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Are you involved in the response to HIV and hepatitis C?

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Transforming our practice: New knowledge, new strategies
Thursday, November 23 to Friday, November 24, 2017
Toronto, ON

 

Program

Please note: The Forum program is subject to change.

Day One: Thursday, November 23

7:30

Registration and distribution of interpretation headsets

Continental breakfast

8:30

Forum opening and welcome

Speakers:

  • Trevor Stratton, Citizen of the Mississaugas of the New Credit First Nation, ON
  • Laurie Edmiston, CATIE, Toronto, ON
  • Lindsay Kretschmer, Ontario Aboriginal HIV/AIDS Strategy, Toronto, ON

9:15

Concrete actions to address HIV, HCV and other STBBIs in Canada

There is now a strong global consensus that the knowledge and tools exist to end the AIDS and hepatitis C epidemics. In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) released ambitious global targets to end the AIDS epidemic by 2030, known as 90-90-90.

In 2016, the World Health Organization (WHO) released a global strategy and targets to end viral hepatitis by 2030, known as the Global Health Sector Strategy on Viral Hepatitis, 2016-2021. Canada has committed to achieving these targets domestically and to supporting the global effort.

This session will provide an overview of these targets and the Public Health Agency of Canada’s (PHAC) strategies and priorities to reach them. The Canadian Positive People Network (CPPN) and Action Hepatitis Canada (AHC) will provide commentary on Canada’s commitments and strategies to meeting the targets outlined in the UNAIDS 90-90-90 Strategy and the WHO Global Hepatitis Strategy.

Moderator: Laurie Edmiston, CATIE

Speakers:

  • Theresa Tam, Public Health Agency of Canada, Ottawa, ON
  • Patricia Bacon, Action Hepatitis Canada, Whitehorse, YT
  • Jeff Potts, Canadian Positive People Network, Ottawa, ON

9:45

New HIV treatment and prevention science and real-world practice: Reaching our 90-90-90 targets

To fully realize the benefits of new HIV treatment and prevention science, people living with HIV must know their status, be linked to culturally safe care, and engage in treatment over the long term. Other community-based and clinical services are also needed to ensure success, such as harm reduction and mental health services, among others. Likewise, people who are HIV-negative but at ongoing risk need access to prevention services, STBBI testing, and other key programs and initiatives to support their health and wellness.

This session will provide an overview of where Canada is situated in relation to the UNAIDS 90-90-90 targets and where our gaps are. It will then focus on how new HIV treatment and prevention knowledge has changed or could change practice in prevention, testing, treatment and linkages across services.

Moderator: Laurie Edmiston, CATIE

Speakers:

  • James Wilton, Ontario HIV Treatment Network, Toronto, ON
  • Isaac Bogoch, Toronto Western Hospital, Toronto, ON
  • Afshan Nathoo, Vancouver Coastal Health, Vancouver, BC
  • Marvelous Muchenje, Women’s Health in Women’s Hands, Toronto, ON

11:10

Break

11:30

What it will take: Eliminating HCV by 2030

Hepatitis C cure (made possible through new HCV treatments that are shorter, more tolerable and much more effective, with cure rates over 95%) has the potential to revolutionize the HCV landscape. This knowledge has stimulated people affected by hepatitis C, service providers, and policy planners, to envision hepatitis C elimination.

To get there, people affected by hepatitis C need more than treatment; they need accessible and culturally safe testing, treatment, and support services, as well as harm reduction, mental health, and other initiatives that address the social determinants of health and support broader health and wellness.

This session will provide an overview of the HCV cascade of care based on three provinces and a snapshot of where Canada is situated in relation to the WHO viral hepatitis targets, including where our gaps are. It will then focus on how new HCV treatments and other HCV knowledge have changed or could change practice in prevention, testing, treatment, and linkages across services.

Moderator: Melisa Dickie, CATIE

Speakers:

  • Naveed Janjua, British Columbia Centre for Disease Control, Vancouver, BC
  • Lisa Barrett, Dalhousie University, Halifax, NS

12:30

Lunch

1:30

Harnessing new testing technologies and approaches to reach the HIV and HCV undiagnosed

HCV and HIV testing and diagnosis is the gateway to care, support, treatment and prevention. However, we know that some people who are living with HIV or hepatitis C are undiagnosed and not being reached by our current testing efforts in Canada. This session will explore newer testing technologies and approaches that we may want to consider adding to our existing testing framework to better reach those not reached effectively with our current approaches.

Moderator: Michael Bailey, CATIE

Speaker: Mark Gilbert, British Columbia Centre for Disease Control, Vancouver, BC

2:20

The shifting landscape of hepatitis C: Responding to the shifting realities and needs of people affected

New HCV treatments mean that a person can be cured of hepatitis C.

This groundbreaking change has fundamental implications for people living with HCV and for service provision, not to mention the new potential to eliminate hepatitis C altogether. In this session, these implications will be explored and key community leaders will be invited to share knowledge about engaging people in HCV treatment, supporting people while on treatment, and what is needed post-cure. It will also shed light on barriers and facilitators to the patient journey.

Moderator: Michael Bailey, CATIE

Speakers:

  • Christian Hui, Toronto, ON
  • Anna-Aude Caouette, Montreal, QC
  • Shujaat Hossain, Toronto, ON
  • Kerrigan Beaver-Johnson, Toronto, ON

3:15

Break

3:35

Concurrent Sessions: Focus on programming

This series of break-out sessions will focus on program planning and delivery related to PrEP as a part of combination prevention, the role of harm reduction in our efforts to address HIV and hepatitis C, HIV and HCV testing strategies, peer health navigation, and integrated models of care.

Increasing access to PrEP – gay, bi and other men who have sex with men, and beyond

As awareness about pre-exposure prophylaxis (PrEP) as a highly effective HIV prevention strategy increases, the greatest obstacle to realizing PrEP’s potential is access. Widespread access for those who could benefit from PrEP requires greater awareness and comfort among prescribers, diverse venues for access, population-specific programming and greater affordability. This session will highlight initiatives and programs that can increase access to PrEP, and will encourage discussion on how to build upon existing work to further increase access to PrEP for diverse populations at high risk of HIV infection.

Moderator: Camille Arkell, CATIE

Speakers:

  • Darrell Tan, St. Michael’s Hospital, Toronto, ON
  • Dane Griffiths, Gay Men’s Sexual Health Alliance, Toronto, ON
  • Mark Hull, St. Paul’s Hospital, Vancouver, BC
  • Jonathan Bacon, RÉZO, Montreal, QC
  • San Patten, San Patten and Associates, Halifax, NS

Addressing drivers and barriers: The role of harm reduction in addressing hepatitis C and HIV among people who use drugs

This session will focus on how harm reduction programs intersect with hepatitis C and HIV work, and how these programs further hepatitis C and HIV-related objectives across the continuum of care, including prevention, testing, and treatment. The session will focus on specific harm reduction initiatives and programs that address the broader social and structural drivers to hepatitis C and HIV and barriers to care. These initiatives will elaborate on how integrated hepatitis C, HIV and harm reduction model can address HCV and HIV drivers and barriers on individual, provider and systems levels.

Moderator: Liam Michaud, CATIE

Speakers:

  • Gillian Kolla, South Riverdale Community Health Centre, Toronto, ON
  • Elyse Magee, St. Paul’s Hospital, Vancouver, BC
  • Nelson Arruda, Université de Sherbrooke, Montreal, QC

Dried blood spot testing: A new community-based approach to hepatitis C and HIV testing and linkage

Hepatitis C and HIV testing are the entry point to care, treatment and other services for those living with HCV or HIV, and to prevention services (e.g. harm reduction and PrEP) for those who are negative but at ongoing risk. While successes exist, there are various challenges in implementing testing in remote and rural communities. In some regions, new approaches are required. This session will explore efforts to bring HCV and HIV testing to rural communities through a testing technology called dried blood spot.

Moderator: John Kim, Public Health Agency of Canada

Speakers:

  • John Kim, Public Health Agency of Canada, Winnipeg, MB
  • Leroy Quoquat, Lac Seul First Nation Community Health Centre, Lac Seul, ON
  • Jordan Feld, University Health Network, Toronto, ON
  • Geri Bailey, Saskatoon Tribal Council, Saskatoon, SK

Peer navigation in HIV

Health navigation programs for people living with HIV improve health and wellness outcomes and a number of Canadian peer health navigation programs have been established to do just that. Peer health navigation is a person-centred approach to guide, connect, refer, educate and accompany people living with HIV through systems of care. The goals of health navigation are to support people living with HIV in their self-determined goals, to build the capacity of clients to self-manage their HIV care, to navigate systems themselves and, ultimately, improve their health and overall wellness. This session will unpack diverse peer health navigation models and introduce participants to newly available Peer Health Navigation Best Practice Guidelines.

Moderator: Murray Jose-Boerbridge, Toronto People with AIDS Foundation

Speakers:

  • Glen Bradford, Positive Living BC, Vancouver, BC
  • Jamie Crossman, Regina Qu’Appelle Health Region, Regina, SK
  • Susanne Nicolay, Wellness Wheel, Regina, SK
  • Wendy Stevens, Positive Living BC, Vancouver, BC
  • Danita Wahpoosewyan, Regina Qu’Appelle Health Region, Regina, SK

HIV Stigma Index: Influencing programs and practice

The People Living with HIV Stigma Index is a community-led, multi-site project that investigates and unpacks HIV stigma experienced by people living with HIV across the lifespan, in different contexts and through different systems (e.g. the legal system, schools and the healthcare system). This session will reveal how the Canadian component of the HIV Stigma Index works, what it is telling us, and how it can and should influence frontline practice and programs in prevention, testing, treatment and care for people living with and affected by HIV.

Moderator: Thomas Egdorf, CATIE

Speakers:

  • Francisco Ibañez-Carrasco, St. Michael’s Hospital, Toronto, ON
  • Colt Burrows, Ontario HIV Treatment Network, Toronto, ON
  • Mike Payne, Nine Circles Community Health Centre, Winnipeg, MB

5:00 – 7:00

Networking reception

Day Two: Friday, November 24

7:30
 

CATIE Annual Meeting registration and distribution of interpretation headsets

Continental breakfast

8:00
 

CATIE Annual Meeting

CATIE Forum registration and distribution of interpretation headsets

Continental breakfast

9:15

CATIE Forum welcome

9:30

HIV stigma through the lens of ‘Undetectable = Untransmittable’

While the scientific realities of living with HIV have fundamentally changed – given our new knowledge in HIV treatment and prevention – HIV stigma remains, and is an important community and public health issue that needs to be addressed. This session will focus on the role of new HIV prevention science in addressing and perpetuating HIV stigma and will initiate a conversation about the implications for frontline messaging that will continue in a break-out session.

Moderator: Darien Taylor

Speakers:

  • Bruce Richman, Prevention Access Campaign, New York, NY
  • Francisco Ibañez-Carrasco, St. Michael’s Hospital, Toronto, ON
  • Precious Maseko, African and Caribbean Council on HIV/AIDS in Ontario and Ontario AIDS Network, Toronto, ON

10:30

Break

10:50

Concurrent Sessions: Focus on programming

This series of break-out sessions will focus on program planning and delivery related to HIV communications in the era of U=U, supervised injection services, programming in the era of new HCV treatments, and linkage to care programming.

Approaches to changing the narrative of HIV communications in an era of new HIV prevention and treatment science

HIV treatment and prevention science has changed rapidly over the past few years. We now know that people who take antiretroviral therapy daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of transmitting the virus to an HIV-negative sexual partner. But for those involved in HIV prevention and support, taking up this knowledge is not necessarily simple. This session will explore how some HIV organizations and providers in Canada have changed the nature of their HIV risk messaging based on HIV treatment and prevention science, and the U=U campaign.

Moderator: Jeff Potts, Canadian Positive People Network

Speakers:

  • Andrea Carter, HIV Community Link, Calgary, AB
  • Sarah Chown, YouthCO, Vancouver, BC
  • Ryan Tran, Asian Community AIDS Services, Toronto, ON
  • Matthew Smith, AIDS New Brunswick, Fredericton, NB
  • Aaron Bowerman, Ontario Aboriginal HIV/AIDS Strategy, Toronto, ON

Counselling clients on perinatal HIV transmission risk in the context of U=U

This session will explore the risks of perinatal/postnatal HIV transmission in the context of U=U (for the sexual transmission of HIV). The audience will learn about how perinatal/postnatal transmission occurs, how doctors should advise and counsel HIV-positive clients that want to get pregnant or who are pregnant, and hear about some of the social, cultural and emotional issues HIV-positive women face in regards to pregnancy and infant feeding. This knowledge will help to inform conversations with clients about HIV transmission risk and infant feeding, with the goal of supporting client decision-making.

Moderator: Camille Arkell, CATIE

Speakers:

  • Mona Loutfy, Maple Leaf Medical Clinic, Toronto, ON
  • Lena Serghides, Toronto General Hospital Research Institute, University Health Network, Department of Immunology at the University of Toronto, Toronto, ON
  • Saara Greene, McMaster University School of Social Work, Hamilton, ON

Supervised consumption services

Supervised injection services (SIS) have long been proven to prevent overdose, reduce the transmission of HIV and hepatitis C, and provide a critical opportunity for linkage to a range of services and care for people who use drugs. This session will focus on the factors that facilitate – or present barriers to – the implementation and operation of supervised consumption sites. It will provide a platform to discuss opportunities to integrate SIS models into HIV and hepatitis C care settings (housing, hospital-based, community-based, etc.), as well as explore emerging areas in supervised consumption (supervised inhalation, unofficial/unsanctioned practices at overdose prevention sites, peer-led models, etc.). Finally, this session will explore how people who use drugs and service users are engaged in the implementation, delivery and ongoing evaluation of SIS services as key stakeholders.

Moderator: Patrick McDougall, Dr. Peter Centre

Speakers:

  • Sandhia Valdamudy, CACTUS, Montreal, QC
  • Chris Buchner, Fraser Health Authority, Surrey, BC
  • Heather Hobbs, AIDS Vancouver Island, Victoria, BC
  • Cindy MacIsaac, Direction 180, Halifax, NS

HIV self-testing in Canada?

An HIV self-test is under regulatory approval with Health Canada. Self-testing has the potential to significantly increase HIV testing uptake among at-risk populations, particularly those who face provider-level and system-level barriers to conventional HIV testing services. However, there are many issues to work out before they arrive on the scene. How will they be accessed? How will we ensure linkage to care and prevention services? For which communities are these going to be most appropriate? This session will include an overview of the self-testing technology/process, how self-testing has been used in Canada, and the potential for this technology here.

Moderator: John Kim, Public Health Agency of Canada

Speakers:

  • John Kim, Public Health Agency of Canada, Winnipeg, MB
  • Nitika Pant Pai, McGill University, Montreal, QC
  • Jane Greer, Hassle Free Clinic, Toronto, ON

Hepatitis C treatment access: Expanding and diversifying HCV treatment models

2017 has been a game changing year in hepatitis C. New treatments were approved that can cure over 95 per cent of people who take them for eight to 12 weeks, with few side effects. A new deal has improved access to many of these new medications in some parts of Canada. We expect treatment access to continue opening up across the country over the coming months and years.

What does this mean for frontline programs offering hepatitis C treatment? With more people eligible for HCV treatment than ever before, what needs to be done in order to expand and diversify hepatitis C treatment models? This session will examine how existing treatment programs are adjusting their practice to maximize treatment uptake and cure, and assess how hepatitis C treatment programming might be expanded broadly.

Moderator: Suzanne Fish, CATIE

Speakers:

  • Lesley Gallagher, Vancouver Coastal Health, Vancouver, BC
  • Mandeep Grewal, Punjabi Community Health Services, Toronto, ON
  • Élaine Polflit, Centre de recherche et d’aide pour les narcomanes (CRAN), Montreal, QC
  • Natasha Tutt, Bloom Clinic, Brampton, ON

12:05

Lunch

1:05

Structural stigma and reaching our HIV and hepatitis C goals

Structural stigma refers to the societal-level conditions, cultural norms and institutional practices that constrain different opportunities, resources and well-being for different communities and individuals across their life course in different ways. Structural stigma, recognized through these inequities and injustices, is one of the most significant barriers we face to achieving our HIV and hepatitis C goals – and our commitment to achieving the UNAIDS 90-90-90 and the WHO viral hepatitis targets.

This session will unpack how structural stigma impacts different communities and individuals and constrains our response to HIV and HCV. It will also offer insight into how structural stigma affects diverse communities differently and where its impact aligns across communities. We will hear more about strategies to address structural stigma in the HIV and HCV response.

Moderator: Laurie Edmiston, CATIE

Speakers:

  • Jody Jollimore, Community-Based Research Centre for Gay Men’s Health, Vancouver BC
  • Alexandra King, University of Saskatchewan, Saskatoon, SK
  • LaRon Nelson, St. Michael’s Hospital, Toronto, ON

2:00

Break

2:15

Concurrent sessions

This series of break-out sessions will narrow in on some specific priorities and program models that relate to African, Caribbean and Black communities; gay, bisexual, two spirit and other men who have sex with men; Indigenous communities; people who use drugs; and newcomer communitiesand people living with HIV. While specific populations form the basis of these sessions, intersectionality will be an important focus.

“Your Blues Ain’t Like Mine”: Multi-level approaches to improving mental health outcomes in African, Caribbean and Black Canadian communities

This dynamic session provides attendees with a range (structural, programmatic and clinical) of evidence-based approaches to reducing the negative impacts of mental health co-morbidities on the lives of African, Caribbean and Black (ACB) people, including ACB people living with HIV.

You will learn about:

  • A structural framework for organizing clinical services that facilitate barrier-free access to treatment and support for people living with addictions
  • A trauma-informed program model that addresses the triggers and challenges of maintaining mental wellness while negotiating substance use and addictions
  • An effective, non-invasive, non-pharmacological treatment that promotes rapid recovery from symptoms of post-traumatic stress disorder
  • The implications of these evidence-based approaches to improving HIV treatment, care and support practice for ACB people and communities

Moderators: LaRon Nelson and LLana James, St. Michael’s Hospital

Speakers:

  • LaRon Nelson, St. Michael’s Hospital, Toronto, ON
  • LLana James, St. Michael’s Hospital, Toronto, ON
  • Irene Njoroge, Women’s College Hospital, Toronto, ON
  • Maureen Owino, Committee for Accessible AIDS Treatment, Toronto, ON
  • Alessandro Bisignano, Committee for Accessible AIDS Treatment, Toronto, ON

Hepatitis C testing and linkage to care among Canadian immigrants and newcomers

Recent data show that just over one in three people who are antibody-positive for hepatitis C in Canada are foreign-born. New developments in hepatitis C testing and treatment have the potential to increase immigrants’ and newcomers’ access to care; however, the challenge is to create programs and services that actually reach this population. With these questions in mind, the session will engage public health professionals, clinicians and researchers to present key research and provide a forum to discuss specific challenges in comprehensively addressing the lack of testing and linkage to care among Canadian immigrants and newcomers.

Moderator: Melisa Dickie, CATIE

Speakers:

  • Naveed Janjua, British Columbia Centre for Disease Control, Vancouver, BC
  • Christina Greenaway, McGill University and Jewish General Hospital, Montreal, QC
  • Fozia Tanveer, CATIE, Toronto, ON
  • Brian Chen, Toronto Public Health, Toronto, ON
  • Sheryl Wolfstadt, Brampton Civic Hospital, Brampton, ON

The Mental Health Challenge: Developing GBMSM mental health services as part of an effective combination HIV prevention response

Our evolving understanding of the role and impact of syndemics on the HIV epidemic among gay, bisexual and other men who have sex with men (GBMSM) has drawn attention to the scarcity of mental health programs and services for this population. Given the HIV sector’s overextended resources and limited capacity to implement mental health services, and the mental health sector’s lack of cultural competence in addressing the mental health of GBMSM, how do we address this mental health challenge? Who should the HIV sector be looking to for new partnerships or to strengthen existing ones? What should we be asking from the mental health sector? And what role can the HIV sector play in developing structural and individual-level interventions that address mental health among GBMSM to support HIV prevention and care goals? This session will explore these issues, showcase programs that address mental health, and facilitate discussion about what the HIV sector can do to address the mental health challenge among GBMSM.

Moderator: Phillip Banks, Peel HIV/AIDS Network

Speakers:

  • Lance McCready, University of Toronto, Toronto, ON
  • Alexandre Dumont Blais, RÉZO, Montreal, QC
  • Matt Harding, MAX, Ottawa, ON

Indigenizing harm reduction

While harm reduction services continue to make efforts toward greater cultural sensitivity, practice, programming and research in this field remains grounded primarily in Western Eurosettler principles that have been applied in colonization. How can harm reduction services be shaped so as to better serve Indigenous people who use drugs and are impacted by HIV and HCV?

Moderator: Alexandra King, University of Saskatchewan

Speakers:

  • Trevor Stratton, Canadian Aboriginal AIDS Network, Mississaugas of the New Credit First Nation, ON
  • Shelda Kastor, Western Aboriginal Harm Reduction Society, Vancouver, BC
  • Delilah Gregg, Western Aboriginal Harm Reduction Society, Vancouver, BC
  • Shohan Illsley, Manitoba Harm Reduction Network, Winnipeg, MB
  • Wanda Whitebird, Ontario Aboriginal HIV/AIDS Strategy, Toronto, ON

 

3:30

Break

3:45

The role of the HIV and hepatitis C response in the overdose crisis

This session will increase understanding of the opioid overdose crisis in Canada, its roots and its impact on people living with HIV and affected by hepatitis C. It will challenge participants to consider their role, as HIV and HCV service providers, in addressing this crisis.

Moderator: Liam Michaud, CATIE

Speakers:

  • Shelda Kastor, Western Aboriginal Harm Reduction Society, Vancouver, BC
  • Delilah Gregg, Western Aboriginal Harm Reduction Society, Vancouver, BC
  • Jordan Westfall, Canadian Association of People Who Use Drugs, Vancouver, BC
  • Mark Tyndall, British Columbia Centre for Disease Control, Vancouver, BC
  • Yvette Perreault, AIDS Bereavement and Resiliency Project of Ontario, Toronto, ON

4:45–5:00

Thank You and closing