Canada's Report on HIV/AIDS 2003

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Increasing the Use of Reliable Information

Canadians and others around the world need access to accurate, up-to-date information on HIV/AIDS. Reliable information enables people at risk to change their behaviours to avoid HIV infection and those living with HIV/AIDS to learn about new treatments, manage their health and improve their quality of life. Information is essential for policy making, programming and delivery of professional health care and support services. CSHA partners continue to devote significant resources to the development and dissemination of reliable information that is having an impact on the lives of individuals and strengthening Canada's response to HIV/AIDS.

Generating New Knowledge and Information Resources

Many CSHA partners report developing new knowledge and information resources in 2002-2003, with the goal of improving understanding and awareness of the epidemic, strengthening HIV/AIDS programming and encouraging broader engagement in the response.

The Canadian HIV/AIDS Information Centre, CPHA, designed, developed and implemented a national, bilingual HIV/AIDS awareness campaign targeted at the general public during Canadian HIV/AIDS Awareness Week in December 2002. Adopting the UNAIDS theme of stigma and discrimination, the campaign ensured that HIV/AIDS awareness resources were available to support local activities throughout the week and on World AIDS Day. Campaign promotional information was sent to more than 14 000 organizations in September 2002, resulting in orders from 926 organizations for a total of 611 245 items - a 300 per cent increase over 2001. The campaign website was visited 98 936 times, and 56 850 documents were downloaded over a five-month period. With encouragement from the CPHA, 164 municipalities officially declared Canadian HIV/AIDS Week and World AIDS Day in their communities.

Using visual methods to convey culturally appropriate messages about stigma, discrimination and HIV/AIDS, CAAN developed and distributed a new poster series with the tag line "HIV/AIDS. Fear. Discrimination. It can end with us." Launched on Aboriginal AIDS Awareness Day (December 1, 2002), four of the posters provide personal messages from Aboriginal individuals whose lives have been affected by HIV/AIDS, fear and discrimination, while a fifth aims to raise awareness of CAAN and its role in supporting Aboriginal people infected with or affected by the disease. CAAN developed a series of fact sheets and radio public service announcements to complement the poster campaign. As well, CAAN is engaged in a two-year project entitled "HIV/AIDS Prevention Messages for Aboriginal Youth in Canada." The project involves a literature review of HIV/AIDS prevention campaigns targeting Aboriginal youth and will lead to the development and distribution of a series of fact sheets.

With funding from FNIHB, the Assembly of First Nations developed HIV/AIDS awareness kits for chiefs. The kits included HIV/AIDS Cost Impact Analysis on Canada's First Nations Population, a report that provides up-to-date information on the economic costs of treating HIV/AIDS.

Health Canada developed a document entitled Sharing Our Stories, which summarizes 18 projects completed under the Non-Reserve First Nations, Inuit and Métis Project Fund. The report shares information about the funded projects and identifies common "lessons learned" that may assist Aboriginal groups and other interested stakeholders in developing initiatives. This was the first time that the Department had developed such a summary document. Sharing Our Stories will help to inform the evolution of the Fund in the years ahead.

CAHR developed a media kit for distribution at its annual conference in Halifax in April 2003. Funded by a grant from Health Canada, the kit helped raise awareness of the work being done by CAHR and of the conference itself, which is an opportunity for scientists from Canada and around the world to share information on new developments in HIV research. More than 250 presentations were made by researchers at the 2003 conference.⁷

CSC released a report on its infectious disease surveillance system entitled Infectious Diseases Prevention and Control in Canadian Federal Penitentiaries 2000-01. The report was prepared jointly by Health Canada and CSC staff, including regional infectious diseases coordinators, registered nurses, chiefs of health services and regional administrators, who played an integral role in the data collection. The report examines the epidemiology of infections, testing patterns and treatment uptakes among inmates during the period from January 2000 to the end of December 2001. It includes information on HIV, hepatitis C, hepatitis B and sexually transmitted diseases and represents the first analysis of infectious disease data obtained through health surveillance in Canadian federal correctional institutions. A total of 223 inmates in federal penitentiaries (1.8 per cent of the inmate population) were reported to be HIV-positive at the end of 2001, compared to 214 (1.7 per cent of the population) at the end of 2000. The surveillance system also revealed that the HIV infection rate among female offenders (5.0 per cent in 2000 and 4.7 per cent in 2001) was significantly higher than among male offenders in all CSC regions. CSC will use the report's findings to address evolving trends in disease management, implement harm reduction strategies and promote healthy lifestyle practices in the federal inmate population.

CATIE developed new publications, such as pre*fix - harm reduction for + users, that focus on specific user groups. Directed at HIV-positive injection drug users and the intermediaries who work with them, pre*fix deals with issues such as using drugs while on HIV medications and side effects that can occur from drug interactions. A special edition of CATIE's magazine, Positive Side, dealt with the challenges HIV-positive women face in their day-to-day lives and now serves as a practical guide for women and HIV.

ICAD continued to add to its fact sheet series on HIV/AIDS and development issues. New fact sheets published in 2002-2003 included the following: Access to Treatment and Care for HIV/AIDS and Other Diseases; HIV/AIDS and Deminers - Issues and Recommendations; HIV/AIDS and African and Caribbean Communities in Canada; HIV/AIDS and Gender; and Implementing the UN's Declaration of Commitment on HIV/AIDS: A Guide for Canadian AIDS Service Organizations. ICAD also produced a special newsletter called Voices, released on World AIDS Day 2002 to illustrate what communities around the world are doing to address HIV/AIDS. Finally, ICAD commissioned a survey of 26 Canadian organizations involved in international twinning partnerships to determine the benefits of these activities for Canada. The resulting report, entitled Benefits of International Twinning Projects for HIV/AIDS Programming in Canada, is available on ICAD's website.

Health Canada published three editions of HIV/AIDS Communiqué, a new electronic newsletter designed to keep CSHA partners and others informed about new initiatives and ongoing work by the Department's various responsibility areas involved in addressing the HIV/AIDS epidemic. HIV/AIDS Communiqué was launched after an informal survey of national CSHA partners revealed that a lack of information from government was widely viewed as an issue that needed to be addressed.

CIDA is developing guidelines to assist HIV/AIDS care, treatment and support in resource-limited settings. Geared to development officers, program consultants/officers and health specialists in CIDA and its partner organizations, the guidelines will provide a framework for assessing HIV/AIDS care, treatment and support projects and programs in countries that have limited resources for addressing the HIV/AIDS epidemic.

Leaders in Disseminating Reliable Information

Using web-based technologies, collaborative relationships and innovative outreach strategies, partners in the CSHA have emerged as world leaders in the dissemination of information on HIV/AIDS prevention, care, treatment and support issues.

The Canadian HIV/AIDS Information Centre, CPHA, is Canada's largest distributor of HIV/AIDS materials. Formerly known as the Canadian HIV/AIDS Clearinghouse,⁸ the Centre is a vital source of HIV/AIDS pamphlets, brochures, manuals, posters and videos. It also offers a range of value-added services, including a lending library, referral services, resource development, direct marketing services and assistance with HIV prevention programming. During 2002-2003, the Centre's distribution service received 18 796 requests (compared to 15 324 requests in the previous year) and shipped a total of 544 566 items (367 560 in 2001-2002). The Centre's library continues to expand - it now holds more than 20 000 titles in over 100 languages - and the number of loan requests jumped more than eightfold in 2002-2003. The Centre's website received 255 011 hits in 2002-2003, compared to 193 823 in the previous year.

CATIE is also a major resource centre, providing free, current, confidential and bilingual information on HIV/AIDS treatment and related health care issues to people living with HIV/AIDS and their caregivers. In 2002-2003, CATIE received more than 2 500 treatment inquiries from across Canada (compared to 2 414 in the previous year) and distributed 60 373 print publications and 23 230 electronic publications (via e-mail). As well, more than 1 million pages of information were delivered through CATIE's website, which makes about 10 000 documents available online. CATIE continued to provide a bilingual, toll-free phone service, and presented 49 workshops to approximately 1 300 participants on topics such as drug therapies, complementary therapies, treatment decision making, depression and pain management. CATIE also launched "Live Positive," a vibrant new website for youth, in 2002-2003. Developed in partnership with Kids Help Phone/Parent Help Line, the Teresa Group and CATIE's National Youth Advisory Committee, and sponsored by the Levi Strauss Foundation, the site provides accessible, youth-friendly information about HIV and its treatment, as well as stories about youth who are living with HIV/AIDS.

Use of CATIE's main website continues to grow, with more than 320 000 hits in 2002-2003 - nearly triple the number from only five years ago. An online survey of visitors revealed that the website is highly regarded in Canada and around the world. Of the 263 visitors who responded to the survey between January and March 2003, 44 per cent indicated that they used information from CATIE to manage their health, 29 per cent shared the information with family or friends, 28 per cent used it for professional development, 23 per cent used it for research purposes, and 12 per cent provided the information to clients or patients. In the fall of 2002, CATIE hired an external consultant to evaluate the organization's activities and accomplishments over the past five years. The consultant concluded that CATIE has made a difference for people living with HIV/AIDS and their caregivers by providing treatment information that is accessible, trustworthy and empowering and that presents a Canadian perspective.

In a survey by the International AIDS Economic Network, the website of the Canadian HIV/AIDS Legal Network ranked 14th in the world as a source of HIV/AIDS information for professionals. The Legal Network's website received more than 4.5 million hits in 2002-2003, including visits from more than 357 000 individuals.

Other CSHA partners are also using the World Wide Web to improve access to and broaden the use of reliable information. CAAN's "LinkUp" web-based resource for information about Aboriginal people and HIV/AIDS was strengthened during the year with the introduction of a new search facility and improvements to electronic document cataloguing. Many of the document's in LinkUp's resource library are not available anywhere else in the world. More than 100 groups and individuals are currently registered users of the LinkUp website.

CIHR continued to share information on funded HIV/AIDS research projects through a database on its website. This database provides the name and institution of the researcher, the title of the project and funding details. CIHR also features key media articles on HIV/AIDS research on its website.

CAS updated its website in December 2002, relaunching the site with a new look and a better search engine feature.

Information Influences Policies, Programs and Decision Making

New knowledge and information is supporting the development of better and broader HIV/AIDS policies, programs and responses in Canada and around the world.

For example, IAD's Enhancing Canadian Business Involvement in the Global Response to HIV/AIDS was disseminated to the business community at the launch of the CARE-Photosensitive photo exhibit in Montréal in December 2002 and at a conference on corporate social responsibility in Calgary in June 2003. The document explains why businesses should participate in the global response to HIV/AIDS and provides concrete examples of how they can become engaged.

During 2002-2003, DFAIT collaborated with the RCMP and the Department of National Defence on HIV/AIDS-related codes of conduct for personnel posted overseas, using information and knowledge derived from a wide range of sources. The Department also works to ensure that sexual health education and training are provided in refugee camps in war-torn parts of the world.

CIDPC is committed to communicating information on the prevention and treatment of sexually transmitted infections to those who work directly with populations at greatest risk. CIDPC continues to work with stakeholders to conduct research and surveillance and to develop web-based tools and resources to provide Canadians with current, accurate and culturally sensitive information that will help them to enhance overall health and avoid HIV/AIDS and STIs. To this end, Health Canada's Canadian Guidelines for Sexual Health Education provide direction for professionals developing programs that support positive sexual behaviours and avoid negative outcomes, including HIV infection. The Canadian STI Guidelines support the development of effective prevention strategies and the appropriate management of STIs. CIDPC has also contributed to an online self-learning module on STIs that enables physicians, medical students, nurse practitioners, nursing students, health care professionals and others to enhance their knowledge and skills regarding STI screening, diagnosis, treatment and prevention (the self-learning module is available on Health Canada's website).

Challenges and Opportunities

Information management continues to be a challenge for CSHA partners. Web-based technologies present many opportunities to improve accessibility to HIV/AIDS information, but some organizations lack the resources - human, financial and technological - to keep their websites current as new information becomes available. As a result, visitors to some websites may be receiving information that is dated or no longer relevant.

Confidentiality issues can also present problems for HIV/AIDS researchers and policy makers. For example, better information is needed to monitor the epidemic and allocate resources accordingly, but confidentiality standards and the difficulty of sharing information between jurisdictions can prevent the current and complete reporting of positive HIV tests and AIDS diagnoses.

As the volume and quality of information about HIV/AIDS continue to grow, CSHA partners are looking for new ways to manage this important element of their work.

Getting Creative - Innovative Outreach Strategies

Recognizing that prevention is the only certain way to beat HIV/AIDS, individuals and organizations involved in the Canadian response are using innovative outreach strategies to head off the spread of HIV infection.

One example is the Labrador Friendship Centre in Happy Valley-Goose Bay, Labrador, which is giving travellers using the coastal ferry service something to think about on their journey. A booth stocked with HIV/AIDS educational and awareness materials is set up on the ferry, and travellers are encouraged to pick up and read the available information. This is one of many ways that the Labrador Friendship Centre reaches out to Aboriginal communities in this sparsely populated region of Canada. The Friendship Centre also integrates HIV/AIDS educational sessions with fun activities, such as bingo and dart nights, youth workshops and youth expos.

In Halifax, Moncton, Montréal and Kamloops, the Safe Spaces Project is providing social support to young gay, lesbian, bisexual and two-spirited youth, with the goal of helping to reduce the risks of HIV infection, sexually transmitted infections (STIs), alcohol and drug use and suicide. This partnership initiative between Health Canada, the McGill Centre for Applied Family Studies, the Canadian AIDS Society (CAS) and the Canadian Public Health Association (CPHA) is based on the successful Project 10 in Montréal. Committees established to oversee the project in each of the four communities were given the autonomy to tailor services to local needs, based on focus groups conducted in each city. Although national funding for this project has expired, each site has developed alternate funding sources. Follow-up research funded by the Canadian Institutes of Health Research indicates clearly that this type of outreach has had positive impacts on the hundreds of youth reached to date.

In February and March of 2001, Grade 8 students from schools in and around St. Paul, Alberta, were invited to attend a two-day overnight camp called "Me and HIV" to learn about HIV/AIDS, other sexually transmitted diseases and healthy lifestyle choices. Each of the two camps featured 18 sessions delivered by trained teen facilitators on such topics as sex and sexuality, birth control, sexually transmitted diseases, HIV, high-risk activities and safe sex. Based on feedback received from participants, a second set of camps was offered to Grade 8 students in 2002.

Pauktuutit Inuit Women's Association and local community workers collaborated to stage community HIV/AIDS fairs in Iqaluit, Taloyoak, Pangnirtung and Arctic Bay in February 2001. Students in each community were encouraged to explore HIV/AIDS in the same way they would research science for a science fair. And as with a science fair, prizes were awarded for the best projects. The community fairs model for HIV/AIDS awareness and education was subsequently expanded to include hepatitis C and to involve many more communities. HIV/AIDS and hepatitis C fairs were held in 12 Inuit communities in 2002 and in 19 communities in 2003.

Strengthening Canada's Capacity to Address HIV/AIDS

Canadian organizations and individuals working in the HIV/AIDS field need to continually renew their knowledge and skills as the epidemic shifts, new challenges arise, new treatment and prevention strategies are developed and the scope of HIV/AIDS-related issues broadens. Partners in the CSHA are investing in a wide range of initiatives to strengthen their abilities - and the abilities of others, both in Canada and internationally - to respond to the epidemic. Key among those whose capacity is being strengthened are people living with HIV/AIDS.

Strengthening Organizational Capacity

Health Canada invests $14.8 million each year to help hundreds of organizations across Canada engage in the response to HIV/AIDS and contribute to the goals of the CSHA.

The largest portion of this funding is administered by the AIDS Community Action Program (ACAP), which provides $8 million each year to support the operations and projects of more than 100 community-based organizations across Canada. This funding is administered through Health Canada's regional offices. Organizations funded by ACAP may also receive financial support from other sources, including the private sector and municipal/provincial/territorial governments and/or regional health authorities.

Recently, Health Canada has begun capturing detailed data on ACAP's impact in Canadian communities. As a first step, information was collected from 178 activities funded in 2001-2002 (90 time-limited projects and 88 operationally funded programs). The results revealed that:

• one-on-one peer-based support services provided by groups that receive funding from ACAP, such as care and support, counselling, home visits and referrals, were used 13 413 times in 2001-2002 (10 821 times by people living with HIV/AIDS and 2 592 times by affected persons)
• people living with HIV/AIDS accessed other support services, such as workshops, health promotion activities,
• drop-in lounges, support groups and retreats, 35 339 times
• millions of Canadians received HIV/AIDS education and prevention messages through workshops, health fairs, street and park outreach initiatives, etc.
• more than 900 000 resource kits, including condoms, lubricant, dental dams and HIV/AIDS information, were distributed
• more than 1 500 workshops were delivered on HIV prevention and education
• almost 70 per cent of the 178 funded projects and programs used volunteers
• to help provide HIV/AIDS services
• the funded projects and programs developed partnerships primarily with the health and social services sectors and other community-based ASOs and agencies, followed by the addictions, private sector, housing and corrections sectors
• the key determinants of health affected by these partnerships were reported to
• be personal health practices and coping skills, social support networks, social environments and health services

Health Canada's national NGO partners in the CSHA receive funding of $2 million each year to help ensure that HIV/AIDS issues are addressed in a strategic, multi-sectoral, collaborative way. This funding supports NGOs in the areas of program delivery, organizational development and relationship building between national, provincial and local organizations and governments.

Each year, FNIHB invests $1.1 million of CSHA funding and $2.5 million of non-CSHA funding to provide HIV/AIDS education, prevention and related health care services to on-reserve First Nations people and Inuit throughout Canada. CIDPC provides an additional $1.2 million to support HIV/AIDS programming in non-reserve Aboriginal communities, bringing the total federal investment in strengthening the capacity of Aboriginal communities to $4.8 million.

Health Canada's DPED receives $100,000 annually from the CSHA to provide expertise in evaluation and performance measurement. DPED is currently working with CIDPC and others to update the CSHA's evaluation strategy. As the evidence base for the CSHA grows, evaluation will help to identify those programmatic responses that are best suited to populations at risk for or affected by HIV/AIDS.

The Project Sustain Basic Training Manual on Grief and Loss was published in 2002-2003. Project Sustain was launched in 1999 to create and strengthen organizational supports for HIV/AIDS workers coping with the impacts of ongoing AIDS-related multiple loss. The manual, which was developed by the AIDS Bereavement Project of Ontario with funding support from the CSHA, provides information to help community-based ASOs enhance their response to multiple loss, change and transition and implement training workshops.

Canada's capacity to contribute to innovative responses to HIV/AIDS is attracting international interest. For example, the very successful "twinning" program supported by CIDA's Small Grants Fund continued during 2002-2003, with 14 new projects receiving funding of $75,000 each. Three existing projects were renewed with additional funding of $25,000 each. The concept of twinning was established in Canada as a way to help organizations implement effective intervention strategies in new locations. In 2002-2003, the Vancouver Area Network for Drug Users was twinned with the Society for Service to Urban Poverty in New Delhi, India, in a project to share information, expertise and resources to reduce the spread of HIV/AIDS in drug-using communities in both cities. In another twinning project, the Faculty of Education at McGill University in Montréal is collaborating with an organization called the Centre for the Book in Cape Town, South Africa, to demonstrate how young authors can become involved in a hands-on literacy initiative to address issues of sexuality and HIV/AIDS.

Canada's HIV/AIDS Research Capacity Continues to Grow

CIHR has established many mechanisms to develop Canada's health research community's capacity to contribute directly to better prevention efforts, better treatments, an improved quality of life for people living with HIV/AIDS, the development of HIV vaccines, and a cure for AIDS.

For example, CIHR supports the training of junior scientists through training awards and training positions paid from research grants. In 2002-2003, CIHR supported 14 new HIV/AIDS training awards for a total of 38 training awards. As well, approximately 175 graduate students and post-doctoral fellows received training as HIV/AIDS researchers through support from research grants and other sources.

Canada's HIV/AIDS research capacity is also increased through salary awards that allow experienced scientists to dedicate more of their time to research. In 2002-2003, CIHR supported one new HIV/AIDS salary award, bringing the total to 12. In addition, it is estimated that more than 280 trained technicians were also supported during the year through HIV/AIDS research grants.

RFAs from CIHR institutes are often aimed at increasing research capacity. Two RFAs launched by the GHRI in 2002-2003 were designed to build capacity for global health research in Canada and in low- and middle-income countries and to encourage research collaboration between countries. The Institute of Infection and Immunity also launched an RFA to address capacity in the area of socio-behavioural issues related to HIV/AIDS and hepatitis C. This initiative will enable interdisciplinary teams to build their capacity, add expertise to their core capabilities and develop strategies for knowledge translation.

The Canada Research Chair Program also strengthens HIV/AIDS research capacity in Canada by helping to attract and retain top-level researchers in Canadian institutions. CIHR supported nine HIV/AIDS researchers through this program in 2002-2003.

Under the CSHA, the Community-Based Research Program awards scholarships of $18,000 annually to full-time master's and doctoral students who apply a community-based approach to HIV/AIDS research.

To date, the program has supported eight students under the Community-Based Research General Stream and three under the Aboriginal Community-Based Research Stream. An important element of the latter stream is the Summer Training Awards, which are administered by CAAN and support Aboriginal undergraduate arts and sciences students to participate in CBR. Six students received Summer Training Awards in 2002-2003 to work under the supervision of an academic advisor and an Aboriginal ASO. CAAN also administers the National Aboriginal Community-Based Research Capacity-Building Program, which supports Aboriginal community organizations and professional researchers to undertake Aboriginal community-based HIV/AIDS research.

The CSHA's Community-Based Research Program also provides funding for research technical assistants (RTAs), who play a key role in developing and enhancing research capacity among non-Aboriginal community organizations. RTAs work with organizations in their geographical area to identify, plan and deliver initiatives that build capacity for CBR. Health Canada is currently funding RTAs for four regional HIV/AIDS coalitions - COCQ-sida in Quebec, the Alberta Community Council on HIV, the Ontario AIDS Network and the British Columbia People with AIDS Society. Health Canada also supports Aboriginal community organizations by providing funding to the National Aboriginal Community-Based Research Initiative. This project ensures that services similar to those of RTAs are available through a national Aboriginal coordinator.

Other CSHA partners are also supporting the strengthening of Canada's research capacity. For example, the CTN's Associateship Program provides financial support for up to six young scientists to work on HIV clinical trials each year. This program has now come full circle, with several associates from the past having become principal investigators. CAHR sponsors New Investigator Awards to attract researchers to four disciplines: basic science, clinical science, social science and epidemiology/public health. (One award is made annually for each track). CAHR also presents a Blue Ribbon Award each year to an individual who has championed HIV work and research. Finally, CAHR funds 16 full scholarships to enable people to attend its annual conference and present their work (eight for students and eight for applicants working in the community).

Strengthening Individual and Community Capacity

In September 2002, Health Canada launched the National HIV/AIDS Capacity-Building Fund with the goal of strengthening the capacity of staff and volunteers across Canada working in areas related to HIV/AIDS. As a result of the first request for proposals (RFP) issued by this fund, nine projects that are national in scope or that have national applicability received approval for funding. For example, the Aboriginal Nurses Association of Canada received funding to deliver a series of training workshops across Canada. These workshops were intended to enhance the capacity of local community service providers to integrate HIV/AIDS into the programs and services they provide to Aboriginal clients. In another funded project, the Planned Parenthood Federation of Canada is developing bilingual guidelines that will help to improve the content, quality and effectiveness of sexual and reproductive health counselling in Canada.

Health Canada launched its Best Practice Models for the Integration of HIV Prevention, Care, Treatment and Support Fund in 2002-2003. Its goal is to identify or develop best practice models of initiatives that integrate HIV prevention and support for people living with HIV/AIDS to maintain and improve their health.9 Seven projects received approval for funding as a result of the initial RFP, which had a deadline of July 31, 2002. For example, the Blood Ties Four Directions Centre Society in Whitehorse received funding to develop and document a best practice model for integrating existing non-HIV/AIDS services in Yukon into HIV/AIDS prevention, care, treatment and support initiatives. Similarly, the Peterborough AIDS Resource Network will develop a best practice model for integrating HIV prevention, care, treatment and support through needle exchange programs in small urban/rural areas, based on the Network's Four Counties Needle Exchange Coalition.

CSC delivers a number of programs to build the capacity of staff and inmates to prevent HIV infection and provide or receive appropriate HIV/AIDS care, treatment and support. Working in collaboration with Health Canada, CSC developed a computer-based self-directed training module to give staff a better understanding of how to prevent and protect themselves from infectious diseases within a correctional environment. CSC's National Infectious Diseases Steering Committee was instrumental in the development of this tool. As well, CSC provided palliative care training across various disciplines, including the faith community. CSC is also continuing to implement its methadone maintenance treatment program for injection drug users. About 500 inmates across Canada are currently receiving methadone treatment. The Department's HIV/AIDS peer-counselling program was expanded in 2002-2003 with the development, in collaboration with CAAN, of a training module for Aboriginal inmates.

The Canadian HIV/AIDS Legal Network held its first Pacific Regional Capacity Building Workshop on Legal, Ethical and Human Rights Issues in Vancouver in October 2002. Topics included the impact of drug laws and policies; methadone maintenance treatment; supervised injection sites; condoms, bleach and needle exchange programs in prisons; and human-rights-based approaches to HIV/AIDS. The objective was to equip community-based organizations that provide services to people living with HIV/AIDS, users of injection drugs and/or inmates with the knowledge and skills needed to address legal and policy issues raised by Canada's drug laws and policies. A second such workshop was held in Montréal in March 2003.

The 4th Canadian HIV/AIDS Skills Building Symposium was held in Calgary from November 20 - 23, 2003. Organized by CAS with the assistance of the 21-member National Program Partners Committee, the Symposium addressed the skills-building needs of front-line HIV/AIDS workers. Participants from across Canada attended the event, which provided skills training and networking opportunities in several learning streams: HIV/AIDS prevention; care/counselling/support; treatment; human rights and legal, ethical and policy issues; organizational and community development; international action; and rehabilitation. Satellite sessions were also held on topics ranging from taking action on HIV/AIDS-related stigma and discrimination to participating in HIV/AIDS clinical trials.

On the international front, ICAD continued to implement a CIDA-funded internship program. Four interns travelled to Kenya, Tanzania and Cameroun to work on community-based HIV/AIDS projects for five months. On returning to Canada, the interns spent a final month sharing their knowledge and experiences at schools and with interested community groups. ICAD also hosted a visit to Ontario and Nova Scotia by the director of ICROSS, an innovative HIV/AIDS and community development project in Kenya. At two universities in Nova Scotia, an essay contest was held, and the winners were awarded free airline flights to Kenya and the opportunity to work at ICROSS during the school break.

CIDA provides funding to a range of organizations working to increase HIV/AIDS capacity in the developing world. For example, CIDA is supporting projects being implemented in South Africa by OXFAM-Canada, Queen's University and the Child and Youth Care Agency for Development. All three projects are supporting community-based initiatives to address capacity building, prevention activities among vulnerable groups and the needs of children. CIDA and Health Canada are also supporting a project to increase regional coordination of the response to HIV/AIDS and tuberculosis in India, Pakistan, Bangladesh, Sri Lanka, Bhutan, Nepal and the Maldives.

Challenges and Opportunities

Capacity building continues to be a significant challenge for organizations involved in the HIV/AIDS response. High staff turnover, staff fatigue, a limited number of well-trained scientists and aging research equipment - which many CSHA partners attribute to a lack of funding - are among the issues that need to be addressed to ensure that Canada has the skills, expertise and infrastructure needed, at home and internationally, in the years ahead.

CSHA partners are tackling these challenges with innovation and determination. Events such as the 4th Canadian HIV/AIDS Skills Building Symposium provide evidence of the widespread commitment to increase the HIV/AIDS capacity of Canadian organizations and individuals. With the development of Canada's action plan for HIV/AIDS, more and better opportunities will arise to ensure that Canada remains at the forefront of HIV/AIDS policy and programming.

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