National Forum on STBBI Testing and Linkages to Care: Reaching the Undiagnosed

February 4-5, 2020 – OTTAWA, ON

Hosted by the CIHR Centre for REACH 3.0 / MAP Centre for Urban Health Solutions, the National Collaborating Centre for Infectious Diseases (NCCID) & the Public Health Agency of Canada (PHAC), the Sexually Transmitted and Blood-borne Infections (STBBI) Testing and Linkages to Care: Reaching the Undiagnosed forum drew over 100 community-based organizations, people with lived experience,  First Nations, Inuit and Métis organizations, clinicians, researchers, decision-makers and other stakeholders.

Objectives

The specific objectives of the forum:

  • introduce new testing technologies and approaches and to share current implementation research (projects and programs) and evidence on STBBI point of care testing and linkages to care;
  • identify and discuss opportunities and challenges to facilitating scale-up of testing and linkages to care;
  • create a common understanding of the current policies related to the STBBI testing landscape and pending developments; and,
  • create a mechanism to support ongoing communication about best practices and lessons learned with the implementation and scale-up of projects and programs across the country.

These objectives were aligned with the overarching strategic goals of the Pan-Canadian Framework for Action: Reducing the Impact of Sexually Transmitted and Blood-borne Infections in Canada by 2030 to 1) reduce the incidence of STBBI in Canada; 2) improve access to testing, treatment, and ongoing care and support; and 3) to reduce stigma and discrimination that create vulnerabilities to STBBI.

Stakeholders

The forum was attended by approximately 100 stakeholders including people with lived experience, community-based organizations that work with communities or populations at greater risk for transmission of STBBIs, including organizations that work with lesbian, gay, bisexual, trans, queer and 2-spirited (LGBTQ2) communities, First Nations, Inuit, and Métis communities, women’s organizations including African, Carribean, Caribbean, and Black (AFCB) women, and people who use drugs. Participants from the health sector included community-based and outreach organizations, HIV and Hepatitis C service organizations, researchers and research institute staff, Government of Canada departments, including the Public Health Agency of Canada, the National Microbiology Laboratory, Health Canada, Indigenous Services Canada, and the Canadian Institutes of Health Research,  Provincial and Territorial health ministries and public health program and laboratory staff, and the medical diagnostic industry. The diverse attendees provided expert and varied perspectives about what needs to be achieved to scale up innovative STBBI testing and linkage to care strategies to reach the undiagnosed and particularly those who are difficult to reach and to link them to the care they need.

Agenda

The meeting provided an opportunity for attendees to share current research and information on a range of STBBI testing modalities and programs from jurisdictions across Canada, and to discuss opportunities, challenges, and potential next steps for reaching the undiagnosed.

Discussions focused on the importance of community engagement in identifying the testing modalities most appropriate for different contexts; the critical importance of linkage to care after testing; the issue of stigma as a barrier to testing; and the challenge of scaling up promising practices into routine practice.

Forum discussions highlighted the complexity of STBBI testing and linkage to care and allowed for the appreciation of roles and responsibilities of the various sectors involved from across the system. At the conclusion of the Forum there was a palpable energy and connections made among participants to continue the momentum of this important work towards expanding access to STBBI testing and linking people to the care and support they need.

Meeting Proceedings – (to follow)

Forum Agenda – Forum on STBBI Testing and Linkages: Reaching the Undiagnosed (PDF)

Forum Evaluation Summary (PDF)

February 4, 2020 - Day 1

Agenda
Welcome
(8:30 am – 9:00 am)

Facilitator: Jody Jollimore, Community-Based Research Centre

• Opening invocation – Elder Annie Smith St-Georges

• Opening remarks from Public Health Agency of Canada – Kimberly Elmslie

• Review of agenda, meeting objectives and introductions
Bringing new innovations in STBBI testing with linkages to care to Canada
(9:00 am to 9:45 am)

Chair: Geneviève Boily-Larouche, Canadian Institute for Health Research

• Setting the stage
- Sean B. Rourke, Centre for REACH 3.0 and MAP Centre for Urban Health Solutions



• What is working in the real world: A Canadian STBBI point of care testing realist review
– Yoav Keynan, National Collaborating Centre for Infectious Diseases



• Global lessons on access to testing and linkage
- Rosanna Peeling, London School of Hygiene and Tropical Medicine



Q/A and Discussion (15 min)
Reaching the undiagnosed – Voices from the community
(10:00 am to 11:15 am)

Chair: Stephanie Van Haute, Nine Circles Community Health Centre

• Scott Elliott, Dr. Peter AIDS Foundation

• Raye St. Denys, Shining Mountains Living Community Services

• Len Tooley, Community-Based Research Centre

• Denese Frans, Women’s Health in Women’s Hands Community Health Centre

• Daryl Luster, Pacific Hepatitis Network

Q/A and Discussion (15 min)
Breakout session – Acknowledging success
(11:15 pm to 12:15 pm)
Lunch and Networking
(12:15 pm to 1:00 pm)
Novel approaches to testing, reaching the undiagnosed and linkages to care: Structural interventions and promising practices
(1:00 pm to 2:00 pm)

Chair: Jordan Feld, University Health Network

• Self-testing innovations for reaching those with HIV/HCV
- Nitika Pant Pai, McGill University



• Advancing testing innovation among gay, bisexual, queer, trans, and two-spirit men
– Kiffer Card, University of Victoria



• Novel dried blood spot models for hard-to-reach populations with HIV and HCV
– John Kim, National Microbiology Laboratory



• HIV-STBBI testing in rural and remote areas in Manitoba
- Mike Payne, Nine Circles Community Health Centre

Cont’d: Novel approaches to testing, reaching the undiagnosed and linkages to care: Structural interventions and promising practices
(2:15 pm – 3:15 pm)

• Dual syphilis and HIV point of care testing to improve access to testing among inner-city, remote, rural and hard to reach populations in Alberta
- Ameeta Singh, University of Alberta



• Population-level approaches to increase STBBI testing
– Jason Wong, British Columbia Centre for Disease Control



• Pharmacy-based interventions for STBBI
– Christine Hughes, University of Alberta



Q/A and Discussion (15 minutes)
Breakout session –Identifying challenges for implementation
(3:15 pm to 4:15 pm)
End of day 1 wrap-up
(4:15 pm to 4:30 pm)

Facilitator: Jody Jollimore, Community-Based Research Centre

February 5, 2020 - Day 2

Agenda
Welcome and recap of day 1
(8:30 am – 8:45 am)

Facilitator: Jody Jollimore, Community-Based Research Centre

• Genevieve Tremblay, Public Health Agency of Canada
Breakout session – Identifying potential solutions
(8:45 am – 10:00 am)
Cont’d Breakout session – Identifying potential solutions (report back and discussion)
(10:15 am – 11:30 am)
Next steps and closing of meeting
(11:30 pm to 12:30 pm)

Facilitator: Jody Jollimore

• What we heard – successes, challenges, gaps, innovations, potential solutions

• Closing invocation – Elder Annie Smith St-Georges