use that are influenced by the experience of HIV, gender differences and other social factors. The proposed study will provide a foundation on which to build and foster future efforts of a new investigative community team. Collectively, the team is ideally positioned to address TR among PLWH and the resources made available through the catalyst grant will enable us to more fully engage with the issues and develop plans for implementing targeted interventions in this setting in the future.

Dates: March 2010 - February 2011

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Catalyst Grant

Source: CIHR

Project R52:

Title: Study of the culture of disclosure among women and men living with HIV/AIDS in media discourse in Quebec

Principal Investigator: Maria Nengeh Mensah

Abstract: Not available.

Dates: 2008 and 2009

Funding Program: Program - Standard Research Grants

Source: SSHRC

Project R53:

Title: Evaluation of "Pouvoir partager/Pouvoirs partagés," a program run by and for women living with HIV that tackles the thorny issue of disclosure

Principal Investigator: Joanne Otis

Co-investigators: Françoise Coté; José Coté; Mylène Fernet, Maria Nengeh Mensah

Abstract: "Pouvoir Partager/Pouvoirs Partagés" (PP/PP) is an empowerment program that aims to give women living with HIV the resources to disclose their HIV-positive status in a variety of contexts. The program was developed and validated as a pilot project in 2006-2007 with the active participation of 26 women living with HIV and four workers in the Montreal area. The validation study demonstrated the relevance and usefulness of PP/PP, but also highlighted the importance of (1) consolidating the process whereby the workers and the women living with HIV take ownership of the program; (2) conducting a more convincing evaluation of the project's effects; and (3) providing written statements of the women's experiences with PP/PP. The purpose of this three-year study is to mobilize women living with HIV and the people working with them and to describe their trajectory of empowerment in the context of the PP/PP evaluation. The evaluation involves the following: (a) designing, implementing and evaluating provincial training for trainer/co-facilitator pairings; (b) introducing and evaluating PP/PP, which the pairs will have facilitated for 11 groups of 8 to 10 participants each; (c) organizing and carrying out knowledge-sharing activities (community forum and production of a collective work). The principles of Empowerment Evaluation are an inspiration for this study, which rests on the use of multiple data collection methods, both qualitative (coordinator's log, shared assessment groups, Web discussions, etc.) and quantitative (self-administered questionnaires). The purpose of this project is to help achieve the objectives of the fight against HIV that pertain to improving the quality of life of women living with HIV, as indicated in the Federal Initiative to Address HIV/AIDS in Canada.

Dates: April 2008 - March 2011

Funding Program: CIHR HIV/AIDS Community Based Research Program - General - Operating Grant

Source: CIHR database

Project R54:

Title: Evaluation of the implementation of a community program aimed at improving the quality of life of Montreal-area women living with HIV

Principal Investigator: Sarine Lory Hovsepian

Co-investigator: Joanne Otis

Abstract: Antiretroviral treatments are increasing the life expectancy of people living with HIV infection, but quality of life remains a concern. The proposed project will evaluate the implementation in six organizations and communities of a community program aimed at helping women living with HIV to feel more in control of their lives. We will first evaluate the degree to which each intervention has been implemented by comparing the activities that are actually implemented to those that were originally proposed. Next, we will outline the contextual factors influencing the implementation of the program by observing community interest and involvement, the level of project appropriation by the community, and the dynamics between actors. This will be done by observing participants and workers, interviewing key contacts and consulting activity reports. We will then evaluate how variations in implementation influence effectiveness by comparing the degrees of implementation to the outcomes of each program. This will be measured by administering questionnaires to participants before and after the intervention. Finally, we will conduct quantitative and qualitative analyses to evaluate how contextual and implementation-related factors jointly influence the program's effectiveness. By evaluating the implementation of a community program aimed at helping women living with HIV feel more in control of their lives, we will be able to evaluate how effectively this program improves their quality of life and will gain a greater understanding of the conditions that yield positive results. This information is essential for directing the choice of environments and contexts in which similar community programs can be effectively implemented.

Dates: May 2006 - April 2009

Funding Program: CIHR Doctoral Research Awards

Source: CIHR database

Project R55:

Title: Evaluation of a tailored intervention program designed to optimize antiretroviral compliance in persons living with HIV

Principal Investigators: José Coté and Gaston Godin

Co-investigators: John Cox, Yann-Gaël P. Guenheneuc, Richard R. Lalonde; Carmen G. Loiselle; Joanne Otis, Maria Pilar Ramirez Garcia, Cécile L. Tremblay

Abstract: While they cannot eradicate HIV, current viral therapies suppress viral replication and help maintain and improve immune response in infected persons. However, interruptions in treatment, even for short periods, can cause the virus to multiply and become drug-resistant, which is why treatment compliance needs to be optimal. Resistance reduces an individual's response to treatment and allows the disease to progress; resistance can also be transmitted to others and therefore constitutes a significant public health concern. The development of interventions to increase compliance with antiretroviral treatment has become a crucial objective in the fight against HIV. The goal of the proposed study is to evaluate the efficacy of information technology-supported tailored interventions in optimizing compliance with antiretroviral treatment and influencing immunological and virological markers. The innovative aspect of this study lies in the fact that it is designed to evaluate the efficacy of interventions that: are developed a priori, according to an intervention mapping approach that integrates research findings, theory and a significant community contribution; are tailored to individual needs; and offer follow-up that is additional and complementary to existing clinical follow up. While direct benefits are expected in terms of HIV client monitoring, the process is obviously applicable to other clienteles that follow complex drug regimens on a daily basis.

Dates: April 2007 - March 2011

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R56:

Title: Evaluation of HIV Health Care providers in Canada: Has anything changed since the last decade or are we still judging?

Principal Investigator: Elena Ivanova

Co-investigator: Kathryn D. Lafreniere

Abstract: Using the theoretical model of Self-Determination Theory (SDT), the study empirically examines the motivational basis of HIV-treatment adherence. Of interest are the following general research questions: Do people living with HIV/AIDS (PLWH) perceive to be stigmatized from healthcare professionals (i.e., doctors, nurses, dentists, dental technicians, etc.), whether PLWH perceive to be given choice over the HIV/AIDS medication prescribed, and lastly if the medical language that medical professionals speak is understood by most PLWH (health literacy levels) in southwestern Ontario (Windsor and Toronto). Seven AIDS service organizations (ASOs) have agreed to participate in this project by allowing me to recruit participants from their pool of clients. This study is currently in the data collection phase. Once completed, it will provide insight into the healthcare related experiences of people living with HIV/AIDS. The study findings may guide the development of much needed HIV-treatment adherence guidelines and recommendations.

Dates: April 2007 - March 2010

Funding Program: Frederick Banting and Charles Best Canada Graduate Scholarships - Master's Award

Source: CIHR database

Project R57:

Title: Examining the effectiveness of a case management intervention for improving the well being of women with HIV/AIDS: A community-based research approach

Principal Investigators: Dr. Adriana Carvalhal and Ms. Louise Binder

Co-investigators: Ms. Danielle Layman-Pleet, Ms. Wangari E. Tharao, and Ms. Anna Van der Meulen

Abstract: Women represent one of the fastest growing groups of people infected with HIV in Canada. Women living with HIV/AIDS face not only a chronic illness and complex medical demands, but also extensive social challenges. Research on evidenced-based behavioural interventions designed specifically for women has been neglected so far in the literature. Objectives: (1) To determine whether 6 months of proactive strength-based case management is effective in increasing physical and mental health-related quality of life, compared to a 'usual care' general health promotion program, in women living with HIV; and (2) To evaluate whether the case management intervention decreases depression levels, improves coping skills, and increases social support. The proposed study will employ a mixed methods approach that combines quantitative and qualitative methods. Quantitative methods will be used to test the effectiveness of a proactive case management community-based intervention. One hundred and sixty participants will be randomized to one of two groups:(1) A proactive case management intervention ("wHEALTH") that will include bi-weekly one-hour individual sessions; and (2) A 'usual care' health promotion program that consists of bi-weekly one-hour group sessions. Measurement times include baseline, 1, 3, and 6 months; durability of the intervention will be assessed at 9 months. The primary outcome will be overall physical and mental health-related quality of life. The secondary outcomes include depression, social support, coping skills, and satisfaction with services. Qualitative methods consist of in-depth interviews, conducted with a subset of 40 participants, to probe the contextual factors related to the quantitative outcomes. This CBR study is a partnership between Voices of Positive Women, Women's Health in Women's Hands, and McMaster University. Our dissemination plan will ensure that outcomes of the study will be made available to CBAOs, policy makers, and women living with HIV/AIDS.

Dates: April 2007 - March 2010

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R58:

Title: Maternity and antiretroviral treatment experiences among Aboriginal, Haitian, African and Quebec women living with HIV/AIDS

Principal Investigator: Isabelle Toupin

Co-investigator:  Joanne Otis and Mylène Fernet

Abstract: Few studies in Canada, and Quebec in particular, have focused on HIV-infected women's perceptions of antiretroviral treatments or looked at the impact of these treatments on women's day-to-day lives. Even fewer studies have been done on African, Haitian and Aboriginal women in a migratory context (Gallant, 2000; Lévy et al., 2000; Rogers et al., 2000; Sendi et al., 1999). The experience of maternity, which few studies have considered, seems key to constructing the relationship to HIV infection, treatment compliance and secondary prevention. Since there are few studies aimed at understanding the experiences of women living with HIV/AIDS who are receiving antiretroviral treatment, including their relationship to children (desire to have children, pregnancy, birth, maternity, vertical transmission), this study will help improve our currently limited knowledge. Once the study is completed, we will be able to launch secondary HIV/AIDS prevention strategies and will have a better understanding of the issues related to compliance with antiretroviral treatments within the ethnocultural communities studied in this project.

Dates: September 2006 - August 2009

Funding Program: CIHR Doctoral Research Award Area of Health Services/Pop. Health HIV/AIDS Research

Source: CIHR database

Project R59:

Title: Exploring Social Participation Among Adults Aging with HIV

Principal Investigator: Patricia E. Solomon

Co-investigators: Kelly K O'Brien and Mary S Wilkins

Abstract: As HIV evolves into a chronic and episodic illness, people are living with HIV for longer. Older adults who have been living with HIV for many years encounter health related challenges of HIV and concurrent health conditions associated with aging. This qualitative study will develop a theoretical model that describes the experiences of aging from the perspective of older adults living with HIV. We will identify the challenges to social participation that older adults living with HIV experience and the strategies they use to manage these challenges and compare the experiences of aging among older men and women living with HIV. The findings of this research will assist in the development of gender and age specific social and health services to maximize participation of older adults living with HIV.

Dates: October 2009 - September 2012

Funding Program: Operating Grant - Priority Announcement: HIV/AIDS Research Initiative - Health Services/Population Health Stream

Source: CIHR database

Project R60:

Title: Exploring the natural history of injection drug use: A qualitative study of social and environmental influences

Principal Investigator: Dr. Thomas H. Kerr

Co-investigators: Dr. Cameron Duff, Dr. Julio Montaner, Dr. Jean Shoveller, Dr. William Small, Dr. Jo-Anne Stoltz, and Dr. Evan Wood

Abstract: The influence of environmental factors upon individual health has increasingly been recognized in public health research, particularly with regard to individuals who inject illicit drugs. The proposed research aims to identify social, structural and environmental influences which may exacerbate HIV risks, impede HIV prevention efforts and hinder access to HIV treatment among injection drug users in Vancouver. Ethnographic and qualitative research methods will be employed, including individual interviews and observational activities. By identifying factors which may mediate the success of current harm reduction programs among injection drug users, this research will allow future efforts to effectively target significant factors beyond the reach of individually focused behavioural interventions. The study will provide insight and evidence informing the development of interventions designed to modify ecological conditions which reduce individual ability to reduce HIV risks, employ prevention strategies and access care.

Dates: October 2006 - September 2009

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R61:

Title: Family functioning in families living with HIV: vulnerabilities and resilience

Principal Investigator: Mylène Fernet

Co-investigators: Martin Blais, Normand D. Lapointe, Joanne Otis, Johanne Samson

Abstract: This research project examines how families affected by HIV deal with HIV-related issues, including disclosure and the management of HIV infection. The investigators will meet with families affected by HIV across Quebec and will quantitatively analyse their functioning in order to identify factors of vulnerability and resilience. Once these findings have been collected, qualitative interviews will be conducted with the families in order to document mother-child communication dynamics through direct observation. The benefits of this project include the development of interventions that will support families living with HIV and help improve their quality of life.

Dates: March 2010 - February 2013

Funding Program:  CIHR Operating Grant  - Priority Announcement: HIV/AIDS Research Initiative - Health Services/Population Health Stream

Source: CIHR

Project R62:

Title: From System Fragmentation to System Synthesis: A Collaborative Approach to Increasing Access to Housing, Health and Social Services for People Living with HIV in Ontario

Principal Investigator: Dr. Saara Greene

Abstract: The Families, HIV and Housing study is a community-based research study aimed at investigating the housing needs and experience of parents living with HIV/AIDS in Toronto. Our most recent analysis, based on 17 in-depth qualitative interviews with HIV-positive African and Caribbean mothers, argues that although HIV-positive mothers experience a number of shared housing-related issues and concerns, these challenges are exacerbated for HIV-positive mothers from African and Caribbean communities. This is due to the multiple systemic issues that marginalize these mothers as a result of their gender, immigration status, culture, and current social positioning as HIV positive women from racialized communities in Canada.

Dates: July 2007 - June 2010

Funding Program: Ontario HIV Treatment Network (OHTN) Operating Grant

Source: CAHR Database

Project R63:

Title: Gender and well-being in the households of persons receiving antiretroviral treatment

Principal Investigator: Dr. Amy Kaler

Co-investigators: Dr. Sean B. Cash, Dr. Walter Kipp, Dr. Marty Luckert, and Dr. Duncan Saunders

Abstract: Not available.

Dates: January 2007 - December 2009

Funding Program: Social Sciences and Humanities Research Council (SSHRC) Operating Grant

Source: CAHR database

Project R64:

Title: Getting to the HAART of the matter: translating LISA findings into action

Principal Investigator: Robert S. Hogg

Co-investigators: Aranka Anema, Julio S. Montaner, David M. Moore, Alexis Palmer, and Surita Parashar

Abstract: The LISA (Longitudinal Investigations into Supportive Ancillary Health Services) project has established an immensely rich resource that provides socio-demographic context to the clinical data collected on people living with HIV who access HAART through the Drug Treatment Program. We propose a variety of methods of knowledge translation in order to tailor messages to our diverse stakeholders (community members, participants, project managers, policy makers). Our first activity involves developing plain language summaries which will be created in collaboration with the communications firm, Kayro Edelman, and distributed to community partners and policy makers. For our second proposed activity, we will develop a website which will disseminate research results in both scientific and popular formats. Thirdly, we will involve community in round table discussions. Finally, arts-based activities, specifically a Photovoice project, will further engage participants, provide an alternative medium to disseminate our findings and capture the attention of policy makers. In addition, our proposal directly pertains to the CIHR HIV/AIDS Research Initiative's objectives. Our findings provide insight on the care and treatment services provided in the province of BC. The LISA data gives voice to positive individuals and illuminates the widespread inequities that persist in the realms of employment, housing and social exclusion/inclusion. These social determinants of health play a vital role in shaping health outcomes and quality of life. Our findings speak directly to the vast differences in vulnerability in Canadian society, as well as to the resilience of those affected by the disease. The study also suggests ways forward in improving supportive and auxiliary services. We would therefore like to be considered for funding from the HIV/AIDS Research Initiative for the implementation of our proposed activities.

Dates: January 2010 - December 2010

Funding Program: Meetings, Planning and Dissemination Grant: Knowledge Translation Supplement

Source: CIHR database

Project R65:

Title: Guidelines for the Determination of Medical Inadmissibility for Canadian Immigration Applicants with HIV/AIDS: Research Synthesis and Knowledge Dissemination

Principal Investigator: Peter Coyte

Abstract: The Canadian Immigration and Refugee Protection Act of 2001 outlines conditions under which individuals may be granted or denied admission to Canada. The Act stipulates that applications for residence will be rejected if their health is expected to generate excessive demand on Canadian health or social services. The purpose of this paper is to derive a statistical definition of excessive demand and to apply that threshold to persons with HIV who are seeking admission to Canada. The paper demonstrates that the current threshold used by Citizenship and Immigration Canada is much lower than the thresholds that may be derived statistically.

Dates: 2008-present

Funding Program: OHTN Grant Board Directed

Source: OHTN database

Project R66:

Title: Health Care Experiences of HIV Positive Aboriginal Offenders Released into the Community

Principal Investigator: Anthony V. De Padua

Co-investigators: Judith E. Mill

Abstract: The goal of the study is to identify the experiences of HIV Aboriginal positive offenders who have been released into the community. The HIV/AIDS epidemic is affecting Aboriginal people in all communities (rural, urban, reserve and prison). In the 2001 census Aboriginal people made up 3.3% of the Canadian population; however, between 1998 and 2003, 23% of individuals living with HIV were Aboriginal. The Correctional Service of Canada reported that within the prison system offenders have higher rates of HIV infection than the general public. Once an offender is released into the community, a lack of health care services can lead to a deterioration in health status and a missed opportunity to prevent the spread of HIV in the community. It is anticipated that the findings from this study will provide new knowledge that can assist nurses to provide culturally safe HIV care and support. Understanding the relationships between Aboriginal culture, offender subculture, and current healthcare practices will improve health care for this marginalized and vulnerable population. This research will address the limited knowledge on the healthcare needs of HIV sero-positive offenders and their experiences with nurses.

Dates: January 2009 - December 2009

Funding Program: Doctoral Research Award: HIV/AIDS Community-Based Research - Aboriginal Stream

Source: CIHR database

Project R67:

Title: Health: Culture and Gender as Determinants of Health for Aboriginal Women Living with HIV/AIDS

Principal Investigator: Tracey Prentice

Co-investigator: Denise Spitzer

Abstract: Not available.

Date: 2010

Funding Program: OHTN Grant Studentship Award

Source: OHTN database

Project R68:

Title: Healthy deliberation: online decision-making and mobilization by HIV and AIDS patients

Principal Investigator: Karen L. Smith

Abstract: Not available.

Date: 2008

Funding Program: Canada Graduate Scholarship - Doctoral Program

Source: OHTN database

Project R69:

Title: High-dimensional data analysis using probabilistic graphical models to infer the causal associations between clinical outcome and virus sequence evolution, drug resistance, and host genetic factors in the context of HIV-1-infected patients undergoing highly active antiretroviral therapy in British Columbia.

Principal Investigator: Arthur F. Poon

Co-investigator: Richard P. Harrigan

Abstract: Highly-active antiretroviral therapy (HAART) is a critical resource for clinical management of individuals infected with HIV-1 and is primarily responsible for the decline in AIDS-related mortality in the past decade. However, HIV-1 rapidly acquires mutations that confer resistance to these antiretroviral drugs. The emergence of resistant variants of HIV-1 within patients undergoing HAART can significantly influence the rate of progression to AIDS, i.e., clinical outcome. My objective is to develop bioinformatic models to predict clinical outcome in HIV-1-infected patients from virus sequence data, patterns of drug therapy, and patient characteristics such as adherence and host genetic factors. As a complex characteristic of HIV-1, drug resistance requires the accumulation of multiple interdependent mutations that often interfere with the growth of the virus. Both the initial genetic composition of an HIV-1 population and the combinations of drugs used in therapy can influence which mutational pathway is taken to become resistant. Because mutational pathways may be associated with different costs to virus infectivity or replication, it is critical in modelling the evolution of drug resistance and clinical outcome to incorporate HIV-1 sequence variation. To accommodate the complexity of this problem, I will employ probabilistic graphical models (PGMs), a branch of bioinformatics that provides a compact framework for modelling complex dynamic systems with many interacting factors. These models will be developed and implemented at the BC Centre for Excellence in HIV/AIDS, which oversees one of the longest followed and best-studied HIV treatment-based cohorts in the world, and maintains an extensive database integrating treatment, clinical, and genetic information. The end product of this project will provide comprehensive patient-specific guidelines to optimize the clinical management of HIV-1 infections.

Dates: July 2008 - August 2010

Funding Program: Fellowships - Priority Announcement: Award in the Area of Biomedical / Clinical HIV/AIDS research

Source: CIHR database

Project R70:

Title: HIV and hepatitis C transmission networks in a cohort of injection drug users in Vancouver's downtown eastside: How structure and context matter

Principal Investigator: Ms. Sheila P. McCarthy

Co-investigator: Dr. David M. Patrick

Abstract: HIV/AIDS has been described as an epidemic in our Aboriginal communities and we must focus on our communities to start our healing journey. Life Experiences of Aboriginal Families and HIV/AIDS: A Qualitative Inquiry has been guided by my motivation to assist to create a better understanding of HIV/AIDS with our Aboriginal communities. The proposed research will build on my years of experience as a First Nations researcher working with the community to address the needs of Aboriginal families living with HIV/AIDS. In Aboriginal communities, it is common for the family constellation to be comprised of immediate, extended and adopted family members and that is the concept of families that will be used in the study. Conducting research with Aboriginal families and HIV/AIDS is a sensitive topic that requires establishing relationships of trust with Aboriginal families. The proposed qualitative study will use grounded theory methods to analyze in-depth interviews with Aboriginal families living with HIV/AIDS. Results will enhance our understanding of culturally specific healthcare needs of Aboriginal families. The goal of this research is to contribute to our limited knowledge of appropriate prevention of this growing epidemic. My collaboration with local, provincial and national Aboriginal AIDS networks will ensure utilization of my findings.

Dates: September 2005 - August 2008

Funding Program: CIHRStudent Award

Source: CAHR database

Project R71:

Title: HIV Health Services Research: Efficacy, Equity, Access and Quality of Life

Principal Investigator: Dr. Ahmed Bayoumi

Abstract: Not available.

Dates: April 2006 - March 2009

Funding Program: Ontario HIV Treatment Network (OHTN) Career Scientist Award

Source: CAHR database

Project R72:

Title: HIV Knowledge Production and Management for Improvement of Health Services in Rural Manitoba

Principal Investigators: Carla Pindera, Marissa Becker, and Ken Kasper

Abstract: HIV prevention and care are important to improving the health and wellbeing of vulnerable populations. However, there are important knowledge gaps related to strategies for achieving the best possible outcomes in prevention and care. In Manitoba, the overall numbers of new HIV diagnosis has increased in the last few years. In the last few years, we have also learned that more people are testing for HIV in rural and Northern areas, most of the time accessing care when very ill. This suggests that some individuals, particularly among the vulnerable and remote populations, are often not accessing care or able to access care, and when they do, they are often presenting late. The University of Manitoba Health Sciences Centre and Nine Circles Community Health Centre with regional partners have begun a process of examination of the knowledge gaps in rural and Northern areas in the province. The overall purpose of the two meetings is to facilitate discussion that can inform further knowledge exchange and research agenda concerning the provision of care in rural and northern regions in Canada. The main objectives of the meetings are (1) to present an update of the Manitoba HIV Program; (2) present and discuss research findings and evidence that supports the development of the Manitoba HIV Program; (3) gain an understanding of the HIV related issues faced in the Region, including current knowledge and resources and the gaps in these areas; discuss strategies to address gaps and shortcomings in relation to HIV primary care, treatment and support, including ways to strengthen the communication and collaboration across Regions. Through interactive sessions we aim to develop a research and projects to begin evaluating the gaps and needs identified by the regions. A report from the workshops will be shared with the other regions in the province as a template for strengthening regional partnerships and HIV program development.

Dates: January 2010 - December 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R73:

Title: HIV Positive Women's Reproductive Decisions: A Longitudinal Assessment of Social and Psychological Contributors to Fertility

Principal Investigator: Anne Wagner

Co-investigator: Trevor A. Hart

Abstract: Women of childbearing age are the fastest growing group in Canada acquiring the HIV virus. Because of recent medical developments, the risk of transmission from mother to child has been reduced drastically. The reduced risk of transmission speaks to pregnancy being a less risky option for HIV+ women with appropriate medical care and assistance from the healthcare system (as reproductive aid is necessary to prevent transmission to a partner). HIV+ women have been found to desire to have children at similar rates as HIV-negative women, however their actual pregnancy outcomes have not yet been examined. The current study will examine what proportion of HIV+ women who intend to have children become pregnant over a two-year period, and will compare this group to a matched HIV-negative group of women. The study will also examine HIV stigma, social support, psychological distress and healthcare barriers as predictors of fertility intentions and pregnancy.

Dates: September 2009 - August 2012

Funding Program: CIHR Frederick Banting and Charles Best Canada Graduate Scholarships - Doctoral Award

Source: CIHR database

Project R74:

Title: HIV Positive Women's Reproductive Decisions: Social and Psychological Contributors and their Implications for Health Care Delivery

Principal Investigator: Anne Wagner

Co-investigator: Trevor A. Hart

Abstract: Not available.

Dates: September 2008 - August 2009

Funding Program: CIHR Canada Graduate Scholarships Master's Awards

Source: CIHR database

Project R75:

Title: HIV, Health care utilization, and bias in a sample of gay, bisexual, and other MSM

Principal Investigator: Todd Coleman

Co-investigator: Greta Bauer

Abstract: Not available.

Date: 2010

Funding Program: OHTN Grant Studentship Award

Source: OHTN database

Project R76:

Title: HIV/AIDS experience of Alberta women who are from countries where HIV is endemic

Principal Investigator: Dr. Aniela Dela Cruz

Abstract: The purpose of this study is to explore and understand the experiences of HIV positive Alberta women who are from Sub-Saharan African countries where HIV is endemic. The objectives of this study are: to understand how women experience their HIV diagnosis, treatment and support in their community; and to understand how women's HIV illness impacts their social and familial relationships. There are a number of women from Sub-Saharan African countries living and working in Alberta who may be infected with or affected by HIV. The literature shows relatively few studies which explore HIV/AIDS among immigrants to Canada from Sub-Saharan Africa. With evidence showing increased number of positive HIV tests and AIDS diagnoses in Sub-Saharan African Canadians, there is still little known of the contextual factors that contribute to this problem, or the experiences of women who are HIV positive and who are living outside of large metropolitan communities. In 2005, there were fifteen documented studies or reports completed in Canada which are specific to HIV and AIDS among people from African and Caribbean countries; all have been completed in Eastern Canada and in larger metropolitan centers such as Toronto or Montréal. Further, there are no completed studies or studies in progress that explore or document the experiences of Alberta women from Sub-Saharan African countries who are infected with or affected by HIV.

Dates: May 2007 - April 2010

Funding Program: CIHR Student Award

Source: CAHR database

Project R77:

Title: HIV/AIDS, Gender-based Violence and Masculinities Workshop

Principal Investigator: Stevenson Fergus

Abstract: The "HIV/AIDS, Gender-based Violence and Masculinities Workshop" is a three-day, scientific and educational workshop scheduled to take place in August 2009. This workshop, building upon an existing HIV/AIDS and gender-based violence (GBV) training session, will bring together relevant international and national stakeholders for whom the dual epidemics of HIV/AIDS and GBV are central. While showcasing Canadian expertise on the global HIV/AIDS pandemic, the workshop will provide a forum for knowledge exchange, information sharing, reflection, and priority-setting concerning the HIV/AIDS and GBV epidemics. The workshop has been designed to provide rigorous training and networking opportunities for the next generation of HIV/AIDS researchers. Finally, this workshop will facilitate the involvement of international and national experts in creating links between the global HIV/AIDS and GBV epidemics and the experience of sub-Saharan African immigrants to Canada.

Dates: September 2008 - August 2009

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R78:

Title: HIV/AIDS, Maternal Health and Motherhood: Health-Related Behaviours, Programming Implications and Narrative Constructions

Principal Investigator: Pamela J.Downe

Co-investigators: Sylvia Abonyi, Karen Lawson, and Jennifer Poudrier

Abstract: This three-year, community-based research will identify and analyze the interrelationship between women's experiences with motherhood and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). In 2006 AIDS Saskatoon identified mothers as a significant and growing constituency among those who access their services but for whom no programs were specifically designed. Twenty-one months of community-based collaboration with 17 organizations and university researchers led to the development of three research objectives: (1) To identify the interrelationship between motherhood and HIV/AIDS; (2) To assess how motherhood affects health-related behaviours of women accessing the services of AIDS Saskatoon; (3) To determine and build capacity to enhance the HIV/AIDS-related services that are identified positively by research participants. Adopting a narrative-based approach, this research is participatory in design and will be guided by AIDS Saskatoon and a 14-member Community Advisory Committee. This project will involve the participation of Aboriginal and non-Aboriginal women who identify as mothers in two sets of interviews, a photovoice project, a two-phase programming analysis, and focus groups. Given that the increasing rates of HIV/AIDS among women are occurring primarily in those of childbearing age and that fewer than 4% of the organizations registered with the Canadian AIDS Society offer maternal health programs, this research will have far-reaching significance to the health and well being of Aboriginal and non-Aboriginal women who have children and who are living with, affected by, and/or vulnerable to HIV/AIDS.

Dates: April 2008 - March 2011

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Operating Grant

Source: CIHR database

Project R79:

Title: HIV/Antiretroviral Update

Principal Investigator: Julio SMontaner

Abstract: On Monday, May 25th, 2009 the BC Centre for Excellence in HIV/AIDS (BC-CfE) will hold the day-long HIV/Antiretroviral Update at the Sheraton Wall Centre Hotel in Vancouver. This free biannual Update presents the latest information on highly active antiretroviral therapy (HAART) for HIV-infected patients and discusses the challenges and benefits of HAART for various population groups. The BC-CfE is committed to working with physicians, nurses, pharmacists and other healthcare providers to link affected individuals with appropriate care, treatment and support and to help reduce the incidence of new HIV infections. Knowledge transfer through continuing medical education to healthcare providers is one of the main ways in which the BC-CfE is helping to achieve its prevention and treatment goals. The BC-CfE would like to engage as many physicians and other healthcare providers as possible, especially those with HIV positive patients (including newly diagnosed patients and patients at risk for acquiring HIV) or simply with an interest in HIV. Notice of the Update has been sent to current ARV-prescribing physicians listed in the Centre's registries, published in our newsletter, and posted on the BC-CfE website. For those who are unable to attend the event in Vancouver, it is live-streamed over the Internet on the website. The event is also archived on our website, so physicians and others can access the talks at a later date. This event is accredited by the College of Family Physicians of Canada so attendees can receive continuing medical education (CME) credits.

Dates: May 2009 - April 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R80:

Title: HIV-Organ Transplantation Information Exchange Conference

Principal Investigator: Curtis L. Cooper

Co-investigator: Edward J. Mills

Abstract: This meeting will provide HIV/AIDS care physicians, organ transplantation specialists, other HIV care providers, researchers, ethicists, decision makers and HIV community members an opportunity to discuss issues associated with HIV/AIDS and liver transplantation. Knowledge exchanged will focus on a meta-analysis and systematic review of liver transplantation in HIV conducted by the lead investigators. This meeting will provide opportunities for peer to peer information exchange with the goal of achieving clarity regarding the science and policy of liver transplantation in those living with HIV/AIDS in Canada. This proposed meeting is relevant to the CIHR HIV/AIDS Research Initiative as it addresses therapy for HIV/AIDS infected Canadians, and Liver Transplantation in HIV as a global health challenge. The outcome of this research and knowledge dissemination will affect health systems, services and policy as access to this procedure is made available to Canadians with HIV. In addition, this research is related to HCV/HIV co-infection which is a CIHR HIV/AIDS Research Initiative priority.

Dates: January 2010 - December 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R81:

Title: HIV-Related Cognitive Impairment in the HAART Era: A Pilot Project

Principal Investigator: Neora Pick

Co-investigators: David R. Burdge, Eliana Castillo, Hélène Côté; Wendy J. Loken, and Allen E. Thornton

Abstract: The lives of people living with HIV have changed greatly over the last 20 years, and the drugs used to treat HIV are helping people to live longer lives. Changes in health that normally happen with aging are starting to be seen in people living with HIV, and some doctors think that these changes are happening at younger ages than for people without HIV. Some of the things that people living with HIV report frequently include lower ability to concentrate, pay attention and remember things. This kind of an effect can make it harder for people to remember to take their medications every day as well as caring for themselves and their families. Since HIV medications lower the amount of HIV virus in the body, forgetting to take them can also have negative effects on their length and quality of life. Not very much is known yet about exactly how HIV drugs affect a person's thinking and memory, and what possible effects this could have on the normal aging process. Even less is known about these effects in women, as most studies have been done with men. Around the world, women represent half of people living with HIV, and we believe it is very important to understand these effects in women. Our team would like to offer a short group of memory and thinking tests. This will help us to know if there is a problem that affects their daily function, and will be the first step towards looking at possible ways to help women cope with it. We believe this information will help to understand more about this new and serious issue. We also believe it is very important to start looking at this right now because in the next 6 years more than 50% of the people living with HIV in North America are going to be older than 50 years of age. This information will however help all HIV positive people regardless of where they live.

Dates: March 2010 - February 2011

Funding Program: CIHR Catalyst Grant: Infection and Immunity - New Investigator Catalyst Grant

Source: CIHR database

Project R82:

Title: Housing and Health: Impact of Housing on People Living with HIV/AIDS Symposium

Principal Investigator: Charlotte R. McKay

Abstract: Alberta Community Council on HIV (ACCH) is a coordinated, community based response to HIV that includes HIV prevention, education, outreach and harm reduction programs, care and support as well as palliative and transitional housing for people living with HIV/AIDS. "The Housing and Health: Impact of Housing on People Living with HIV/AIDS Symposium", organized by ACCH, will bring together stakeholders from different sectors (HIV, community, housing, government and academia) from Alberta, the Prairies and the rest of Canada. The focus of the Symposium will be on knowledge exchange and identifying research gaps and/or research priorities in order to influence development of a housing strategy specific to people living with HIV/AIDS. Utilizing current initiatives (such as "The Housing and Health Research to Action Symposium"), the Symposium will establish a strong provincial/regional/national link that will significantly contribute to the development of the national HIV/AIDS housing collation. It will play an important role in building a strong national response to the issue of housing for individuals living with HIV/AIDS.

Dates: September 2008 - August 2009

Funding Program: Meetings, Planning and Dissemination Grant: Knowledge Translation

Source: CIHR database

Project R83:

Title: If hepatitis C virus (HCV) is an opportunistic infection, why has HAART not led to dramatic improvements in liver disease among HIV-HCV co-infected persons?

Principal Investigator: Marina B. Klein

Co-investigators: Brian Conway, Curtis L. Cooper, Pierre Côté, John Cox, Michael J. Gill, Shariq Haider, Mario A. Ostrowski, Danielle Rouleau, Samy Suissa, Sharon L. Walmsley, and David K. Wong

Abstract: An increasing number of people are infected with both Hepatitis C (HCV) and HIV. HIV appears to make HCV related liver disease progress more rapidly. Liver disease is now one of the leading causes of death in HIV-HCV-infected persons. By restoring the immune system, it was expected that effective anti-HIV treatments would lead to improved liver health. However, it remains unclear why liver disease continues to be such a large problem in co-infection. We propose to study how HIV therapy impacts HCV related liver disease. We will study 950 HIV-HCV infected persons from across Canada over five years. We will look at social and biologic factors that may contribute to liver disease and evaluate non-invasive methods to measure liver health. We will also examine the immune function of participants receiving HIV therapies compared to those not treated. This work will allow a greater understanding of how these two viruses interact to cause disease and will provide insights into to how best to design therapies so that in the future, HIV-HCV infected individuals may be able to derive benefits from the treatment advances being realized for HIV infection.

Dates: April 2006 - March 2009

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R84:

Title: Impact of Food Security on Health Outcomes in People Living with HIV Across Canada

Principal Investigators: Ruthann Tucker and Robert S. Hogg

Co-investigators: Aranka Anema, Tsegaye M. Bekele, Sarah J. Fielden, Jennifer E. Jones, Murray G. Jose, Rick A. Kennedy, Marina B. Klein, Christiana Miewald, Kenneth M. Monteith, Sean B. Rourke, and David Swan

Abstract: The Principal Aims of the proposed study are to examine and isolate the primary causes, context-specific risk factors (social, economic, and environmental) and the access barriers affecting food insecurity at the individual and population levels, and how food insecurity affects the clinical course of HIV disease, health outcomes and health-related quality of life, and survival. To achieve these aims, we have assembled an expert community-academic team from Ontario, BC and Quebec that is well positioned to conduct this CBR initiative, and to mobilize the critical research evidence generated to inform and influence: (1) best practices in food and support programs and services in the community; and (2) policies that limit the availability and access to appropriate food sources and nutrition for people living with HIV in Canada. This will be the first time in the history and evolution of the CIHR HIV/AIDS CBR program that clinical and community cohort data from three major regions in Canada will be brought together to address the health needs of people living with HIV/AIDS. Major Objectives: (1) To assess the prevalence of general and various sub-types of food insecurity  (i.e. food insufficiency, poor food quality/diversity, and range of methods of food acquisition) among individuals with HIV in BC, ON and QC; (2) To examine the socio-demographic and determinants of health correlates of general food insecurity and sub-types of food insecurity among individuals with HIV in BC, ON and QC; (3) To examine whether having adequate, appropriate and stable food security is associated with improved access to medical care among individuals with HIV in BC, ON and QC; and (4) To examine the clinical and health-related quality of life outcomes and survival benefits associated with having adequate, appropriate and stable food security and access to food programs in individuals with HIV in BC, ON and QC.

Dates: April 2006 - March 2009

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R85:

Title: Impacts of criminal prosecutions for HIV exposure and transmission on people living with HIV

Principal Investigator: Dr. Barry Adam

Abstract: In the contemporary context of a rising number of prosecutions of HIV transmission following the 1998 Cuerrier decision by the Supreme Court of Canada, this project examines how people living with HIV perceive the law and the legal obligation to disclose serostatus to prospective sexual partners. There is a dearth of evidence as to the impact of criminal law, even as public policy is evolving through decisions by police investigators, prosecutors, and courts. The research investigates how HIV-positive people have been advised of legal developments by AIDS service organizations, health providers, and other relevant agencies. It also investigates: (a) how legal proceedings and press coverage of legal proceedings affect understanding of rights and responsibilities of self to others concerning transmission, stigmatization, and vulnerability to prosecution; (b) how legal proceedings affect decisions to test for HIV; (c) how legal proceedings affect disclosure practices of self and sexual partners; and (d) how they affect safer sex practices of self and others. By elucidating the social impacts of public policy being created through court decisions, this project seeks to contribute towards a better understanding of: (a) ways in which criminal prosecution for HIV non-disclosure to sexual partners affect HIV prevention efforts in various ways, beneficially or adversely; (b) ways in which HIV prevention might be made more effective without resorting to the criminal justice system; (c) alternative trajectories to that which leads to criminal prosecution; and (d) best practices for the appropriate articulation of public health measures with the criminal justice system.

Dates: April 2008 - March 2011

Funding Program: Ontario HIV Treatment Network (OHTN) - Operating Grant

Source: CAHR database

Project R86:

Title: Informal social supports, caregiving and HIV/AIDS: A community-based study

Principal Investigators: Dr. Carla Pindera and Dr. Javier Mignone

Co-investigators: Dr. Margaret Akan, Dr. Lawrence J. Elliot, Dr. Carol D. Harvey, and Dr. Christine N. Smith

Abstract: In Manitoba and Saskatchewan, increasing rates of HIV indicate a need for coordinated prevention and support programs. The increasing number of people living with HIV leads to increased reliance on formal community services as well as informal caregiving networks to cope with the illness. The proposed community-based research study will focus on the practical and research needs related to optimizing the care and social support systems for people living with HIV/AIDS in Manitoba and Saskatchewan. The project's goal is to increase understanding of the reality of those providing (informal) care, as well as those receiving it. This knowledge will assist in improving the quality of life of people living with HIV/AIDS and their informal caregivers (i.e. partners, family and friends). Research questions will be addressed through a combination of qualitative methods with research tools designed in collaboration with community members, i.e., people living with HIV and their caregivers. A range of participatory data collection tools will be utilized including literature review, photovoice and individual in-depth interviews. Findings will be organized and disseminated in ways which will be of most benefit and use to the community and community partners offering HIV care, treatment and support.

Dates: April 2007 - March 2010

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R87:

Title: Innovative approaches for diagnosing tuberculosis in the era of HIV

Principal Investigator: MadhukarPai

Co-investigators: Peter Daley, Nandini Dendukuri, Keertan Dheda, Christina A. Greenaway, and Richard Menzies

Abstract: Tuberculosis (TB) is an infectious disease of great global importance. Each year, 8-9 million people develop tuberculosis, and a further 2 million will die from TB each year. TB is the leading cause of death among people living with HIV infection. Identifying and diagnosing cases of active TB, particularly in HIV infected individuals is critical for TB control programs here in Canada and around the world. However, existing tests for TB are decades old, and use imperfect technologies. Improved diagnostic tests are urgently needed to control the TB epidemic. The proposed research involves evaluating the accuracy of new and innovative tools for diagnosing TB in both HIV infected and non-infected persons in 3 countries with varying levels of HIV and TB in the community. These countries include: Canada (low levels of TB and HIV), India (high levels of TB and intermediate levels of HIV) and South Africa (high levels of TB and HIV). In addition to examining test accuracy, we are interested in evaluating whether feasibility and test characteristics differ among those with and without HIV infection. Lastly, we will examine the cost effectiveness of the new tests in the 3 different countries. The study results will be helpful in guiding evidence-based decisions for global TB control. The project will also result in sustained and balanced collaborative relationships between researchers in Canada and India/Africa in order to promote the assessment and application of innovative technologies in the setting where they are needed most.

Dates: October 2008 - September 2011

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R88:

Title: Ontario HIV Treatment Network -Interdisciplinary Centre for Community-Based IMPACTS on HIV Policy

Principal Investigators: Sean B. Rourke and Barry D. Adam

Co-investigators: Jean Bacon, Ahmed M. Bayoumi, Laurie Edmiston, Jacqueline C. Gahagan, Robert S. Hogg, Rosemary J. Jolly, Susan A. Kirkland, Frank McGee, Gerry J. Mugford, Eric Mykhalovskiy, Stephanie A. Nixon, and Michael Orsini

Abstract: The front-line organizations that deliver HIV prevention and support programs, community-based AIDS service organizations and public health units are under increasing pressure to demonstrate that their programs and interventions are evidence-based, effective and affordable. The proposed Interdisciplinary Centre for Community-Based IMPACTS on HIV Policy will bring together: researchers from a wide variety of disciplines; people living with HIV; front-line service providers; federal, provincial and regional policy makers; and organizations with a mandate for KTE. It will provide infrastructure support to enable social science researchers, the HIV community and policy makers to design and evaluate community and public health interventions for HIV prevention, care, treatment and support. In terms of approach, the Centre will support the outcomes-based evaluation that characterizes HIV social and behavioural intervention research in the US, but it will go beyond that to understand and address the political, social, economic, health policy, health services and other social and structural determinants that enhance or limit the effectiveness of a variety of interventions. The Centre's goal is to enhance the health and well-being of people living with and at risk of HIV and contribute to healthy public policy. By building on existing regional networks of researchers and service providers, the Centre will provide a powerful national platform for interdisciplinary research on population health, health services and community-based and public health interventions, and knowledge translation. The Centre's objectives are to: (1) Build capacity for interdisciplinary population health and health services research; (2) Support population health and health services research in HIV/AIDS; (3) Support adoption of evidence informed, community-based/public health interventions; and (4) Translate and evaluate research into action to influence healthy public policy.

Dates: September 2008 - December 2008

Funding Program: CIHR HIV/AIDS Population Health and Health Services - LOI

Source: CIHR database

Project R89:

Title: Investigating and addressing barriers to human immunodeficiency virus (HIV) and hepatitis C virus (HCV) care among injection drug users

Principal Investigator: Dr. Evan Wood

Co-investigators: Dr. Thomas H. Kerr, Dr. Julio Montaner, Dr. Anita Palepu, Dr. Jo-Anne M. Stoltz, Dr. Mark W. Tyndall, Dr. Richard P. Harrigan, and Dr. Robert Stephen Hogg

Abstract: Since its introduction in the mid-1990s, the benefits of antiretroviral therapy for the treatment of HIV disease have been well established. New antiretroviral regimens have resulted in marked improvements in HIV-related morbidity and mortality among persons on antiretroviral therapy, particularly gay and bisexual males. Although the side effects of HIV treatment present challenges, disease progression and AIDS deaths have become so rare among persons on antiretroviral therapy that, in many areas of the world, HIV infection is increasingly being viewed as a chronic and manageable illness. These findings have emerged amidst increasingly urgent concerns regarding inequitable access to antiretroviral therapy among those infected during the later stages of the HIV epidemic in North America, particularly HIV-infected illicit injection drug users (IDUs). IDUs suffering from HIV-infection are at immediate risk of declining health and avoidable mortality due to limited access to antiretroviral therapy and retention in medical care, and, in turn, contribute to substantial healthcare expenditures when opportunistic infections result in lengthy hospitalizations. This proposal will support the development of an interdisciplinary research program, based around a new prospective cohort study of HIV-infected IDUs, that will identify barriers and facilitators of AIDS care among this extremely vulnerable population.

Dates: April 2006 - March 2011

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R90:

Title: Investigations into clinical outcomes and adverse events among HIV infected individuals receiving antiretroviral therapy

Principal Investigator: Dr. Janet Raboud

Abstract: Not available.

Dates: April 2005 - March 2009

Funding Program: Ontario HIV Treatment Network (OHTN) Career Scientist Award

Source: CAHR database

Project R91:

Title: Involving heterosexual HIV-positive men in identifying their health care, support, and research needs and priorities

Principal Investigator: Mona R. Loutfy

Co-investigators: Tony Antoniou, Richard H. Glazier, and Carol J. Strike

Abstract: Heterosexual men living with the human immunodeficiency virus (HIV) have been under-represented in the HIV literature since the origins of the epidemic in the 1980s. Several potential reasons exist for the exclusion of heterosexual men from the HIV research culture. In comparison with women and gay men living with HIV, heterosexual men lack a readily identifiable community to which they belong, thereby being rendered largely invisible in the context of the broader epidemic. In addition, the targeting of HIV-related media towards the gay community may reinforce stereotypes about the nature of the HIV-positive demographic and promote feelings of stigmatization among heterosexual men living with the disease. Finally, there has not been a sustained effort by researchers and care providers to engage HIV-positive heterosexual men. As a result, virtually nothing is known about the lived experience of being an HIV-positive heterosexual man in Canada. In addition, there are no data describing the health care and support needs of this population, and whether perceived gaps in required services for these patients exist. We therefore propose to develop the first large program of research describing the health care and social support needs of HIV-positive heterosexual men. The proposed research involves the use of focus groups with HIV-positive heterosexual men to identify perceived gaps in health care, research and social support needs. A community advisory board including individual men living with HIV and providers from various AIDS service organizations will be established to strengthen community-academic research, knowledge transfer and exchange partnerships. We believe that by fostering dialogue between academic researchers, heterosexual men with HIV and service providers, a productive partnership can be nurtured that will ultimately inform the development of policies and strategies directed at identifying and meeting the needs of these patients.

Dates: September 2009 - August 2011

Funding Program: CIHR HIV/AIDS Community Based Research Program - General - Operating Grant

Source: CIHR database

Project R92:

Title: Involving Ontario HIV-positive women and their providers in determining their research needs and priorities

Principal Investigators: Dr. Mona Loutfy and Dr. Wangari Tharao

Co-investigators: Dr. Louise Binder, Dr. Trevor Hart, Dr. Danielle Layman-Pleet, Dr. Lynne Leonard, and Dr. Janet Raboud

Abstract: Historically, there has been a deficiency in collaboration and lack of trust between academic researchers and community groups. Accordingly, there is a need for better communication and for increased input from community members and affected individuals into what research questions should be addressed. This is particularly important in the field of women and HIV/AIDS as women are continuously underrepresented in many decision-making and study design processes and the majority of research done to date has focused on male populations. This project aims to determine what research topics interest Ontario women living with HIV/AIDS and to strengthen community-academic research, knowledge transfer and exchange partnerships. A Community Advisory Board will be formed and HIV-positive women and their service providers will be asked to participate in interviews, focus groups and surveys to generate qualitative and quantitative data.

Dates: March 2007 - September 2009

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R93:

Title: Knowledge, action, and transformation in HIV/AIDS care: Exploring the role of community-based organizations in evidence-based change

Principal Investigator: Eric Mykhalovskiy

Abstract: Not available.

Dates: September 2006 - June 2009

Funding Program: CIHR IHSPR, KT New Investigator (HIV/AIDS) - Health Services/Population Health

Source: CIHR database

Project R94:

Title: Lipodystrophy, stigmatization and identity: A study of the identity transformation process in women living with HIV/AIDS

Principal Investigator: Mrs. Marilou Gagnon

Abstract: The introduction of Highly Active Antiretroviral Therapy (HAART) in 1996 transformed the prognostic of people living with HIV/AIDS. This therapeutic innovation led to a dramatic decrease in morbidity and mortality rates in the HIV population. However, we are now confronted with the new face of the HIV epidemic in regards to the daily management of a disease that contains a strong social, psychological, emotional and physical burden. What is emerging from the literature and the clinical settings is that HIV-positive individuals experience the oppressiveness of a new reality, one that captures the chronicity of HIV and the concurrent re-emergence of bodily manifestations of the disease. Recent data demonstrate that people living with HIV/AIDS are willing to forego up to 15 years of life expectancy to avoid HAART-related body shape changes. This Canadian study reports the consequences of an insidious process that thrives from the physical manifestations of lipodystrophy. A number of cross-sectional studies report a high prevalence rate of lipodystrophy in people living with HIV/AIDS, reaching 80% in some population. However, few studies have examined the biophysical, psychological, emotional, sexual and social burden of this metabolic complication. Qualitative studies report that lipodystrophy contains a strong social component. Morphological manifestations of this syndrome become the source of a multidimensional stigmatization process. This social dynamic suggests that lipodystropy not only transforms the body, but also the identity of people living with HIV/AIDS. The present grounded theory study aims at exploring this phenomenon in women living with HIV/AIDS. The main research goals will be to understand the experience of HIV-positive women who live with a disfigured body and to describe the identity transformation process that is indirectly induced by highly active antiretroviral therapy (HAART).

Dates: May 2007 - April 2010

Funding Program: CIHR Student Award

Source: CAHR database

Project R95:

Title: Liver transplant outcomes for HIV/HCV co-infected patients: A guideline development for Canada

Principal Investigator: Edward J Mills

Co-investigators: Prosanto K. Chaudhury, Curtis L. Cooper, and Julio S. Montaner

Abstract: Liver transplantation is a life saving procedure. Advances in new medicines and in the dosing of these medicines have improved outcomes for transplant patients. However, because of possible drug toxicity and little known efficacy, patients that have a co-infection with HIV and hepatitis C are rarely offered transplants. We aim to determine the evidence for clinical effectiveness and complications from transplants in co-infected individuals as determined by survival, HIV disease progression and developments of cancer. Our study will be a large scale data synthesis of cohort studies in order to determine rates of death, AIDS and cancers at 1, 3 and 4 years post-transplant.

Dates: March 2010 - February 2011

Funding Program: CIHR Catalyst Grant: Infection and Immunity - PHAC-CAID/CIHR Hepatitis C Research Initiative - Psychosocial/Behavioural/Epidemiology Stream

Source: CIHR database

Project R96:

Title: Longitudinal impact of adherence on HIV/AIDS disease progression: Implications for treatment interventions

Principal Investigator: Dr. Viviane Lima

Abstract: Since the introduction of highly active antiretroviral therapy (HAART) in the mid-1990s to treat HIV/AIDS infected individuals, we have seen an increased benefit associated with this therapy in improving survival and quality of life among individuals living with this disease. The success of HAART has been accompanied by difficult challenges, with the inability of HIV/AIDS patients to fully adhere to the prescribed therapy being the biggest barrier to the success of HAART. Therefore, we propose to identify and assess the merit of competing therapy-management interventions to improve patient adherence and care, and minimize the progression of HIV/AIDS to advanced disease stages or ultimately mortality. The overall goal of this study is to identify and assess the effectiveness of competing treatment-management interventions to improve adherence over a person's treatment history, in order to prevent or reduce the following disease outcomes: therapeutic failure, development of HIV drug resistance, AIDS and death. (1) We propose building a mathematical model for HIV/AIDS progression to develop future adherence recommendations that are more effective in preventing or reducing disease progression. (2) We hypothesize that each disease outcome requires a different, but sustained, high level of adherence for a person to avoid an adverse disease outcome. Given the significant impact of HIV/AIDS in the health of populations, the issues that will be dealt with in this study will be important for a better provision of patient care, in addition to directly addressing a large gap in this field of research.

Dates: June 2007 - May 2010

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R97:

Title: Measuring the actual effect of adherence on virologic and resistance outcomes in HIV-infected injection drug users (IDUs): A longitudinal study

Principal Investigator: Jesse D. Raffa

Co-investigators: Joel A. Dubin and Brian Conway

Abstract: In the past, medical studies have shown that in order for HIV-infected patients to have effective therapy, they'd be required to take 95% or more of their pills. Considering that HIV/AIDS is currently a life-long condition, this means meeting this threshold indefinitely. The previous studies were done using older drugs, which have now been shown to be much less effective than the drugs given to HIV-infected patients today. More recent studies have begun to cast some doubt on the 95% requirement, and this study will attempt to define new standards in a population of injection drug users receiving HIV therapy. Moreover, this study will examine if you were to miss a set percentage of doses, what would be the best way to miss them? For example, if we found out that the new requirement was 67%, would it be best to miss every third day, every third week, or every third month? This information would be useful in more effectively structuring programs at our own clinic, and would contribute to possible modifications to treatment for patients starting or continuing on therapy at large.

Dates: September 2006 - August 2009

Funding Program: CIHR Doctoral Research Award Area of Health Services/Pop. Health HIV/AIDS Research

Source: CIHR database

Project R98:

Title: Migratory workers and HIV/AIDS: Exploring the risks through partnership with community-based HIV/AIDS organizations

Principal Investigator: Donna E. Bulman

Co-investigators: Michelle Boutcher, Catherine A. Donovan, Margaret C. Dykeman, Diana Gustafson, and Maria Mathews

Abstract: In many areas of the world, migratory workers are at high risk for acquiring HIV/AIDS as they may engage in risky behaviours when away from home for extended periods of time. These behaviours may include having multiple sexual partners and drug use. This places migratory workers at high risk of acquiring HIV/AIDS, sexually transmitted infections, and other diseases. When workers return to their home communities, they may place local people at risk of infectious diseases such as HIV/AIDS. The risk to local people may vary depending upon how frequently workers return to their local communities. Many young people who grow up in Newfoundland are forced to leave the province in order to find employment and escape poverty. It is currently unclear if the risky behaviours associated with migratory workers in other areas of the world apply locally. By talking with migratory workers, we will gain an increased understanding of current risk factors and how these factors are managed when workers return to their home communities within Newfoundland and Labrador. This project is being developed in conjunction with people who are members of the HIV/AIDS community. This includes HIV-positive people and staff, clients, and members of community-based HIV/AIDS organizations. The information gained will be useful to people in the community-based HIV/AIDS movement as it will help them to develop innovative HIV/AIDS prevention programs that meet the needs of migratory workers and their families, partners, and associates. It is anticipated this research project will lead to the development of a larger program of research examining not only the risky behaviours of migratory workers, but also the role of employers in promoting the health of their workers and that of the larger population.

Dates: April 2008 - March 2009

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Catalyst Grant

Source: CIHR database

Project R99:

Title: Mitochondrial DNA damage in infants exposed to HIV antiretroviral drugs in utero

Principal Investigator: Hélène Côté

Co-investigators: Sean A. Bitnun, David R. Burdge, John C. Forbes, Richard P. Harrigan, Deborah M. Money, and Stanley E. Read

Abstract: HIV therapy with antiretrovirals has been very successful at reducing mother-to-child transmission of HIV. If possible, HIV-infected pregnant women start HIV therapy in their second or third trimester to avoid exposing their developing baby to the drugs during early development, to minimize toxicity. As women in Africa are about to receive large-scale HIV treatment, many will conceive babies while on therapy. We know that antiretroviral drugs can damage DNA, especially mitochondrial DNA (mtDNA which is necessary for the body's energy production. This project will study the effect of HIV drug exposure at the time of conception on the mitochondrial DNA of infants born to HIV infected mothers that were on therapy at the time they became pregnant, and compare it to that of infants exposed only later during the pregnancy, as well as unexposed HIV negative controls. We hypothesize that infants exposed early during their development will have more mtDNA damage than those exposed later. We currently do not know what the long-term effect of exposing embryos to HIV drugs is. This research will provide crucial information that may influence how HIV-infected women of child-bearing age, as well as pregnant ones, are treated worldwide, both in terms of what drugs are used, and the timing of the therapy.

Dates: April 2006 - March 2009

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R100:

Title: Mitochondrial toxicity in HIV/HCV coinfection antiviral therapy

Principal Investigators: Hélène Côté and Valentina C. Montessori

Co-investigators: Rolando Barrios, Marianne Harris, Julio S. Montaner, and David C. Walker

Abstract: This research project aims at studying drug-induced liver toxicity during antiviral therapy in HIV/HCV-coinfected individuals. This dually infected population is more difficult to treat, tolerates drugs less well and has more treatment failure than the HCV mono-infected population. We will collect liver biopsies before and after HCV therapy, as well as blood samples throughout therapy, from patients that may or may not be receiving HIV antiretroviral drugs at the same time. By using mitochondrial DNA, RNA and electronic microscopy as markers of drug toxicity, we will evaluate mitochondrial damage, in both the liver and the blood cells, using several means. We will determine whether such damage is associated with the fact that many individuals cannot tolerate this type of antiviral treatment and need to discontinue treatment early due to drug-related adverse events. We will also determine whether monitoring blood mtDNA could provide a useful tool and help predict the occurrence of adverse effects. This project should enhance both our biological and clinical understanding of drug toxicity in HCV and HIV therapy in this patient population.

Dates: March 2007 - February 2010 and April 2005 - March 2010

Funding Program: CIHR New Investigator (HIV/AIDS) - Biomedical/Clinical Stream and CIHR Operating Grant - Priority Announcement: HIV/AIDS Research Initiative - Biomedical/Clinical Stream

Source: CIHR database

Project R101:

Title: Model-based economic evaluation of hepatitis C treatment strategies in individuals co-infected with HIV in Canada

Principal Investigators: Christopher T. Bauch and Murray D. Krahn

Co-investigators: Ahmed M. Bayoumi, Marina B. Klein, Hla Hla Thein, and David P. Wilson

Abstract: In Canada, the emergence of hepatitis C virus (HCV) in individuals infected with HIV is an increasingly significant problem. However, the future health and economic burden associated with this population is unknown. Hepatitis C affects approximately one in three of people living with HIV (and approximately one in ten of those infected with hepatitis C are also infected with HIV) in Canada. Injecting drug use is the most common way that people become infected by both HIV and HCV. Other populations that are affected by co-infection with HCV and HIV in Canada include Aboriginals and prisoners. Highly active antiretroviral HIV therapy (HAART) does not appear to significantly reduce HCV-related outcomes such as advanced scarring of the liver, liver failure, liver cancer, or other liver-related death. Furthermore, hepatitis C-related advanced scarring of the liver is found to be significantly associated with higher risk of developing AIDS-defining illness (2-3-fold), AIDS-related death, or hospitalization in HIV/HCV co-infected patients than in HIV mono-infected patients. Treatment for chronic HCV infection decreases the risk of these events, in particular, through prevention of progression to advanced scarring of the liver. The advances in HCV therapy and the improved cure rates (sustained virologic response rate of one in two to four treated) and tolerability make treatment a more feasible option for many co-infected patients. Current guidelines recommend that all HIV-infected patients with chronic HCV infection be considered as treatment candidates for HCV therapy. Despite this, very few co-infected individuals receive treatment for HCV, and thus its overall effectiveness on the natural history of HCV disease in these populations has been relatively small. This project aims to use simulation models to evaluate the health impact and cost-effectiveness of hepatitis C treatment strategies on the future burden of disease related to HIV and HCV co-infection in Canada.

Dates: March 2010 - February 2012

Funding Program: CIHR Operating Grant - Priority Announcement: HIV/AIDS Research Initiative - Health Services/Population Health Stream

Source: CIHR database

Project R102:

Title: Moving Evidence to Action: Developing an Action Plan to Address HIV & Hepatitis C in Atlantic Canada

Principal Investigators: Susan A. Kirkland, and Margaret C. Dykeman, Jacqueline C. Gahagan, and Gerry J. Mugford

Co-investigators: Lois A. Jackson, Jo-Ann M. MacDonald, Kevork M. Peltekian, and Ingrid S. Sketris

Abstract: AIRN is a network of individuals and organizations working in the area of HIV/AIDS and Hepatitis C in the Atlantic Region. It includes a core group of researchers from a variety of disciplines based in four universities across Atlantic Canada (see list of Applicants),working in collaboration with other government and community-based stakeholders involved in HIV/AIDS and Hepatitis C (HCV). Funded by CIHR for four years (2005-2009), its goal is to share information and coordinate research efforts in order to shape policy and improve the quality of life of those affected by HIV and HCV. To date, AIRN has accomplished all of its key tasks. AIRN has been successful in developing a stakeholder network of over 200 individuals and organizations with an interest in HIV/AIDS and HCV, developing knowledge transfer and exchange mechanisms to share research, forming an Advisory Committee of policy makers and other stakeholders to support the movement of evidence into action, undertaking research in key areas with stakeholders, and building capacity within the region to undertake research (through the mentorship and provision of awards to students via a competitive process). AIRN proposes to bring its key stakeholders together to: - Review original vision, goals, objectives of AIRN as stated at its inception and re-affirm/re-fine for the future - Review AIRN work plan, activities and accomplishments over the past 4 years to determine status of completion - Review research undertaken by AIRN and its partners in the intervening time period - Review current policy issues and research priorities as identified by stakeholders (government, community, academic researchers, and individuals affected by HIV and HCV) in community consultations and regional workshops and by the AIRN environmental scan - Identify new activities, priorities and develop a plan of action for moving forward for the next 4-5 years.

Dates: September 2008 - August 2009

Funding Program: Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R103:

Title: Multiplex screening assays for HIV and co-infections: will they benefit patients, providers and health care systems?

Principal Investigator: Nitika Pai

Co-investigators: Mira Johri, Lawrence Joseph, Marina B. Klein, and Mark A Wainberg

Abstract: Targeted screening of at-risk individuals is a proven cost effective strategy. Vulnerable at-risk populations are difficult to follow up, so that regular screening for all co-infections and HIV is often not conducted in them. Due to the asymptomatic nature of early infections and the lack of regular testing, a vast majority of affected individuals are living with un-diagnosed infection. Early diagnosis and early treatment are proven to reduce morbidity and mortality, health care costs and transmission. Recently developed multiplex strategy makes it possible to inexpensively test individuals for several biomarkers for multiple infections with just a single drop of blood, with immediate results precluding the need for follow-up visits. MultiploTM (MedMira Inc, Halifax, Canada), is one such multiplex point-of-care device that detects four infections (i.e., HIV, HBV, HCV and Syphilis) with a small 5 micro-litre finger stick blood sample in 5 minutes. In this proposal, we will investigate whether introducing MultiploTM as a first line screening assay helps impact: a) healthcare management of patients; b) clinical decision making by providers; c) improve estimates of co-prevalence; and lastly, d) offer cost and time savings to the healthcare systems.

Dates: March 2010 - February 2011

Funding Program: HIV/AIDS Bridge Funding - Biomedical/Clinical Stream

Source: CIHR database

Project R104

Title: National Aboriginal Centre for HIV/AIDS Research

Principal Investigator: Charlotte J. Loppie Reading

Co-investigators: J. K. Barlow, Roy Cain, Brenda D. Elias, Dionne Gesink Law, Robert S. Hogg, Judith E. Mill, John D. O'Neil, Barbara L. Paterson, Raven P. Sinclair, and Patricia M. Spittal

Abstract: The purpose of the proposed National Aboriginal Centre for HIV/AIDS Research (NACHAR) is to establish and sustain a national network that integrates advanced population health and health services and policy research, capacity-building and knowledge translation. NACHAR will involve trainees, researchers, Aboriginal communities and organizations, public and voluntary agencies, policy and health services professions and other stakeholders in the area of Aboriginal HIV/AIDS. NACHAR will foster research-community partnerships and support the mobilization of research knowledge translation (KT) and the establishment of multi-disciplinary, inter-sectoral teams that address the social, cultural and environmental determinants of Aboriginal HIV/AIDS, while addressing pressing health services concerns and public policy issues relevant to Aboriginal people living with or affected by HIV/AIDS.

Dates: September 2008-December 2008

Funding Program: CIHR HIV/AIDS Population Health and Health Services

Source: CIHR

Project R105:

Title: National HIV Pregnancy Planning Guidelines Development Team Meeting

Principal Investigators: Mona Loutfy and Shari Margolese

Co-investigator: Mark L. Yudin

Abstract: Our primary objective is to link national experts in order to develop National HIV Pregnancy Planning Guidelines (NHPPG) to support HIV-positive individuals living in Canada with their fertility and pregnancy planning needs. There are four components to this project: 1) complete a review of available literature and current best worldwide practices on the topic and to share it with the stakeholders leading to knowledge exchange; 2) gather national experts in HIV and fertility along with other key stakeholders in order to develop a NHPPG Development Team that will guide the initiative; 3) organize ten teleconferences and two in-person workshops with the NHPPG Development Team members in order to develop and finalize the guidelines (4 teleconferences will be prior to the first in-person workshop and 6 will be afterwards); and 4) publish these guidelines in a peer-reviewed journal. The first in-person meeting was held to bring stakeholders together for the first time and was an official event of the Canadian Association of HIV Research (CAHR) Conference in Vancouver, April 22-23, 2009. The second in-person meeting will be held to finalize the guidelines. This proposal is specifically related to the request of funds to support the second in-person meeting of the NHPPG Development Team members to finalize the consensus on the NHPPG. The second in-person meeting will bring together, 40 Canadian experts including fertility and infectious disease experts, obstetricians, psychiatrists, policy experts and community representatives who have interest and knowledge in the fertility and pregnancy planning needs of HIV-positive Canadians. This meeting is essential to finalizing consensus on these guidelines. We are happy to be partnering with the CIHR Canadian HIV Trials Network (CTN) which has agreed to include our meeting as part of its bi-annual meeting to be held at Montréal's Queen Elizabeth Hotel from October 26-29, 2009.

Dates: September 2009 - August 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity; and OHTN Grant Workshop, Symposium and Conference Fund

Source: OHTN database

Project R106:

Title: National Housing and HIV/AIDS Research Summit IV

Principal Investigator: Sean B. Rourke

Co-investigators: Jean Bacon, Frank McGee, and Ruthann Tucker

Abstract: The North American Housing and Health Research Summit IV - Mobilizing Knowledge: Housing is Effective HIV Prevention and Care, June 3 to 5, 2009 in Washington, DC - will bring together 300 researchers, policy experts, consumers and providers of housing and related services for people living with HIV from across North America. The Summit is an interdisciplinary, interactive forum for the presentation of research findings, coupled with dialogue on public policy implications and strategies. It will be preceded by a half-day training institute for consumers of HIV/AIDS housing and services to enhance their capacity to participate in the design, guidance and interpretation of research. In addition, the Summit call for abstracts will cover a range of topics relevant to HIV/AIDS housing policy, including, for the first time at Summit IV, international research to inform the development of culturally appropriate housing resources as a key element of global HIV prevention and care strategies. The explosive growth in the literature on HIV, housing and health outcomes has created an exciting opportunity for data driven policy change. Summit IV will provide a critical opportunity to work collectively with international partners to increase understanding of the role of housing in the prevention and treatment of illness, and to tie housing to other public priorities, including: healthcare access; addressing health disparities; successful re-entry from prison and jail; and the critical need for affordable housing for disabled persons and others on fixed incomes. The OHTN is co-sponsoring and co-planning the summit with the National AIDS Housing Coalition (NAHC), the founder of the Summit Series, and the Johns Hopkins Bloomberg School of Public Health. This is the first time a Canadian research group has been asked to collaborate in this event. Summit IV will be the first regional research and policy meeting of its kind.

Dates: January 2009 - December 2009

Funding Program: Meetings, Planning and Dissemination Grant: International

Source: CIHR database

Project R107:

Title: Novel Approaches to Studying Liver Fibrosis in HIV-Hepatitis C Co-infection: A Proteomics Discovery Programme

Principal Investigator: Marina B Klein

Co-investigators: Momar Ndao and Brian J. Ward

Abstract: An increasing number of people are infected with both Hepatitis C (HCV) and HIV. HIV appears to make HCV related liver disease progress more rapidly. Liver disease is now one of the leading causes of death in HIV-HCV-infected persons. By restoring the immune system, it was expected that effective anti-HIV treatments would lead to improved liver health. However, it remains unclear why liver disease continues to be such a large problem in co-infection. Liver biopsies are currently the only way to follow liver disease progression in HCV. They are the main way of deciding who should receive HCV treatment and when. However, liver biopsies can be painful, costly and carry some risk. Non-invasive methods to measure liver health (referred to as biomarkers) could provide a safe alternative to monitor liver disease. We will use data and specimens from the patients participating in the Canadian HIV-HCV Cohort Study and compare them to individuals with HCV infection only. We will measure protein profiles from the blood to determine if that are particular patterns of proteins that are associated with various stages of liver disease and with HIV infection. Protein biomarkers identified as part of this study may be important in reducing need for liver biopsy, facilitating follow-up and timing of HCV treatment, and evaluating the impact of HIV and its treatment as well as other factors on liver disease. Finally, biomarkers may provide insights into to how best to follow patients so that in the future, HIV-HCV infected individuals may be able to derive benefits from the treatment advances being realized for HIV infection.

Dates: October 2008 - September 2011

Funding Program: Operating Grant - Priority Announcement: HIV/AIDS Research Initiative - Biomedical/Clinical Stream

Source: CIHR database

Project R108:

Title: Ontario HIV Pregnancy Planning Initiative: An Evidence-Based Province-Wide Multi-Disciplinary Program Assisting People Living with HIV with Fertility and Pregnancy Planning

Principal Investigator: Mona Loutfy

Abstract: The Ontario HIV Pregnancy Planning Initiative (OHPPI) is designed to champion a collaborative program that guides and assists all people living with HIV (PLWHIV) in Ontario with their pregnancy planning and fertility needs in a holistic, ethical, supportive and medically sound manner. This project is Phase 2 of a multi-phase program and was specifically aimed at addressing the gap between the need for HIV pregnancy planning and fertility resources and services in Ontario and the availability of such services and to build the capacity of a number of provincial community members who played the roles of co-principal investigator, co-investigators, coordinator and peer research assistants (PRAs).

OHPPI is a solid example of community-based research (CBR) in action. Through the development of our community advisory board (CAB); the establishment of a province wide multidisciplinary expert list and the implementation of focus groups we have successfully engaged relevant healthcare providers, community members, policy makers, academic researchers and PLWHIV. These activities have led to an increased understanding of the barriers faced by all parties in both the provision of and access to such services and have created a dialogue between stakeholders such as fertility and infectious diseases specialists who have previously been disconnected.

Through the development and focus group testing of a program implementation plan which includes pamphlets, workshops, a network list and clinical guidelines, we have established the most effective ways in which to conduct knowledge translation and exchange (KTE) activities amongst a variety of stakeholders. These results provide an evidence base from which to conduct subsequent phases of OHPPI including future KTE activities such as dissemination of the workshops, pamphlets, guidelines and network list and the creation of a website dedicated to HIV pregnancy planning.

We have established important relationships with the Canadian Fertility and Andrology Society, the Society of Obstetricians and Gynecologists of Canada and Assisted Human Reproduction Canada have significant implications to the development and implementation of policy surrounding access to HIV pregnancy planning and fertility services for PLWHIV in Ontario and across Canada.

Our innovative capacity-building approach to this project has resulted in a unique method of applying CBR in which we not only trained community leaders, including PLWHIV as PRAs but also as active principal and co- investigators. We have implemented the principle of the Greater Involvement of PLWHIV (GIPA) through significant involvement of PLWHIV in all phases of this project including development of the research question and study tools, implementation of the study, analysis of the results and in knowledge transfer and exchange activities. In order to build capacity of PLWHIV and community team members, teaching seminars were developed and executed regarding scientific community-based research including the definition of research, planning and execution of a project and analyzing and communicating results.

We have achieved success in conducting KTE activities in 2010 through presentations at the XVIII International AIDS Conference in Vienna and at the AIDS Committee of Toronto Research Day. Abstracts have also been accepted for presentation at the Canadian Fertility and Andrology Society annual conference which takes place in October 2010 and the Innovations in Gender, Sex and Health Research Conference scheduled for November 2010. Additionally, abstracts have been submitted to the OHTN research conference and preparation of a manuscript is underway.

Date: 2009

Funding Program: OHTN Grant CBR Capacity Building

Source: OHTN database

Project R109:

Title: Optimizing effective treatment strategies for antiretroviral therapy in vulnerable groups in Vancouver's downtown eastside: a mathematical modelling study

Principal Investigator: Kathleen N. Deering

Co-investigator: Mark W. Tyndall

Abstract: Within a cohort of female sex workers (FSWs) in Vancouver's Downtown Eastside (DTES), we aim to: 1) understand transmission dynamics of human immunodeficiency virus (HIV) through both sexual and drug injection routes; and 2) determine optimal treatment strategies for effective delivery of highly active antiretroviral treatment (HAART). We will answer the following research questions: 1) which characteristics of FSWs contribute to sustaining the HIV epidemic; and 2) what are the optimal treatment strategies for HAART on a population level in Vancouver's DTES? Results from this project will help direct scarce public health resources to have the greatest impact on reducing the severity of the HIV epidemic in the DTES, and help direct HIV/AIDS policy in Vancouver and similar areas. Methods: Transmission dynamics models, which account for infection biology, behavioural and demographic characteristics of the population and describe the spread of infection over time, will be used to compare treatment strategies for HAART under different assumptions for transmission reduction, HIV risk behaviour change and uptake and adherence to HAART. A series of ongoing cohort studies (BC Centre for Excellence in HIV/AIDS) will provide strong data to parameterize and build models. Multivariate statistical methods will be used to understand which parameters are the most important and explain heterogeneity in model results. Outcome of project: The following data will be collected from modeling simulations to evaluate treatment strategies under different treatment strategy assumptions (i.e. potential impact 5, 10, 15 years after HAART is introduced, versus no HAART): incidence of HAART-resistant HIV; numbers of new infections averted (acquired and transmitted); changes in HIV prevalence. Results from this analysis will provide valuable HIV treatment and care recommendations that will help maximize use of HAART among the most marginalized groups in the DTES and Canada.

Dates: May 2005 - April 2011

Funding Program: CIHR Doctoral Research Award Area of Health Services/Pop. Health HIV/AIDS Research

Source: CIHR database

Project R110:

Title: Parent Child Communication on Sex and HIV Amongst African-Canadians

Principal Investigator: Clemon George

Co-investigators: Jacqueline Gahagan, Carolyn Byrne, Saara Greene, Robert Weaver, Orville Browne, and Josephine Etowa

Abstract: Not available.

Dates: 2008-2009

Funding Program: Grants Awarded, Cycle 21 (2008-2009), Canadian Foundation for AIDS Research (CANFAR)

Source: CANFAR database

Project R111:

Title: Pathological and functional correlates of antiretroviral drug exposure in patients co-infected with HIV/hepatitis C

Principal Investigator: Elizabeth J. Phillips

Co-investigators: Hélène Côté, Ruth Joy, Julio S. Montaner, and Valentina C. Montessori

Abstract: HIV and hepatitis C virus (HCV) co-infection affects almost 50% of those in the drug treatment program in British Columbia. Since HIV accelerates HCV progression toward cirrhosis, antiretroviral therapy (ART) is an important component of the treatment of HCV. Despite the fact that major components of ART such as the protease inhibitors (PIs) are broken down by the liver and that HCV is a known risk factor for ART-associated hepatotoxicity, little is understood about the correlation between liver disease and the overall exposure or pharmacokinetics (PK) of these drugs. Furthermore, since there does not seem to be a correlation between the PK of these drugs and markers of liver function measured in the blood such as transaminases, other factors such as pathologic stage/grade of liver disease may prove more important in defining these associations. Definition of structural and functional pharmacologic relationships in this patient population will be extremely important in clarifying and predicting 1) The need for drug monitoring and adjustment of the dose of HIV drugs at various stages of liver disease 2) The overall risk of toxicity associated with ART in the HCV/HIV co-infected population. This work will have direct application to the clinical care for people who are living with both HIV and HCV.

Dates: April 2006 - September 2009

Funding Program: CIHR Operating Grant

Source: CIHR

Project R112:

Title: Planning and evaluation of provincial training for workers implementing "Pouvoir partager," a program for women with HIV

Principal Investigator: Caroline Racicot

Co-investigator: Joanne Otis

Abstract: On October 23-24, 2008, a provincial training session was held for women living with HIV and workers from all parts of Quebec (n=26) in order to introduce them to the "Pouvoir partager/Pouvoirs partagés" (PP/PP) intervention program and help them acquire the tools needed to implement and facilitate the program in their respective community organizations. The goal of the PP/PP program is to provide women living with HIV/AIDS with resources to deal with the issue of HIV disclosure in a constructive, proactive way (i.e. disclosing/not disclosing, based on their assessment of different situations). In order to evaluate the impact of the provincial training, which is based on the principles of empowerment and capacity-building, the participants were asked to complete a questionnaire before (pretest) and after (post-test) the training. Participants also took part in a plenary session designed to evaluate their level of satisfaction and the lessons they learned through the training.

Overall, the training seems to have improved women's understanding of the legal implications associated with the issue of HIV disclosure. However, the training does not appear to have had a significant impact on participants' attitude toward HIV and women affected by HIV, since they already had a very positive attitude and most had been in close proximity with people living with HIV for many years; moreover some of the participants were themselves living with HIV. For participants with less experience in this area, the training appears to have inspired greater empathy and admiration for women living with HIV. The training also significantly reinforced participants' belief in their personal ability to implement and facilitate the program in their respective work environments; it also increased their awareness of potential barriers to program implementation and facilitation and enhanced their ability to find appropriate solutions, both individually and collectively.

Dates: September 2008 - August 2009

Funding Program: CIHR HIV/AIDS Community Based Research Program - General - Master's Award

Source: CIHR database

Project R113:

Title: Profile and modelling of risk-taking related to HIV and STIs in young Quebeckers of Haitian origin

Principal Investigator: Marianne Beaulieu

Co-investigators: Clément Dassa and Louise Potvin

Abstract: The incidence of heterosexually-transmitted HIV infection continues to increase among Canadian women. Therefore, it is important to examine the quality of life of this growing vulnerable population. A variety of factors appear to play a role in the quality of life of women living with HIV, including coping strategies and social support. The objectives of this project are therefore to (1) quantitatively study the relationships between coping strategies, social support and the quality of life of women living with HIV; (2) qualitatively document coping strategies, social support and the quality of life of women living with HIV; and (3) disseminate and share the results with partners from community organizations. A path analysis will be conducted with a sample of women living with HIV (n=225) (Otis, Godin et al, 2004) to test the mediating effect of social support on the relationship between coping strategies and quality of life. After these relationships have been modelled, 10 women with HIV will be invited to three meetings, one every three months, for semi-structured interviews that will document the same aspects. Once the interviews have been completed, the women will be invited to discuss and review the exploratory model as part of a discussion group. Achieving the proposed objectives will increase our knowledge of the quality of life of women living with HIV and improve the services offered, which will help provide psychosocial and support services that are adapted to the needs of Quebec women living with HIV. Above all, women living with HIV will be involved in the research phases; this will promote their active participation and the dissemination of research results and will strengthen their capacities and those of community groups. Since the community groups will be actively involved in the research process, they will be able to work on improving the programs offered to enhance the quality of life of women living with HIV.

Dates: September 2008 - August 2011

Funding Program: Bourse de recherché au doctorat: VIH/sida Recherche communautaire - volet général

Project R114:

Title: Positive Spaces, Healthy Places - Phase IV: Monitoring and Evaluation to Understand the Health Effects of Housing Status in HIV/AIDS

Principal Investigators: Sean B. Rourke, Saara Greene, and Ruthann Tucker

Co-investigators: Jean Bacon, Anne Bowlby, Steve Byers, James R. Dunn, Stephen W. Hwang, Jay Koornstra, Frank McGee, Laverne E. Monette, and Michael Sobata

Abstract: The knowledge gained from recent HIV, housing and health research initiatives has the potential to change the housing landscape for people living with HIV and AIDS (and communities at risk), and improve their health and reduce the risk of HIV transmission. Positive Spaces, Healthy Places, funded by CIHR, is the first longitudinal community-based research initiative in Canada to examine housing, health and HIV. As part of our original CIHR study, we recruited and followed more than 600 people living with HIV over the course of 1 year to assess their housing status and the impact of housing instability on health and health-related quality of life. Our main findings so far demonstrate that participants face significant housing instability, considerable disadvantages in housing opportunities and support services, and substantial financial risks and discrimination that varied by geographical region. These findings also reinforce the notion that a number of preventable determinants of health are increasing the health risks of people with HIV while negatively affecting access to care. For Phase IV, we will collect ongoing quantitative data in a longitudinal, province-wide study design in which people living with HIV will be followed for up to 3 additional years. Changes in housing status will be observed, along with factors that play a role in these changes (e.g., social determinants of health, access to health services) and health outcomes and survival resulting from these changes. Our project team has already developed strategic partnerships with HIV service providers, housing providers and policy makers within and outside Ontario, and has had considerable success in KTE. With these partnerships and policy, program and community links, we are well positioned to ensure that our community-based research work can inform housing policies and programs that may lead to improved health outcomes and health-related quality of life for people living with HIV/AIDS.

Dates: January 2009 - March 2012

Funding Program: CIHR HIV/AIDS Community-Based Research Program - General - Operating Grant

Source: CIHR database

Project R115:

Title: Predictors of antiretroviral pharmacokinetics in HIV-infected women with virologic suppression on combination antiretroviral therapy

Principal Investigator: Dr. Mona R. Loutfy

Co-investigators: Dr. David Burdge, Dr. Elizabeth Phillips, Dr. Janet Raboud, Dr. Anita Rachlis, Dr. Alice Tseng, and Dr. Sharon Walmsley

Abstract: Women constitute the fastest rising population group at risk for infection with HIV and AIDS in Canada. Women now constitute approximately 20% of cases in Canada. This alarming statistic is compounded by the fact that women have been routinely underrepresented in both clinical trials assessing antiretroviral (ARV) therapy and clinical HIV studies in general. There are a few particular areas of HIV research in women which are crucial to their care and quality of life that have been under-evaluated. Two of the most important areas are: 1. How ARV therapy requirements and responses differ in women from men; and 2. ARV adverse events (AEs) and how they differ in women from men. Many small studies have suggested that HIV-infected women taking ARV treatment have more adverse events (AEs) than men. The occurrence and management of AEs is currently the most important issue in the treatment of HIV. Understanding the differences of AEs in HIV-infected women is critical and has yet to be evaluated within a large cohort. Some studies have found that ARV drug levels are higher in women and that these higher drug levels are associated with the increased toxicity. The objective of this study is to assess ARV pharmacokinetics (Cmin and Cmax) in HIV-infected women and to determine if they are higher as compared to the mean drug levels in the historical general population (which is primarily men); as well as to assess if ARV drug levels, particularly Cmin, are associated with body weight in women; and if higher ARV drug levels, particularly Cmax, are associated with higher frequency and severity of adverse events. If funded, this study will be the largest study done assessing ARV pharmacokinetics in HIV-infected women.

Dates: April 2006 - February 2013 and October 2008 - September 2009

Funding Program: CIHR Operating Grant and HIV/AIDS Bridge Funding - Biomedical/Clinical Stream

Source: CAHR database

Project R116:

Title: Preference Measures for HIV Antiretroviral Decision Making

Principal Investigator: Ahmed M. Bayoumi

Co-investigators: Tony Antoniou, Jeffrey S. Hoch, Laura Park-Wyllie, Carol J. Strike, and Nathan A. Taback

Abstract: HIV antiretroviral therapy is often associated with difficult trade-offs. While these medications can improve survival and well being, they are also associated with potentially troubling side-effects, challenges for long-term use, and considerable costs. Individual patients need to understand these competing demands to make clear decisions that are commensurate with their own values. Researchers and decision makers also need to understand these trade-offs to be able to interpret the results of clinical trials and economic analyses correctly. One method of assessing such trade-offs, based in economic theory, asks participants to consider what they might be willing to forego (such as time) or accept (such as a risk of death) in return for improved health. Such methods have become standard in health economics, but are prone to well known error and biases. An alternative method seeks to understand what is important to individuals by asking them to consider trade-offs between health states, defined by a set of attributes. Our study will compare and contrast these methods. We will use both qualitative interviews and quantitative statistical methods to analyze the results. We will assess which methods are most helpful to individuals, comparing results between methods, examine biases in each method, explore whether one set of scores can predict another, and examine how such results can be used in real-world applications such as decision aids, clinical trials, and health economics studies. Thus, our results promise to be helpful to individuals living with HIV, clinicians, and policy makers.

Dates: October 2008 - September 2010

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R117:

Title: International meeting on youth and HIV: consolidating alliances

Principal Investigators: Hélène Sylvain and José Coté

Co-investigators: Philippe E. Delmas and Eliana Galano

Abstract: Researchers from three countries (Canada, France and Brazil) are set to establish new research partnerships in the area of youth and HIV. In addition to the funding already being requested in France (ANRS) and Brazil (CCC) for a research project on the life experience and treatment compliance behaviours of youth living with HIV in Sao Paulo, Brazil, the Canadian funding application is designed to extend beyond the project itself and to help organize a meeting that will further consolidate this emerging team of researchers and collaborators. Canada's contribution will also go toward a review of recent research and an examination of the projects currently being carried out by this group of researchers. Finally, the proposed gathering will also serve to promote the implementation of an action plan to establish international research programming that will focus, among other things, on the development and evaluation of innovative interventions to help this highly vulnerable group, namely HIV-positive youth. This application for financial support for a scientific meeting exceeds the standard $10,000 normally requested since it involves the participation of foreign researchers who will be travelling from France and Brazil. Since funding applications have been submitted to the other two countries, obtaining CIHR funding would represent a significant Canadian contribution, as well as an important step toward the consolidation of international cooperation in research on youth and HIV.

Dates: January 2010 - December 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R118:

Title: Reproductive trends among HIV-positive women in British Columbia's HAART era: Examining the interplay between pregnancy antiretroviral adherence and HIV disease progression

Principal Investigator: Angela Kaida

Abstract: A growing proportion of new HIV infections, both locally and globally, are among women of childbearing age, and heterosexual contact is an increasingly important risk of HIV transmission. While it is clear that HIV-positive women continue to desire children, become pregnant, and give birth after knowing their HIV-positive status, the reproductive health concerns and rights of people living with and/or affected by HIV have received little attention. Highly active antiretroviral therapy (HAART), the standard of HIV treatment in BC, is reducing the health risks and barriers to reproduction for people living with HIV. With appropriate adherence to treatment, HAART increases life expectancy, decreases morbidity, and dramatically reduces the risks of HIV transmission from mother-to-child and to sero-discordant sexual partners. Angela Kaida's research seeks to describe the reproductive trends of HIV-positive women in BC's "HAART era" (roughly 1996 and onwards) and to investigate the complex interplay between pregnancy, antiretroviral adherence, and HIV disease progression. Owing to the structure of HIV-related services and population-level data capture methods, BC provides an entirely unique and highly valuable environment in which to investigate critical questions related to HIV, HAART, and pregnancy. Notably, no other jurisdiction in the world has published population level findings on this topic. This research will provide evidence to guide the development of effective and responsive reproductive and sexual health services and policies for HIV-positive women in BC and beyond. These services are intended to support the rights of HIV positive women to be sexually active and achieve their fertility goals, while minimizing associated risks to maternal, fetal, and partner health. The findings will contribute vital information to the development of provincial, national, and international guidelines that support reproductive decision making among HIV-affected couples and inform the use of antiretroviral therapy during pregnancy.

Date: 2009

Funding Program: 2009 Research Trainee Award, Post Doctoral Fellow

Source: Michael Smith Foundation for Health Research database

Project R119:

Title: Resilience: the effect of sexual and injecting risk behaviour on the health of Indigenous populations in Australia, Canada and New Zealand

Principal Investigators: Dr. John Kaldor and Prof. Andrew Grulich

Co-investigators: Dr. Sandra Eades, Dr. Clive Aspin, Dr. Thomas Wong, Mr. Chris Lawrence, Dr. John Daniels, Mr. Kevin Barlow, Dr. Neil Andersson, Dr. Chris Archibald, Dr. Rhys Jones, Prof. Linda Smith, and Dr. Nigel Dickson

Abstract: HIV/AIDS has become one of the most important health problems in the world today. Like several other infectious diseases, it is mainly spread by behaviours that most people consider to be part of their private lives, such as sexual intercourse and drug use. In many societies, the search for ways to prevent and treat these infections has been complicated by the fact that people find them embarrassing to discuss, or fear discrimination if they have them. While surveys of sexually transmitted infections have found high rates in some Indigenous communities in Australia, New Zealand and Canada, so far only Canada has seen increased rates of HIV/AIDS among Indigenous people. There is much we need to learn about prevention and treatment in Indigenous people. We are therefore proposing to set up collaborative studies in each of the three countries that will explore how Indigenous people are able to protect themselves against these infections. We are especially interested in finding out about their resiliency, the way in which they make use of their own and their communities' strengths to protect themselves and enhance their health and well-being. A good understanding of what resiliency is about will help us discover how Indigenous health programs can help all people in their communities to have the best chance of avoiding these infections, or getting the right kind of care, support and treatment if they do have one or more of these infections. The research will be done in full collaboration with Indigenous communities in every aspect, from planning through to regular reporting of results. The program will provide opportunities for Indigenous people in the three countries to develop and enhance research skills in this important area, and allow non-Indigenous people to share knowledge and experience with Indigenous communities.

Dates: July 2006 - May 2011

Funding Program: CIHR Operating Grant

Source: CAHR

Project R120:

Title: Risking it: examining the experiences of gay/bi/queer transmen and HIV/AIDS

Principal Investigator: Broden Giambrone

Abstract: Not available.

Date: 2009

Funding Program: Canada Graduate Scholarships Program - Masters Scholarships Program

Source: SSHRC database

Project R121:

Title: Role of Socio-Cultural Factors in Pregnancy Planning of Women Living with HIV

Principal Investigator: Dr. Trent S. Newmeyer

Co-investigators: Dr. Mona Loutfy and Dr. Saara Greene

Abstract: Not available.

Dates:

Funding Program: Grants Awarded, Cycle 21 (2008-2009), CANFAR

Source: CANFAR database

Project R122:

Title: Sexual Health Matters: Concerns of HIV+ Adolescents and Young Adults

Principal Investigator: Tamara Landry

Co-investigator: William Fisher

Abstract: HIV+ youth face vulnerabilities such as stigma, emotional or sexual disturbance, compromised immune system, 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, and c) their access to available support services. It compares HIV disclosure experiences of HIV+ youth infected at birth or infected during adolescence to identify key distinctions. The results will provide evidence for educators and HIV+ youth to support safe and successful disclosure of HIV status.

Methodology: In June 2010, a youth advisory committee identified key themes, and helped develop interview questions. Up to forty HIV+ youth from London and Toronto, Ontario, 14-29 years of age, will be participating in in-depth interviews that commenced in August 2010 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 healthcare providers, intimate friends and partners.

Date: 2010

Funding Program: OHTN Grant Studentship Award

Source: OHTN database

Project R123:

Title: Sexual violence, HIV/AIDS and Aboriginal women

Principal Investigators: Mr. J. K. Barlow and Dr. Charlotte J. Loppie

Co-investigators: Dr. Gail Valaskakis and Dr. Cornelia Wieman

Abstract: Using a combined visual/in-depth interview methodology, the Canadian Aboriginal AIDS Network will focus attention on the issue of sexual violence in the context of HIV/AIDS service provision. This exploration will ask the following research questions: (1) How do women represent and then interpret the impact of sexual violence on their lives in the context of HIV/AIDS through visual means? Visual methodology is a unique approach to research often used to explore difficult concepts that people may be unable to verbalize. (2) How does gender, culture and HIV/AIDS status manifest itself for Aboriginal women when accessing services? (3) What cultural tools or methods are being utilized by Aboriginal women living with HIV/AIDS to manage their health? (4) What policy/program implications arise when considering issues of sexual violence, gender, culture and HIV/AIDS?

Dates: April 2006 - March 2009

Funding Program: CIHR- Operating Grant

Source: CAHR database

Project R124:

Title: Social anxiety as a risk factor for HIV transmission risk behaviour among HIV-seropositive and HIV-seronegative men who have sex with men: Mechanisms of action

Principal Investigator: Dr. Trevor Adam Hart

Co-investigator: Dr. Ted Myers

Abstract: As persons with HIV and AIDS live longer and fuller lives as a result of advances in medical treatment, there is increasing need for systemic research on risk behaviours in HIV-seropositive and HIV-seronegative persons. Guided by previous research documenting associations between social anxiety and unprotected intercourse among samples of adolescent men who have sex with men (MSM) and HIV-positive adult MSM in the United States, this study examines how social anxiety may lead to risky sexual behaviour among adult HIV-positive and HIV-negative MSM in Ontario. Participants will complete brief semi-structured interviews and self-report measures assessing social anxiety, mood problems, alcohol and drug use, attitudes regarding HIV/AIDS, and sexual behaviour. This study will provide information to help healthcare providers improve health care and to prevent HIV and AIDS among men who have sex with men and other populations at higher risk for HIV and AIDS-related problems.

Dates: October 2005 - June 2011 and October 2005 - June 2009

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R125:

Title: Socio-ecological analysis of HIV/AIDS treatment-related behaviours & health outcomes in an era of HAART: Considering individuals in the context of their communities

Principal Investigator: Angela K. KAIDA

Abstract: The introduction of highly active antiretroviral therapy (HAART) for the treatment of HIV/AIDS has been accompanied by dramatic improvements in quality of life and survival among individuals infected with the disease. In Canada, despite access to free medications and a publicly funded, equal access healthcare system, these improved outcomes are not evenly distributed among HIV-infected individuals. For example, HIV+ women, injection drug users, and socio-economically disadvantaged individuals are consistently described as "vulnerable groups" who have not experienced the dramatic health improvements observed in other groups. Aspects of the treatment regimen are now being investigated as explanations for this inequity. To date, much research has focused on individual risk factors, however, there is increasing awareness that the communities in which we live also influence our health. This study seeks to understand how individual- and community-level factors (and the interaction between them) influence treatment-related behaviours and subsequent health outcomes. The findings will inform the design of interventions and policies that support equal distribution of the benefits of HAART therapy to prolong and improve the quality of life for all Canadians affected by HIV/AIDS.

Dates: January 2006 - August 2009 and September 2006 - August 2009

Funding Program: Michael Smith Foundation for Health Research Student award and CIHR - Doctoral Research Award Area of Health Services/Population Heath HIV/AIDS Research

Source: CIHR database

Project R126:

Title: Studies of host factors and HIV-1 determinants during pregnancy

Principal Investigator: Dr. Hugo Soudeyns

Co-investigators: Dr. Marc Boucher and Dr. Normand D. Lapointe

Abstract: Women living with HIV face unique challenges related to their gender. As HIV evolves into a chronic, cyclical illness, there is a need for understanding of factors which enable participation in society. This research uses qualitative methods to identify promoters and barriers to participating in Canadian society experienced by women living with HIV. Thirty women with HIV will be recruited from the community to participate in in-depth interviews. As part of the interpretation process, the results of the interviews will be discussed with 6 key informants to determine how the findings might inform future action agendas for reform. The identification of women's unique promoters and barriers to participation will assist in the development of gender specific social and health services to optimize participation.

Dates: April 2005 - March 2009

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R127:

Title: Systematic review of HIV transmission between serodiscordant couples where the HIV-positive partner has full viral suppression with antiretroviral therapy

Principal Investigators: Mona R. Loutfy, Louise Binder, Shari L. Margolese, and Frank McGee

Co-investigators: Tony Antoniou, Paula A. Rochon, and Sergio Rueda

Abstract: The impact of antiretroviral therapy (ART) on the natural history of HIV infection is indisputable, with dramatic reductions in morbidity and mortality along with decreased rates of vertical transmission (from mother to child). An issue of increasing interest is the prevention of horizontal transmission of the virus from the infected partner in a serodiscordant couple to the non-infected partner. Currently, there are opposing viewpoints on prevention strategies on horizontal transmission which require a need for clarification of the research to guide policy on this issue. The first objective of this project is to conduct a scientifically rigorous systematic review of the risk of HIV transmission in serodiscordant couples where the HIV-positive partner has full plasma viral suppression while taking ART. The second objective of this project is to create effective knowledge translation resources to assist with counselling on the risk and prevention of HIV transmission in the discordant couple setting.

Dates: January 2010 - December 2010

Funding Program: CIHR Knowledge Synthesis Grant

Source: CIHR database

Project R128:

Title: Systematic review of the effects of stigma and discrimination on health in HIV/AIDS

Principal Investigators: Dr. Sean B. Rourke, Dr. John Cairney, Dr. Randy Jackson, Dr. Rosemary Jolly, and Dr. Samuel Noh

Co-investigators: Dr. Barry D. Adam, Dr. Jean Bacon, Dr. Winston Husbands, Dr. Alan Li, Dr. Margaret Millson, Dr. Sarah Rubenstein, Dr. Sergio Rueda, Dr. Carol Strike, Dr. Wangari Tharao, Dr. Robb Travers, and Dr. Anna Van Der Meulen

Abstract: HIV/AIDS is increasingly being viewed as a chronic condition as opposed to a terminal illness. Research has shown that HIV-related stigma and discrimination are associated with poor physical and mental health. Objectives: (1) To conduct a quantitative and qualitative systematic review of the research literature on the effects of stigma and discrimination on the health and healthcare access/utilization of people living with HIV/AIDS; (2) To make the results of both reviews available to key stakeholders through a comprehensive knowledge translation strategy. Methods: A systematic search of electronic databases will be performed on journal articles published from January 1996 onward. Our search will include "grey" literature as well as contact with researchers in the field to solicit unpublished data. Two reviewers will independently perform the study selection, quality assessment, and data abstraction. We will report the study findings separately based on outcomes and will perform sensitivity analyses according to study design and quality. Knowledge Translation Plan: Our research team includes key stakeholder representatives who will be involved in all stages of the investigation which will ensure that existing knowledge regarding the effects of stigma and discrimination on health and access to care in people living with HIV/AIDS will be made available in useful forms to community-based AIDS service organizations, key policy makers, HIV physicians, and people living with HIV/AIDS.

Dates: February 2008 - January 2009

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R129:

Title: The 2008 Ontario HIV Treatment Network Research Conference

Principal Investigator: Sean B. Rourke

Abstract: The OHTN Research Conference is a unique opportunity for Canadian HIV investigators to showcase the most up-to-date and important advances in basic science, clinical, socio-behavioural, epidemiological and community-based research. In the ten years that this conference has been running, it has become a key yearly event for the HIV research field in Ontario and beyond. The conference program is designed to promote and support knowledge translation among all of our stakeholder groups, community members, researchers, policy makers and service providers - and consists of a variety of skills-building workshops, round table luncheon discussions, interactive panel presentations, video documentaries, debates, oral abstract presentations and guided poster tours. The theme of this year's conference is "A Decade of Discovery to Drive Policy and Care: Looking Back, Moving Forward." The 2008 OHTN Research Conference marks the OHTN's 10th anniversary, and we have designed a program to highlight advances in basic, clinical, socio-behavioural, epidemiology and community-based research, how these advances have led to important changes in policy and care for the Ontario community and beyond, and emerging directions in HIV research that can guide research investments over the next ten years. Attendance at our conference has increased each year; we anticipate that approximately 570 people will attend our 2008 conference from across Canada and around the world including: 200 HIV researchers, 270 community stakeholders, 60 government representatives and policy makers, 40 primary care physicians or other healthcare professionals. While the mandate of the OHTN is Ontario focused, the Conference is designed to showcase a diversity of research outcomes and partnerships, both Canadian and international. This year, we are pleased to be profiling leading Canadian researchers focused on national HIV issues.

Dates: September 2008 - August 2009 and 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 R130:

Title: The African, Caribbean and Black Canadian HIV/AIDS Research Think Tank

Principal Investigator: Wangari Tharao

Abstract: Not available.

Date: 2009

Funding Program: OHTN Grant Workshop, Symposium and Conference Fund

Source: OHTN database

Project R131:

Title: The Canadian HIV vascular study

Principal Investigator: Marek J. Smieja

Co-investigators: Kevin A. Gough, Eva Lonn, Kenneth L. Rosenthal, Fiona M. Smaill, and Lehana Thabane

Abstract: Antiretroviral treatment for the human immunodeficiency virus (HIV) has greatly prolonged life expectancy of patients with advanced HIV infection. However, HIV treatment may cause a high blood cholesterol, high glucose, and changes in fat metabolism, and there is growing concern that these will lead to an increase in cardiovascular disease in HIV-positive patients. In this study, we propose investigating the progression of blood vessel thickening, in order to examine the relative contribution of various drug regimens, the immune system, and pre-existing cardiovascular risk factors in the genesis and progression of atherosclerosis in HIV-positive subjects. We have carefully assembled a cohort of 273 HIV-positive subjects in five Canadian centres who are under going baseline and 1-year high-resolution carotid artery ultrasound. We have standardized the technique, data collection, and blood collection. In the current submission, we propose a four-year follow-up study in which these subjects will continue with yearly carotid artery ultrasound. This study will examine the role of the immune system and immune reconstititution of macrophage/monocytes versus t-lymphocytes in the progression of atherosclerosis; the role of various drugs including zidovudine, stavudine, efarirenz, and the protease inhibitors; and the role of pre-existing cardiovascular risk factors such as smoking or hypertension. Lipids will be examined both as independent risk factors, and as part of the causal pathway for drug-induced atherosclerosis. The study should yield important data on progression of cardiovascular disease among HIV-positive subjects; and examine some of the putative pathways, including lipid and immunologic pathways.

Dates: April 2005 - March 2010 and September 2006 - August 2011

Funding Program: CHIR Operating Grant and CIHR New Investigator

Source: CIHR database

Project R132:

Title: The Cedar Project: Exploring HIV and Hepatitis C Vulnerabilities among Young Aboriginal Drug Users in Three Canadian Cities

Principal Investigator: Patricia M Spittal

Co-Investigators: Martin T. Schechter, Catherine P. Baylis, Russell C. Callaghan, Wayne M. Christian, Kevin J. Craib, Patricia A. Janssen, Reinhard M. Krausz, Caroline Miller, Akm Moniruzzaman, Eugenia Oviedo-Joekes, Chris G. Richardson, Christopher H. Sherlock, and Eric M. Yoshida

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 BC'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, BC. 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: April 2009 - March 2012

Funding Program: CIHR Operating Grant

Source: BCCfE

Project R133:

Title: The epidemiology of sexually transmitted infections and blood borne pathogens in an inmate population

Principal Investigators: Dr. Carole Beaudoin and Dr. John Wylie

Co-investigators: Dr. Magdy Dawood, Dr. Trina Larsen, Dr. Marilyn Sloane, Dr. Paul Van Caeseele, and Dr. Michelyn Wood

Abstract: The aim of this study is to inform effective and innovative prevention efforts in reducing the transmission of sexually transmitted infections (STI) and blood borne pathogens (BBP) among an inmate population. The need to identify and quantify STI and BBP prevalence and related risk behaviours among individuals incarcerated in correctional facilities is necessary to inform prevention and harm reduction activities. As such, this study will engage in a collaborative research project between the University of Manitoba, the provincial health and justice ministries in Manitoba (Manitoba Health and Manitoba Justice, respectively), and the Public Health Agency of Canada to assess within an inmate population: (a) the seroprevalence of HIV, Hepatitis C, gonorrhea, chlamydia, and syphilis; (b) the behaviours engaged in by inmates which may put them at risk for transmission of an STI/BBP; (c) the knowledge (or lack thereof) of disease risk behaviours; and (d) the social and environmental barriers to disease prevention that exist within a correctional setting. To this end, seroprevalence screening for gonorrhea, chlamydia, syphilis, Hepatitis C, and HIV in addition to in-depth interviews will be conducted with 400 incarcerated study participants over a six-month period. In addition to conference presentations and peer reviewed publications, knowledge translation of the behavioural risks and the social and environmental influences on those risks will be conducted with local community organizations that support prevention, harm reduction and health services, and with both federal and provincial health and corrections departments to support the development of evidence-based policy and programs.

Dates: November 2007 - October 2009

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R134:

Title: The impact of actual or perceived HIV status on refugee determination

Principal Investigator: Kristi H. Kenyon

Abstract: Not available.

Date: 2008

Funding Program: Canada Graduate Scholarship - Doctoral Program

Source: SSHRC database

Project R135:

Title: The impact of antiretroviral care on the health and well being of persons infected with HIV/AIDS

Principal Investigator: Robert S. Hogg

Co-investigators: Thomas H. Kerr, Julio S. Montaner, and Evan Wood

Abstract: The primary objective is to establish a new population-based cohort of 500 HIV infected men and women accessing antiretroviral therapy via the BC HIV/AIDS Drug Treatment Program in order to evaluate the impact of supportive health services (like methadone treatment, MAT/DOT, physician care, pharmacy supervision, and addiction services) and ancillary services (quarterly CD4 and viral load test, and drug resistance testing as required) on adherence and response to antiretroviral therapy.

Dates: July 2006 - March 2009

Funding Program: CIHR Capacity Building through Enhanced Operating Grants in HIV/AIDS

Source: CIHR database

Project R136:

Title: The lived experiences of health and well-being among Aboriginal people living with HIV/AIDS: Beyond a deficiency model

Principal Investigator: Dr. Tracey Prentice

Abstract: In partnership with the Canadian Aboriginal AIDS Network (CAAN) and its member organizations, this community-based participatory research (CBPR) project will focus on the 'health' of Aboriginal people living with HIV/AIDS (APHAs). The study responds to published commentaries from Indigenous/Aboriginal researchers and CAAN research with Aboriginal women that highlights the need for stories and images of health and wellness among APHAs. The predominance of the 'deficit model' and the focus on pathogenesis (the origins of illness) in Aboriginal HIV/AIDS research has created an overall picture of suffering, disease, and dysfunction in Aboriginal and APHA communities that is neither a true or complete representation of the APHA experience. Such representations are misleading, disempowering, and demotivating. The proposed research seeks to counterbalance the above by exploring the lived experience of health and well-being among APHAs through community-led focus groups and participant observation at formal and informal gatherings of APHAs. The specific research questions this project will address are: (1) How do APHAs understand and experience health and wellness in the context of living with HIV/AIDS? (2) What factors contribute to health and wellness among APHAs? (3) What role, if any, does culture play in the way APHAs understand and experience health and wellness? (4) What role, if any, does sex and/or gender play in the way APHAs understand and experience health and wellness? Consistent with principles of CBPR and ownership, control, access and possession (OCAP), community-led focus groups will provide opportunities for capacity building and facilitate community ownership and leadership in this research. In addition, partnering with CAAN and its member groups at local and provincial levels will ensure that findings from this research are fully utilized and contribute to the development of more responsive and culturally appropriate supports and services.

Dates: September 2007 - August 2010

Funding Program: CIHR Student Award

Source: CAHR database

Project R137:

Title: The makings and meanings of men who have sex with men: a study in race, gender, sexuality and citizenship

Principal Investigator: Andil Gosine

Abstract: Not available.

Date: 2008

Funding Program: Standard Research Grants Program

Source: SSHRC

Project R138:

Title: The quality of life in older adults coping with HIV/AIDS in Canada

Principal Investigator: Patricia A. Khokher

Abstract: Not available.

Dates: February 2008 - February 2010

Funding Program: CHSRF/CIHR Fellowships

Source: CIHR database

Project R139:

Title: Towards Evidence-informed Support Services for PHAs: A Scoping Review of Existing Research

Principal Investigators: Winston C. Husbands, Sergio Rueda, and Michael G. Wilson

Co-investigators: Le-Ann Dolan, Angela Eady, Nicole R. Greenspan, and Rick A. Kennedy

Abstract: Since the introduction of HAART, people living with HIV/AIDS (PHAs) are now living longer. As a result, there is a growing need for support services and programs for PHAs in order to help increase their quality of life and functioning. Currently, services and programs in counselling and case management (CCM) and health promotion are offered by AIDS service organizations (ASOs) across the country, but research evidence to improve the content and quality of these services is limited. Access to current research is also a concern. This study will identify research evidence to improve support services by: 1. identifying all existing systematic reviews related to CCM and health promotion for PHAs; 2. assessing the quality and local applicability of the systematic reviews that are identified; 3. mapping the primary studies related to CCM and health promotion for PHAs; and 4. disseminating in user friendly formats the findings of our study to ASO decision-makers, researchers, and policy makers, including suggested strategies for addressing the identified knowledge gaps. In order to facilitate an evidence-informed approach for support services and programs in ASOs, we will use a comprehensive knowledge transfer strategy that consists of "push" efforts (e.g., publishing papers and fact sheets), "pull" efforts (e.g., providing a listing of identified systematic reviews on ACT's and its partners' websites with user-friendly summaries) and "exchange" efforts (e.g., hosting a series of forums held in various provinces that will include ASOs and decision-makers). PHAs are in involved in the design, implementation and dissemination of this project.

Dates: November 2008 - October 2009

Funding Program: CIHR Knowledge Synthesis Grant

Source: CIHR database

Project R140:

Title: Trans PULSE project: Exploring HIV vulnerability in Ontario's trans communities

Principal Investigators: Dr. Greta Bauer and Dr. Robb Travers

Co-investigators: Dr. Rebecca Hammond, Dr. Michelle Hancock-Boyce, Dr. Matthias Kaay, Dr. Rupert Raj, Dr. Kyle Scanlon, and Dr. Anna Travers

Abstract: HIV does not affect all groups equally. Studies from across North America strongly suggest that trans communities have higher than expected rates of HIV. This is perhaps not surprising considering evidence that many trans people experience violence and discrimination, and are having difficulty accessing the most basic of services. These include employment, health care, and housing. It is critical to consider these broader factors when trying to understand HIV in marginalized groups such as Ontario's trans communities. To address this, members of these communities - with partners from the Ontario HIV Treatment Network, Sherbourne Health Centre, The 519 Community Centre, The University of Western Ontario, and TGStation.com - have formed a community-based research project - The Trans PULSE Project. Trans PULSE will use a mix of qualitative and quantitative methods to provide the richest possible understanding of the ways that social marginalization may produce HIV vulnerability within trans communities and how social factors, such as healthcare access as well as the source and stability of one's income, can affect quality of life for those trans people who live with HIV. This project addresses a significant lack of relevant information, and reflects a desire by community members to see HIV within a broader context of trans lives and experiences. The project is made up of an 8 person Investigators Committee, 5 of whom are trans, who have worked together in identifying research goals, designing the study, and increasing community involvement to ensure that this research is relevant to the needs of trans communities. Community soundings, wherein trans community members in three different Ontario communities discussed their experiences around health, health care, and HIV risk, have been important in shaping the research.

Dates: April 2007 - March 2010

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R141:

Title: Trans PULSE Symposium: Building Our Communities

Principal Investigators: Robb Travers and Greta R. Bauer

Co-investigators: Michelle J. Hancock-Boyce and Kyle A. Scanlon

Abstract: This request (please also consider for the CIHR HIV/AIDS Research Initiative Funding) is for the Trans PULSE Symposium, that brings together diverse decision makers including, transgender people, researchers, service providers and policy makers to discuss the quantitative data from the Trans PULSE survey, and to plan 'research to action' strategies. Trans PULSE is a CIHR-funded, community-based research project that responds to problems identified within transgender communities in Ontario regarding access to health and social services and the broader social determinants of health. It aims to understand the multifaceted ways in which social exclusion shape the provision of services for trans people, and adversely impact their health outcomes. The largest study of its kind in Canada to date, it fills a significant gap in knowledge. A major focus is better understanding HIV/AIDS risk factors as well as broader prevention, care and support issues. Trans PULSE data will contribute significantly to the prevention of acquisition and transmission of new infections by providing frameworks by which to better understand HIV vulnerability in these highly marginalized communities. It will inform interventions and standards of care for trans people affected by HIV, and will illuminate access barriers to health care and provide action strategies for overcoming them. This will ultimately improve quality of life and slow disease progression for trans people living with HIV. The Trans PULSE Symposium will provide a unique opportunity for stakeholders to share and understand Trans PULSE data, and to begin to apply knowledge associated with the various social determinants of health in building a sound theory of community-level HIV (and other health-related) vulnerability. Through their participation, this group of stakeholders will constitute the beginnings of a 'knowledge network' who work to create longer term changes in support of enhancing transgender health outcomes.

Dates: January 2010 - December 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

Project R142:

Title: Two-Spirit Women's experience of homophobia in the context of HIV/AIDS service provision

Principal Investigators: Mr. Randy Jackson and Dr. Janice Ristock

Co-investigators: Dr. Shari Brotman, Dr. Laverne Monette, and Joyce Seto

Abstract: Adopting a community-based research design, the Canadian Aboriginal AIDS Network (CAAN) is pursuing a qualitative study of two-spirit women's experience of homophobia in the context of HIV/AIDS service provision. This study builds on a recent CAAN survey where trends are highlighted to asking more in-depth research questions: (1) When two-spirit women access care and homophobic discrimination is encountered, how do two-spirit women subjectively experience such situations? How do they understand the intersection between their identities as two-spirit, HIV/AIDS and as women? (2) What is the impact of homophobia and heterosexism in terms of access to HIV/AIDS services? In other words, how do two-spirit women respond and what are the reasons they provide that guide their decision-making process? (3) What are the best practice and policy features necessary to mitigate homophobia in service provision from this population's perspective? Underpinning the study, respecting principles of OCAP is essential to maximizing any potential benefit.

Dates: April 2006 - March 2009

Funding Program: CIHR Operating Grant

Source: CAHR database

Project R143:

Title: Understanding the HIV-Related Transitions of Families Living with HIV

Principal Investigator: Orville Browne

Abstract: Not available.

Date: 2009

Funding Program: OHTN Research Operating Grant

Source: OHTN database

Project R144:

Title: Understanding virological and host determinants of HIV disease progression in a cohort of slow progressors

Principal Investigators: Cécile L. Tremblay and Nicole F. Bernard

Co-investigators: Jonathan B. Angel, Jean-Guy Baril, Pierre Côté, Alexandra De Pokomandy, Michael J. Gill, Marianne Harris, Colin Kovacs, Mona R. Loutfy, Julio S.Montaner, ;Anita R. Rachlis, Jean-Pierre Routy, Benoit Trottier, and Christos M. Tsoukas

Abstract: A certain number of patients, very few, infected with HIV are able to control the virus with no anti-HIV medication. This group of rare patients has been identified as "long term non-progressors" and may have special mechanisms that enables them to control the virus on their own. Learning more about such mechanisms may be very important to help designing vaccines and/or new therapies or prevention strategies for HIV. We will be recruiting HIV-1 infected subjects who are long term non-progressors and patients who have a normal disease progression, to study how various factors such as the type of virus they are infected with, their immune system, or their cells, help them to control the infection. In addition, we want to determine the long-term clinical and psychological natural history of the infection for such patients and evaluate whether superinfection may alter their disease progression.

Dates: April 2009 - March 2014

Funding Program: CIHR Operating Grant

Source: CIHR database

Project R145:

Title: Understanding vulnerability: a cultural analysis of HIV/AIDS

Principal Investigator: Sarah Sanford

Abstract: Not available.

Date: 2008

Funding Program: Canada Graduate Scholarship - Doctoral Program

Source: SSHRC

Project R146:

Title: Women and HIV in Canada

Principal Investigator: Janelle D. Hippe

Abstract: Not available.

Dates: 2008 and 2009

Funding Program: Canada Graduate Scholarship - Doctoral

Source: SSHRC database

Project R147:

Title: Workshop and Guidelines on Cardiovascular Risk in HIV Patients

Principal Investigators: Astha Ramaiya and Marek J. Smieja

Abstract: Antiretroviral treatment greatly prolongs the life expectancy of human immunodeficiency virus (HIV)-infected people, but drug-induced hyperlipidemia and other metabolic abnormalities may predispose them to cardiovascular (CV) disease. Protease inhibitors, in particular, have been associated with high total and LDL-cholesterol, high triglycerides, insulin resistance, and diabetes mellitus. Additionally, HIV-infected people have a higher prevalence of standard CV risk factors such as smoking, compared with the general population. There is an urgent need to place the current evidence in the appropriate context of overwhelming clinical benefit of antiretroviral treatment, while clearly guiding clinicians in strategies to mitigate CV risk. We propose developing evidence-based guidelines for CV risk assessment and disease prevention in HIV-infected patients. Specifically, we propose: 1. To identify, review, summarize and grade the relevant published/presented literature on HIV or antiretroviral therapy (ARV) and cardiovascular risk. 2. To organize an expert workshop in order to develop Canadian guidelines, aimed primarily at HIV physicians and cardiologists. 3. To publish these guidelines in a peer-reviewed journal.

Dates: May 2008 - April 2009

Funding Program: CIHR Meetings, Planning and Dissemination Grant: Knowledge Translation

Source: CIHR database

Project R148:

Title: Workshop: What can we learn from HIV-1 infected subjects with slow disease progression?

Principal Investigators: Cécile L. Tremblay and Nicole F. Bernard

Abstract: HIV-1 infected individuals with slow disease progression are rare and constitute an important population in which to study virus/host interactions contributing to the control of HIV-1 infection. These studies will likely provide information on rational vaccine design as well as potential new therapeutic targets. We have set up a cohort of HIV-1 infected individuals with slow disease progression (Slow Progressors) in Quebec, and are now expanding it to the rest of Canada. We have secured the collaboration of most of Canada's clinician scientists working in the HIV field. In order to make the best scientific use of the data that will be collected throughout this 5-year cohort study, we wish to organize a one-day workshop to exchange with all these collaborators on ideas and progress that has been made to date on HIV-1 pathogenesis relating to disease progression. The workshop will comprise scientific presentations from international experts in the field. The second part of the workshop will be used for scientific discussions on the various projects supported by the cohort. Finally, the third part will be used for the organization and coordination of the cohort's activities for the next year. This workshop will enrich our project and enhance the collaboration among this group of researcher.

Dates: May 2009 - April 2010

Funding Program: CIHR Meetings, Planning and Dissemination Grant - Planning Grant - Priority Announcement: Institute of Infection and Immunity

Source: CIHR database

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