Canada's Report on HIV/AIDS 2004

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3d Increasing the Use of Reliable Information

Reliable, up-to-date information is a fundamental building block for effective HIV/AIDS prevention programming; for developing and delivering efficient care, treatment and support; and for continuing to advance our knowledge of HIV/AIDS. Equally important, information empowers people living with HIV/AIDS to manage their health and lives and enables at-risk individuals to avoid HIV infection. Thus, the development and dissemination of reliable information that improves the lives of individuals and strengthens Canada's response to HIV/AIDS continues to be a core activity of all CSHA partners.

Information Dissemination A Key CSHA Activity

Through HISI, CSHA funding is provided to two national organizations whose work is central to ensuring that trustworthy, up-to-date information is available to Canadians engaged in the HIV/AIDS response and to individuals living with HIV/AIDS.

The Canadian HIV/AIDS Information Centre, CPHA, is Canada's largest distributor of free HIV/AIDS materials, with a client base that includes community-based organizations, the education sector, health intermediaries, federal/provincial/territorial governments, other NGOs and the general public. As a distribution point for HIV/AIDS pamphlets, brochures, manuals, posters and videos developed by more than 60 partner organizations across Canada, the Centre responded to 15 630 requests for information and shipped 361 074 items in 2003-2004. The Centre's web site was accessed more than 384 000 times, including repeat visits by more than 7 000 individuals and organizations.

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. From plain and simple fact sheets and practical guides to breaking research news, CATIE's publications are designed to empower people and help them make informed decisions. In 2003-2004, CATIE staff and volunteers responded to 2 621 requests for treatment information received through its bilingual, toll-free telephone service and by e-mail, facsimile and surface mail, a slight increase from the 2 576 requests reported in 2002-2003. More than 69 000 publications were distributed in response to these requests (48 905 print publications and 20 156 electronic publications). CATIE's national reference library grew to include 1 500 books, 1 200 web resources, 10 000 articles and 76 medical journals and periodicals. CATIE also presented 53 workshops in 2003-2004, reaching more than 1 000 participants from diverse target populations and regions of Canada. CATIE's web site, which now has more than 10 000 pages of content, is recognized as one of the world's premier sources of on-line HIV/AIDS treatment information, with more than 1.4 million page views annually.

A third CSHA national partner - the Canadian HIV/AIDS Legal Network - also fulfils an important information dissemination role. During 2003-2004, staff of the Legal Network participated in 65 interviews with Canadian and international journalists on a variety of legal, ethical and human rights topics. The Legal Network also responded to 337 requests for information and distributed thousands of copies of new and previously published papers and information sheets. Its redesigned web site has now received more than 6 million hits from Canada and around the world.

Developing New Information Resources

Many CSHA partners developed and distributed new information resources in 2003-2004 to improve understanding and awareness of the epidemic, strengthen HIV/AIDS programming and encourage broader engagement in the response.

In response to needs identified through its annual survey of clients, the Canadian HIV/AIDS Information Centre, CPHA, developed four new resources: an updated pamphlet entitled Basic Facts About HIV/AIDS; a pamphlet focussing on serodiscordant relationships; a poster/pamphlet resource intended to dispel sexual health myths identified in the Canadian Youth, Sexual Health and HIV/AIDS Study; and an updated teacher's guide and student booklet for students in grades 3 to 5.

CATIE also produced a number of new publications and information resources in 2003-2004. These included two new issues of its magazine The Positive Side, covering topics ranging from lipodystrophy and the Aboriginal medicine wheel to the secrets of long-term HIV/AIDS survivors. Two other CATIE resources - CATIE News and Treatment Update - provided breaking news on treatments, complications, side effects, co-infections, nutrition and other research. New fact sheets were published on atazanavir and herb-drug interactions, and CATIE's Practical Guide to Complementary Therapies and Practical Guide to Herbal Therapies were updated to include new information.

With contribution funding from FNIHB, national Aboriginal organizations have also developed new information resources and tools. For example, the Assembly of First Nations developed a Youth Peer Education training curriculum kit and community implementation template. CAAN received funding for a national media campaign to make First Nations and Inuit communities aware of the availability of its Aboriginal AIDS Awareness Day activity kit, as well as posters and fact sheets highlighting HIV/AIDS-related issues facing Aboriginal women, children and families.

Health Canada provided both financial support and expertise to a number of groups to develop "Syphilis is Back," a public service announcement designed to raise awareness of the recent resurgence in Canada of this STI. The 60-second animated video was produced in cooperation with the AIDS Committee of Ottawa, Pink Triangle Services, Boomstone, Action Séro Zéro, the City of Ottawa and Régie Régionale de la Santé et des Services Sociaux de Montréal-Centre. Syphilis infection increases the risk of being infected with HIV by three to five times (the genital sores caused by syphilis in adults make it easier to transmit and acquire HIV). Thus, efforts to control the rate of syphilis in Canada can also help control the HIV epidemic.

ICAD added to its fact sheet series on HIV/AIDS and development issues. New fact sheets published in 2003-2004 included HIV/AIDS and Homophobia, which discusses the impact of homophobia on HIV/AIDS programs around the world, and HIV/AIDS and the Response of Christian Churches, which discusses the significant role that faith-based organizations can play in addressing the global pandemic. ICAD's Voices newsletter was again released on World AIDS Day 2003, this time focussing on what communities in Bangladesh, Lesotho, Tanzania, Mexico and Canada (Edmonton) are doing to address HIV/AIDS. ICAD also published An Overview of Potential Canadian Government Sources of Funding for Canadian NGOs Doing International HIV/AIDS Work.

ICAD has also been collaborating with Canadian partners to develop an education resource kit entitled "Behind the HIV/AIDS Pandemic." Initiated by the Unitarian Service Committee and AIDS Vancouver, the kit aims to help Canadian ASOs, international development agencies and educational institutions better understand international HIV/AIDS issues and the links between HIV/AIDS and social inequity and poverty.

CAS produced a document entitled Advocacy in Action 2002-2003 as a reference tool and guide for the advocacy activities of its members and stakeholders. CAS also published a pamphlet entitled Disability and Income Security - AIDS in the Workplace, which was distributed to member organizations and is now available through the Canadian HIV/AIDS Information Centre, CPHA. The AIDS in the Workplace section of CAS's web site was completed and launched in 2003-2004, and CAS developed and distributed an information sheet entitled HIV Testing Policies in Canada: Responding to the Media and the Public to help its member organizations address the preponderance of HIV/AIDS testing-related stories in the media.

With funding from Human Resources Development Canada, CAS launched a project to combat the lack of comprehensive and accessible information about federal and provincial income security, employment support and health benefits for people living with HIV/AIDS. Through partnerships with researchers and disability and poverty organizations, the National HIV/AIDS Income and Benefits Information Project will generate and disseminate information about current programs and benefits to people living with HIV/AIDS, community-based AIDS organizations, other anti-poverty and disability organizations, program administrators and policy makers.

The CWGHR continued to deliver education programs to increase awareness among people living with HIV/AIDS of the availability of rehabilitation services and to ensure that rehabilitation professionals are better able to support and care for such individuals. During 2003-2004, for example, the CWGHR developed a training manual to support the delivery of rehabilitation workshops at the community level.

In November 2003, the Legal Network cosponsored a week-long screening in Montréal of FIX: The Story of an Addicted City, a feature-length documentary by award-winning filmmaker Nettie Wild that profiles the struggle to establish a safe injection facility in Vancouver. Presentations of the film were followed by panel discussions featuring local activists, community workers, police, medical officials, and current and former drug users.

Sharing Scientific Information

As Canada's primary federal funding agency for health research, CIHR has an important role to play in sharing information with HIV/AIDS researchers and other stakeholders. This is achieved primarily through CIHR's participation in national and international conferences and through the CIHR web site.

In 2003-2004, CIHR developed a document for distribution at the 13^th Annual Canadian Conference on HIV/AIDS Research in Montréal to update the research community and other stakeholders on its HIV/AIDS research program. CIHR also provided an update on HIV/AIDS research funding, funding opportunities and CIHR developments at CAHR's annual general meeting, which took place during the conference.

Other tools for sharing information include a newsletter produced by the CIHR Institute of Infection and Immunity that focusses on the activities of the Institute and scientific developments in the area of infection and immunity. The newsletter published in Winter 2004 had a particular focus on HIV/AIDS research. A brochure outlining CIHR's HIV/AIDS research program, its achievements and funded researchers, as well as a look at the future of HIV/AIDS research, was also produced in May 2004 and was included in a CD-ROM prepared for distribution at the XV International AIDS Conference in Bangkok.

Through its web site, CIHR also shares information on research funding opportunities and funded HIV/AIDS research projects. Information on funded projects is available through a database on the web site, which can be searched for research projects on a particular topic, by a particular researcher, or conducted in a certain research institution. This database provides the name(s) and institution(s) of the researcher(s), the title of the project, a project abstract and funding details.

CIDPC and NACHA partnered to create a new Epi Note summarizing the HIV/AIDS epidemic among Aboriginal peoples in Canada. The Epi Note was drafted by CIDPC and shared with a committee that included representatives from First Nations, Inuit and Métis communities in Canada, as well as technical experts from CIDPC. The draft document was also shared with territorial and provincial partners. The final draft of the Epi Note was reviewed at the NACHA-sponsored Aboriginal Summit on HIV/AIDS in Vancouver in April 2004. In addition to building epidemiology and surveillance knowledge and capacity among Aboriginal representatives, this project improved understanding of issues important to the Aboriginal community and of the most effective methods of presenting Aboriginal HIV/AIDS surveillance data.

Correctional Service Canada continued to publish its Focus on Infectious Diseases newsletter. The Summer 2003 issue focussed on STIs in correctional institutions. The theme of the Winter/Spring 2004 issue was emerging infectious diseases. Correctional Service Canada and CIDPC jointly published an article entitled "HIV and hepatitis C virus testing and seropositivity rates in Canadian federal penitentiaries: A critical opportunity for care and prevention" in the July/August 2004 issue of the Canadian Journal of Infectious Diseases and Medical Microbiology.

HIV/AIDS Social Marketing Campaigns

The National Steering Committee on HIV/AIDS Awareness continued to guide the development of a national HIV/AIDS awareness strategy for Canada. The strategy will include enhanced communications efforts to increase the profile of the role of federal partners in responding to HIV/AIDS, awareness initiatives to support behaviour and/or attitudinal changes in specific target populations, and programs to address societal stigma and discrimination in order to improve the environment for HIV/AIDS prevention, harm reduction and care activities.

In support of this work, Health Canada commissioned a report entitled Review of Canadian HIV/AIDS Campaigns Carried Out Between 2000 and 2002. The report provides information on the strategies, successes and lessons learned from 11 current or recently completed HIV/AIDS awareness campaigns in Canada. Among other uses, this information will inform the development of parameters for a national social marketing campaign aimed at broad audiences to be undertaken by the Public Health Agency of Canada as a key component of the National HIV/AIDS Awareness Strategy.

In the meantime, CIDPC continues to support the development and implementation of national, community-led social marketing campaigns intended to increase awareness and reduce the negative impacts of HIV/AIDS for target audiences identified by the National Steering Committee. To this end, two projects were approved under the National HIV/AIDS Community-based Social Marketing Fund for the 2003-2006 period, with the goal of leveraging the Public Health Agency of Canada funding through partnerships with private and non-profit partners. For example, AIDS Vancouver has received funding for a social marketing campaign entitled "Assumptions - How do you know what you know?," with the goal of reinvigorating HIV/AIDS prevention among Canadian gay men and reducing the number of new HIV infections in this population (see feature article on page 32). The three-year campaign challenges gay men to reconsider their assumptions about the serostatus of their partners. Similarly, the CPHA received funding to develop, implement and evaluate a three-year national, bilingual social marketing campaign targeted at the general public. Entitled "Anytime. Anywhere. Anyone. HIV/AIDS Doesn't Discriminate. Do You?," the campaign is intended to reduce societal stigma and discrimination against people living with or at risk of HIV/AIDS. Planned activities include the development and dissemination of posters, postcards, fact sheets, condom holders, bookmarks, public service announcements (video and print) and other electronic tools with HIV/AIDS messages. The CPHA will also update its Community Action Toolkit and develop newsletter articles and public service announcements to support local campaigns and activities.

Challenges and Opportunities

Canadians now have access to more information than ever about HIV/AIDS - including information on how to prevent the spread of HIV. Nevertheless, the number of new HIV infections reported in Canada from year to year shows no signs of abating. For those living with HIV/AIDS, the wealth of available information on treatments, as well as on legal, ethical and human rights issues, is welcome and empowering. At the same time, it can be daunting in its sheer volume and complexity.

CSHA partners continue to focus on developing new knowledge and information that will arrest the spread of HIV and help those living with the disease to better manage their lives. Simultaneously, many are also wrestling with the challenge of managing their information resources more effectively to ensure that the information remains reliable, accessible, comprehensible and appropriate to users. CSHA partners also need to strengthen their capacity to document Canadian experiences at the international level, to make that knowledge available globally, and to better use it in the domestic response.

Partnerships Sustain Saskatchewan Aboriginal AIDS Service Organization

Partnerships are key to Canada's HIV/AIDS response, and they are happening at all levels across the country. But the concept of partnership is more important for some organizations than for others. In the case of at least one Saskatchewan AIDS service organization (ASO), if it was not for partnerships, the organization would not exist.

The All Nations Hope AIDS Network (ANHAN) is an Aboriginal HIV/AIDS and hepatitis C network operating out of Regina. It provides awareness and prevention education, information, support and other services to First Nations, Métis and Inuit people throughout the province.

"Partnerships really allow us to do our work," says Margaret Akan, Executive Director of ANHAN. "Working together is the only way we can achieve concrete results and implement the many HIV/AIDS and hepatitis C strategies that have been developed in this province. We just don't have the money to sustain all of our activities on our own."

ANHAN was established in 1995 as a program of AIDS Regina, now called AIDS Program South Saskatchewan (APSS). After almost a decade of being mentored by its parent organization, ANHAN was incorporated as an autonomous entity in 2004 - the only Aboriginal group in Saskatchewan with a specific HIV/AIDS mandate.

Although ANHAN now operates as a separate agency, it continues to share office space and administrative services with APSS, and the two organizations deliver a number of shared events. These include two major annual functions - the Epidemics in Our Communities conference and the Saskatchewan Healthcare Excellence Awards. ANHAN is also collaborating with APSS and others to host the 3rd National Aboriginal Hepatitis C Conference in May 2005.

"Our relationship with APSS is critical, but we also work closely with many others, including AIDS groups in Saskatoon, Prince Albert and North Battleford, and friendship centres across the province," says Ms. Akan. "For example, we collaborate with AIDS groups to deliver workshops in schools, mostly in rural and northern areas of the province. We also work with regional health authorities and with the corrections and addictions communities. We may have different roles and mandates but often our target audiences overlap - Aboriginal people are also among the homeless, some use injection drugs, and so on."

At the provincial level, ANHAN sits on the Saskatchewan Advisory Committee on HIV/ AIDS and regularly interacts with Saskatchewan Health. Nationally, it delivers workshops at numerous conferences and is represented on the board of directors of the Canadian Aboriginal AIDS Network.

"Through partnerships, we've been able to do more work with less money," concludes Ms. Akan. "We are able to call on the expertise of different people from other organizations to assist us with our work. Without partnerships we wouldn't exist. And that means a lot of people would be without education and support services - and the spread of HIV/AIDS and hepatitis C among Aboriginal people in Saskatchewan would be even more serious than it already is. That's why we value our partnerships so much."

For more information on ANHAN and its partnership initiatives, visit www.allnationshope.ca .

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