Prevention in Focus

Fall 2018 

In case you missed it…

CATIE resources

Practice Guidelines in Peer Health Navigation for People Living with HIV

CATIE and a national working group have developed national evidence-based guidelines on peer health navigation in HIV. The guidelines provide agencies with research- and practice-based information and recommendations to develop, implement and strengthen peer health navigation programs.

Individual chapters can be accessed through a web portal that includes additional resources and tools to support the implementation of recommendations for each chapter. Created by Canadian and international organizations, the resources range from guides and manuals you can consult during program planning and delivery, to forms and templates you can use as models for your program.

Peer Health Navigation in HIV Services

This webinar reviews diverse peer health navigation models and introduces participants to the new Practice Guidelines in Peer Health Navigation for People Living with HIV

Peer Health Navigation: GIPA, MEPA and Your Organization

This webinar, presented by CATIE in partnership with Positive Living B.C., focuses on assessing the capacity of a host agency to work within a GIPA/MEPA (greater involvement and meaningful engagement of people living with HIV) framework prior to the development of a peer health navigation program. It also discusses the importance of using a GIPA/MEPA framework and challenges agencies to improve their practice at all stages of the program development process.

New Canadian HIV PrEP/nPEP guidelines: public health and community perspectives

This webinar reviews key messages from the PrEP and nPEP guideline; discusses how community-based service providers can understand PrEP/nPEP eligibility in order to support PrEP and nPEP access for clients at high risk of acquiring HIV; and presents service provider and public health perspectives and experiences on using the guideline to help clients access PrEP and/or nPEP.

U=U Community Perspectives

Evidence shows that people living with HIV who are on treatment and maintain an undetectable viral load do not transmit HIV to their sexual partners (known as undetectable = untransmittable, or U=U). This webinar reviews the scientific evidence supporting U=U; outlines how to use U=U as a prevention strategy; showcases community perspectives on U=U benefits and considerations; and draws attention to the legal implications of U=U by examining the legal context of HIV criminalization.

Strengthening efforts to eliminate hepatitis C: An overview of the latest in research and implications for frontline workers

This webinar reviews key research and the implications on front-line practice and community perspectives. Topics include micro-elimination as a strategy to support the elimination effort; priority populations, real-world implications, and remaining gaps and opportunities; a population-level cascade of care in hepatitis C; and new information related to re-infection.

CATIE Forum 2017 video interviews
In November 2017, CATIE welcomed 400 participants to the CATIE Forum 2017Transforming our Practice. During the CATIE Forum, we recorded short video interviews with several presenters on key HIV and hepatitis C practices for prevention, testing and treatment.

The Power of Undetectable: What you need to know about HIV treatment as prevention

This client resource provides people living with HIV and their care providers with up-to-date, easy-to-understand information on the prevention benefits of HIV treatment. The booklet explains how HIV medications and maintaining an undetectable viral load can be used to prevent the transmission of HIV in the following contexts: during sex, during and after pregnancy, and when injecting drugs.

8 Questions About PrEP for Guys

This client brochure provides basic information about pre-exposure prophylaxis (PrEP) for gay, bisexual, and other men who have sex with men (MSM). It includes key messages on who should consider taking PrEP, how to take PrEP, effectiveness and safety, and other benefits. Simple language and design are used to ensure broad accessibility for a diverse range of men.

I Know My HIV Status

Basic information about HIV testing for people who are thinking about getting tested for HIV or have questions about HIV testing. It explains who should get tested; what to expect; when to get tested; what the results mean; and where to go for an HIV test.

Strong Medicine

By weaving together Indigenous knowledges of culture and well-being and Western knowledge of HIV testing and treatment, this video from the Canadian Aboriginal AIDS Network (CAAN) and CATIE shares accurate information about HIV testing and treatment. It encourages people to get tested and to start, resume or stay on HIV treatment for their own health and wellness. This video is a positive and supportive educational tool for all Indigenous people living with HIV and those affected by HIV.

Staying Healthy Behind the Walls: Hepatitis C, HIV and You

This brochure from PASAN and CATIE provides basic information about hepatitis C and HIV specifically for people in prison. It covers transmission, prevention, testing, treatment and staying healthy with either virus. And it’s all in the context of prisoners’ realities.

Staying Healthy Behind the Walls: Tattooing, Piercing and You

This brochure from PASAN and CATIE provides information on preventing hepatitis C and HIV transmission while tattooing or piercing in prison (or other non-professional settings). Topics include preparation of the equipment and workspace, safer practices during the session and tips for after care. And it offers information on testing for hepatitis C and HIV.

CATIE News

PrEP’s social impact on the lives of some gay men in Toronto

As part of a PrEP demonstration project to assess its acceptability, use and effectiveness among gay, bisexual and other men who have sex with men (MSM), researchers interviewed early adopters of PrEP in Toronto about their experience. Participants reported that their use of PrEP left them feeling “proud” and “liberated,” although stigma and judgment related to PrEP also led some participants to conceal their use of it.

On-demand PEP to prevent HIV infection

To expedite initiation of post-exposure prophylaxis (PEP), two Toronto clinics prescribed PEP medications in advance to some clients. Candidates for “PEP-in-pocket” prescriptions were people who were not at ongoing high risk for HIV infection so did not require daily pre-exposure prophylaxis (PrEP), but who remained at risk and were eager to pursue a biomedical prevention strategy. Of the 30 men who were prescribed PEP in advance, only four (13%) of the men took it. All started PEP less than 10 hours after a potential exposure and none of them became infected. This strategy may be another way of helping to prevent HIV infection in a minority of patients.

Telemedicine provides care and treatment for people with hepatitis C living in rural and remote communities

The Ottawa Hospital and Regional Viral Hepatitis Program’s Telemedicine Program was developed to reduce barriers to specialist hepatitis care for people with hepatitis C living in rural areas of Eastern Ontario through the Ontario Telemedicine Network (OTN). A study compared clinical outcomes between patients in the Telemedicine Program (TM) and the Ottawa Hospital Viral Hepatitis Outpatient Clinic (non-TM). The researchers found that the Telemedicine Program was successful at providing care and treatment to patients with hepatitis C who live in remote communities. The new era of DAA treatment for hepatitis C has found increasing numbers of TM patients initiating treatment with equivalent cure rates between TM and non-TM patients.

Latest Canadian hepatitis C guidelines encourage offer of a test to baby boomers

The Canadian Association for the Study of the Liver (CASL) has issued updated guidelines for the management of hepatitis C virus (HCV) infection. The 2018 update emphasizes that healthcare providers should offer HCV testing to baby boomers and people at risk for infection with this virus. Also, given advances in HCV treatment over the past several years, the update encourages healthcare providers to offer treatment to all people with chronic HCV infection. The guidelines list all treatment options for HCV and have information on the medical monitoring of HCV infection.

Study finds high burden of psychosocial issues among PEP users

An Ontario study conducted in three clinics in Toronto and Ottawa examined looked at psychosocial issues facing post-exposure prophylaxis (PEP) users. At least one psychosocial issue was identified in 74% of the 186 participants in the study. Researchers suggest screening PEP-seeking patients for depression and other issues.

Canadian resources

Reducing the health impact of sexually transmitted and blood-borne infections in Canada by 2030: A pan-Canadian STBBI framework for action

The Pan-Canadian STBBI Framework for Action from the Public Health Agency of Canada (PHAC) sets out an overarching and comprehensive approach that will support and contribute to achieving global STBBI targets. It provides a vision, strategic goals, and guiding principles to support cohesive action to address STBBI in Canada across all sectors with an emphasis on four pillars: prevention, testing, initiation of care and treatment, and ongoing care and support.

The Pan-Canadian STBBI Framework for Action also identifies key opportunities for action related to each pillar and acknowledges the foundational support provided by increased surveillance, research, knowledge mobilization, and regular monitoring and evaluation to the success of any policy, program, or intervention to address STBBI.

Summary: Estimates of HIV incidence, prevalence and Canada’s progress on meeting the 90-90-90 HIV targets, 2016

This report from PHAC provides Canada’s 2016 national estimates of HIV incidence and prevalence and progress towards meeting the UNAIDS 90-90-90 targets.

HIV in Canada

An infographic from PHAC on HIV in Canada in 2016.

Can we eliminate hepatitis C?

The July issue of the Canada Communicable Disease Report (CCDR) published by PHAC focuses on hepatitis C in Canada:

The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

Since the last Canadian guideline on the management of chronic hepatitis C virus (HCV) infection from the Canadian Association for the Study of the Liver was published in 2015, there have been remarkable treatment advances. Thus, there was a need for an updated, evidence-based guideline. This guideline was written to assist physicians and other healthcare professionals in the management of adult patients with chronic HCV infection. 

Canadian HIV Pregnancy Planning Guidelines
The objective of the guidelines from the Society of Obstetricians and Gynaecologists of Canada is to provide clinical information and recommendations for healthcare providers to assist Canadians affected by HIV with their fertility, preconception, and pregnancy planning decisions. These guidelines are evidence- and community-based, flexible, and take into account diverse and intersecting local/population needs based on the social determinants of health.

Implementing Supervised Injection Services

This nursing best practice guideline from the Registered Nurses' Association of Ontario is a comprehensive document that provides an overview of principles, resources and structures for delivering evidence-based supervised injection services (SIS). It is not intended to be a manual or “how-to” guide; rather, it supports best practices and decision making for nurses, health workers and health system leaders.

Application and action: TRC reading guide for non-Indigenous organizations

This kit from the Manitoba Harm Reduction Network can be used by organizations to read and apply the Truth and Reconciliation Commission (TRC) report. This toolkit will be most helpful for organizations that have already begun the work of decolonization, and understand some of the concepts and analysis therein.

Prison-based needle and syringe programs: Myths and facts

This fact sheet from the Canadian HIV/AIDS Legal Network looks to dispel some of the common myths surrounding prison-based needle and syringe programs.

International resources

Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2017 Update: a clinical practice guideline

This clinical practice guideline from the US Centers for Disease Control and Prevention (CDC) provides comprehensive information for the use of daily oral antiretroviral pre-exposure prophylaxis (PrEP) to reduce the risk of acquiring HIV infection in adults in the United States.

Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2017 Update: clinical providers' supplement

This supplement to the PrEP Clinical Practice Guidelines is intended to provide additional information that may be useful to clinicians providing PrEP.