Stigma Index Project
Stigma and discrimination are some of the biggest challenges for people living with HIV and are barriers to HIV prevention, treatment, care and support. HIV-related stigma needs to be understood in the social and cultural context in which it occurs to effectively target and design appropriate interventions to improve the health, well-being and community participation of people living with HIV.
1. To develop a strong research partnership between communities affected by HIV, service providers and researchers to address the challenges of the persistent stigma and discrimination experienced by people living with HIV in Manitoba.
2. To convene a series of 3 collaborative forums with members of affected communities, service providers, researchers and policy makers to develop community-based strategies for research and action to address HIV stigma in Manitoba.
3. With the input of affected communities, pilot test and assess the feasibility of implementing the People Living with HIV Stigma Index (HIV Stigma Index) in Manitoba.
4. To develop future community-based research projects that address the challenges of stigma and discrimination experienced by people living with HIV in Manitoba and across Canada.
HIV Stigma and Discrimination in Manitoba Project Summary
Northern Readiness Project
The HIV rates in Manitoba have been rising in recent years, primarily in the urban Winnipeg centre where treatment and programs are situated. However, there is a significant gap in our knowledge about the rates of HIV in Northern Manitoba. Key concerns are: Do the low numbers of people from Northern Manitoba who entered HIV care in 2015 reflect low numbers of people being tested for HIV? How can we ensure that HIV detection, treatment, and care are available for the predominantly First Nation people in Northern Manitoba?
One of the emerging ways of addressing complex issues such as HIV is through a community readiness approach. Community readiness assessment is a model for community change that integrates the community’s culture, resources and level of readiness to more effectively address an issue. It brings the community together, builds cooperation and increases its capacity for prevention and intervention.
In partnership with Northlands Denesuline First Nation, we are conducting a pilot study to assess the community readiness regarding testing and community support for people living with/at risk of HIV in Northern Manitoba. Ultimately we are working towards increasing HIV testing (diagnosing and monitoring) by increasing HIV awareness, providing training, and addressing access to care for those First Nations people living with HIV throughout Northern Manitoba while using methods and processes that are respectful of First Nation cultures.
HIV Community Readiness in Northern Manitoba
Collective Impact Network
The Manitoba HIV Collective Impact (Research-Evaluation-Action) Network was launched in March 2016 and for the first time has brought together a broad range of partners including researchers, community-based organizations, regional health authorities, policymakers, Indigenous organizations, peers and others in Manitoba to work together on common HIV goals.
We understand HIV issues in Manitoba can be “complex”, requiring a systems approach to understanding and making change. This is why we have adopted a collective impact approach. “No single organization has the ability to solve any major social problem at scale by itself. Collective impact is a powerful new approach to cross-sector collaboration that is achieving measurable effects on major social issues”¹.
¹Kania J., Kramer M. (2011). Collective Impact. Stanford Social Innovation Review
Advancing Primary Healthcare for Persons Living with HIV in Canada (LHIV)
Under the Leadership of Dr. Clare Liddy, the project is being led by Dr. Sean Rourke and Frank McGee in Ontario, Dr. Marissa Becker and Patricia Caetano in Manitoba and Dr. Shabnam Ashghari and Dr.Chris Kaposy in Newfoundland.
- To create a better understanding of the health, healthcare utilization, and quality of care of persons living with HIV.
- To implement and evaluate an integrated care model for HIV care delivery in our affiliated clinics.
- To examine the patient’s perspectives of receiving care through a primary healthcare approach.
- To build the Living with HIV (LHIV) Innovation Team: a new, highly skilled, interdisciplinary HIV primary health care team, including: researchers in primary and HIV care delivery, clinicians, community-based agencies, people with lived experience, and policymakers.
Missed Opportunities for Diagnosis of HIV Epidemiological Study (MODES Manitoba)
MODES Research Team led by Dr. Marissa Becker (Manitoba HIV Program; University of Manitoba)
It has been over 30 years since the first case of HIV/AIDS was diagnosed, and since that time there have been many advances in the diagnosis and treatment of this disease. Unfortunately, many patients continue to present at an advanced stage of the disease. When patients access care late in their disease course, they have a much higher risk of dying as a result of their HIV. The reasons for late presentation to care are potentially many and include factors related to both provider and patient.
The goal of this study is to explore the health care seeking patterns of new HIV positive patients and to understand whether there have been missed opportunities for earlier diagnosis and linkage to care. Further, we are aiming to explore the social networks of HIV positive persons newly presenting to care to provide information on the impact that these networks have on health care seeking, use and engagement in care, both prior to and after an HIV diagnosis. By understanding health care patterns and the drivers of health care use, we will be much better positioned to further develop our HIV prevention, testing and care programs.