Building. SHARing. leARning. woRking.

AnnuAl report 2013/14 CATIE is Canada’s source for up-to-date, unbiased Together: information about HIV and hepatitis C. We connect people living with HIV or hepatitis C, at-risk communities, Partnering for a robust, healthcare providers and community organizations national response with the knowledge, resources and expertise to reduce transmission and improve quality of life. Reflecting on how CATIE and many agencies across Canada work to effect a collaborative and CATIE’s Vision effective national response to HIV and hepatitis C, CATIE will be a catalyst for a renewed and the concept of bringing parts of a whole together integrated national response to reduce the readily comes to mind. And the familiar Aristotelian transmission of HIV and hepatitis C (HCV), idea that ‘the whole is greater than the sum of its and to improve the quality of life of people parts’ seems particularly apt. Inside with HIV and HCV.

The national partners, myriad frontline service providers, community-based organizations and Message from the Chair and Executive Director 2 healthcare practitioners, as well as researchers CATIE Board of Directors, 2013/2014 4 and government officials, all contribute to the national response. Through CATIE’s long-standing CATIE Staff 5 and continued commitment to offer the front line Together 6 opportunities for growth in scientific knowledge Building Together 14 and service capabilities, we are actively responding SHARing to the need for health information. Knowledge Together 30 leARning exchange is, of course, very much a two-way Together 36 street. At CATIE, we help facilitate a dialogue — woRking Public Funders, Corporate Donors 40 and we all learn from, and are richer for, that communication. CATIE, for example, learns greatly Financial Information 40 from the field and incorporates those insights into CATIE Partners 41 the development of our own information resources and educational programs. CATIE by the Numbers 44

2 CAtI E Much that happened during fiscal year n Pre-exposure prophylaxis (PrEP) had 2013/14 emphasized the truly robust and already shown promising results in changing nature of HIV and hepatitis C reducing the risk of infection from sexual treatment and prevention issues. To name exposure, but new research in 2013 also just a few significant markers: demonstrated that it is also effective at reducing the risk of HIV among people n Research studies have demonstrated that who inject drugs; and In the context of delivering information effective antiretroviral therapy can greatly to specific audiences, we continue to reduce viral load in a person living with n From national guidelines for HIV testing partner with various organizations in HIV, and greatly reduce the risk of passing to best-practice recommendations the development of resources using on the virus. Investigators of the break- for harm-reduction programs, 2013 the most appropriate language and through PARTNER study concluded was a good year for evidence-based images that resonate most clearly with that the overall risk of HIV transmission approaches to HIV and hepatitis C. their communities. through condomless sex for couples in stable serodiscordant relationships As the testimonials in this Among CATIE’s activities in the last (when the HIV-positive partner is on Annual Report attest, CATIE’s fiscal year, highlights include: The CATIE ART, receives regular HIV care, and has communications and partnering Forum, which brought more than 300 an undetectable viral load) is extremely have been well-received by the front professionals from across Canada low, but also cautioned that uncertainty line. Favourable results from the together to investigate options for over the risk of transmission remains, surveys and outreach evaluations we integrated treatment and prevention particularly over receptive anal sex, and conducted last year also speak highly programming in HIV and hepatitis C; that further follow-up research in MSM of our efforts (See page 35). growth of our popular Learning Institutes populations is essential to provide more that facilitate knowledge exchange precise estimates for transmission risk; We thank all our partners for the from national and regional conferences generosity they continue to show us to frontline communities; an expansion as we, together, build the resources n With two new drugs approved for of our educational outreach to various and programs that position us for use as part of combination therapy for ethnocultural communities to increase current and future challenges. hepatitis C, other treatments are also awareness of Hep C; and continued waiting in the wings. These are exciting partnering with regional events across developments but there are uncertain the country. issues surrounding cost and accessibility;

Laurie Edmiston Patrick Cupido

annual report 2013 / 14 3 CATIE Board of Directors, 2013/2014

CATIE wishes to thank Patrick Cupido, Chair, and the Board of Directors for their diligence in providing governance and support of our work. Your insights and commitment to your respective regions, and to CATIE as a whole, ensure that CATIE evolves to meet our communities’ needs.

Back row (from left): Terry Pigeon, Susanne Nasewich, René Lavoie, John McCullagh, Darren Lauscher, Ken Bristow, Patrick Cupido, Hermione Jefferis, Lyle Watling.Front row: Trevor Stratton, Gerard Yetman, Haoua Inoua, Dr. Lynne Leonard. Not pictured: Stephen Alexander, Marcie Summers.

FIND US CONTACT CATIE 2013/14 Annual Report 555 Richmond St. W., Tel: 1-800-263-1638 Writers & Editors: CATIE staff Suite 505, Box 1104 Fax: 416-203-8284 www.catie.ca Design & Layout: GravityInc.ca Toronto, ON Canada [email protected] © CATIE, 2014 M5V 3B1 Charitable Registration Ordering Centre # ATI-90175 # 132258740 RR0001

4 CAtI E CATIE Staff, 2013/2014

Laurie Edmiston, Executive Director Jacqueline Holder, Executive Assistant/Office Manager

Communications and Social Marketing Jim Pollock, Director, Communications and Social Marketing Back row (left to right): Andrew Brett, Michael Stringer, Dapeng Qi, Jim Pollock, Tim Rogers, Lara Barker, James Andrew Brett, Specialist, Advertising and Digital Wilton, Ed Jackson, Thomas Egdorf, Barb Panter, Michael Bailey, Debbie Koenig, Laurel Challacombe, Barry Plant. Middle row: Flora Lee, Sean Hosein, Brittany Howlett, Alexandra Martin-Roche, Melissa Egan, Logan Broeckaert, Marketing Jacqueline Holder, Zak Knowles, Fozia Tanveer, Erica Lee. Véronique Destrubé, Specialist, Front row: Jeff Rice, David McLay, Tsitsi Watt, Laurie Edmiston, Scott Anderson, Shamim ShambeMiradam. Communications and Social Marketing Not pictured: Véronique Destrubé, Melisa Dickie, Maria Escudero, Christine Johnston, Len Tooley, Hywel Tuscano, Joseph van Veen, Coordinator, Events and Event Joseph van Veen, Matthew Watson, Sophie Wertheimer. Marketing James Wilton, Coordinator, Biomedical Science of Sophie Wertheimer, Regional Health Education HIV Prevention Project Coordinator (Quebec) Information Technology Michael Stringer, Manager, Information Technology Operations and Resources Program Development Dapeng Qi, System Administrator and Developer Barry Plant, Director, Operations and Resources Ed Jackson, Director, Program Development Matthew Watson, Online and Digital Media Editor Maria Escudero, Bookkeeper Lara Barker, Interim Manager, Program Development Flora Lee, Manager, Finance Logan Broeckaert, Researcher/Writer, Treatment and Prevention Programming Knowledge Exchange Shamim ShambeMiradam, Program Assistant Melisa Dickie, Manager, Program Development Tim Rogers, Director, Knowledge Exchange Brittany Howlett, Resources Coordinator Scott Anderson, Researcher/Writer, Program Delivery Christine Johnston, Manager, Hepatitis C Program Michael Bailey, Director, Program Delivery Community Prevention Programs Laurel Challacombe, Manager, Research/ Melissa Egan, Regional Health Education Coordinator Jeff Rice, Coordinator, Hepatitis C Program Evaluation and Knowledge Management (Alberta, Manitoba, Saskatchewan) Fozia Tanveer, Coordinator, Hepatitis C Ethnocultural Sean Hosein, Science & Medicine Editor Thomas Egdorf, Regional Health Education Education and Outreach Zak Knowles, Web Content Manager Coordinator (New Brunswick, Newfoundland and Len Tooley, Coordinator, Community Health Debbie Koenig, Writer/Editor Labrador, Nova Scotia, Prince Edward Island) Promotion Programming Erica Lee, Information Specialist Barb Panter, Regional Health Education Coordinator Hywel Tuscano, Coordinator, Hepatitis C Alexandra Martin-Roche, French Editor (Ontario) Ethnocultural Education and Outreach Program David McLay, Manager, Publication Development Tsitsi Watt, Manager, Program Delivery

annual report 2013 / 14 5 Building.

Integrating new research and approaches into frontline programs

There’s a science and an CATIE helps facilitate the knowledge hepatitis C information into art to bringing together exchange that brings the pieces of various communications programs, program design together and enhances reflecting a rise in demand for disparate but related the frontline response to the needs of providing support for service parts to form a fuller, those living with, or at risk of, HIV and providers whose clients are more unified whole. That hepatitis C. co-infected with HIV and Hep C. is clearly the case when it CATIE’s ongoing connections We apply an evidence-based approach with national, regional and comes to developing and that can advance integration of local agencies have deepened implementing programs interventions and program services our outreach and partnerships, when so many client needs across the full continuum of prevention, spreading up-to-date information must be juggled and testing, treatment, care and support. in new and innovative ways.

accommodated — and those This past year, The CATIE Forum needs have become more brought together frontline professionals numerous and complicated from across Canada to share their as the landscape of social experiences and discuss issues that inform policy and practice on the circumstance and frontline front lines. We integrated HIV and service has evolved.

6 CAtI E CATIE advances Program Science to strengthen HIV and hepatitis C programs

The discipline of Program Science uses research methods to help program planners and frontline workers improve the design, implementation and evaluation During the past year, CATIE has significantly n The 2013 CATIE Forum provided a of their programs. It is ideally suited expanded knowledge exchange in national forum on programming in to developing holistic, client-centred Program Science, as it is an approach that Canada which incorporated a Program programs through which multiple health is becoming increasingly important for Science framework. factors are addressed in an integrated way. advancing the response to HIV and hepatitis C both in Canada and internationally: Advancing Program Science in Canada Successful strategies for HIV and through knowledge exchange will hepatitis C programming involve selecting n I n the Strengthening Programming section continue to be a priority for CATIE and implementing an effective combination of our website we added a new collection for the next few years. of interventions to meet the needs of of links to key national and international specific communities. Program Science can resources for program planners and provide important information about the frontline workers; effectiveness of individual interventions. “CATIE is a crucial Additionally, it can provide crucial n O ur online Programming Connection now component to the information about the holistic aspects of a includes case studies of programs that work that we do. It program, such as the mix of interventions, were developed using Program Science; how they are combined or linked together, would be a disservice and how they are embedded within the n Through webinars and articles in to everyone if CATIE broader healthcare system. Prevention in Focus, we discussed the wasn’t available.” implications of significant research findings for frontline programs in Canada; and – Anon ymous survey respondent

annual report 2013 / 14 7 Great strides integrating HIV and hepatitis C information

CATIE has been taking steps to fully integrate hepatitis C into its programs and information services since 2008 when we were first commissioned by the Ontario Hepatitis C Secretariat to develop a suite of varied Hep C resources. This past year, CATIE made great strides in this ongoing process.

The stepped-up integration of HIV and There are many instances where CATIE n Sage, the new digital repository for hepatitis C information reflects the has enhanced, and made more accessible, resources useful to community groups information needs of the front line. CATIE’s Hep C information: developed during the past fiscal Program Delivery department has seen (see page 29), will be open for posting a great rise in demand for hepatitis C n Content of the once-separate of both HIV and Hep C documents workshops from across the country as www.hepCinfo.ca site has been integrated and will be promoted to both HIV and organizations increase their capacity to into www.catie.ca, creating a one-stop HCV-focused organizations; provide support for those who are co- access point for information on either HIV or Hep C; infected with HIV and Hep C or living with n TreatmentUpdate and CATIE News now Hep C. A foundational Hep C workshop also cover the latest developments in is now a standard CATIE offering and has n Resources for both Hep C and HIV are Hep C treatment and our communication been presented at a number of CATIE jointly available through one simple vehicle The CATIE Exchange covers both regional conferences as well as at harm ordering process in the Ordering Centre; hepatitis C and HIV resources and events; reduction conferences this past year. CATIE also organized a Learning Institute n CATIE information tables at workshops at both the Hepatitis C Symposium and conferences always showcase both rd in Montreal and at the 3 Canadian HIV and Hep C resources; Symposium on HCV in Toronto.

8 CAtI E “Thank you for all the Increasingly, when CATIE develops client and service provider resources, hepatitis C resources that you and information will be included with HIV “CATIE is a fantastic your team provided us information (and vice versa) when it makes partner. It also helps with. I was touched by sense for the target audience. This year, for to ensure that we are example, Pre-fix, a plain-language client one of our members resource for people who use drugs and providing consistent who attended our are HIV-positive, was expanded to include information across workshop, who told us people who use drugs and are HCV-positive. the country.”

how these resources – Anon ymous survey respondent played such an

important role in the CATIE’s range of resources includes numerous lives of her community items related to both HIV and hepatitis C. and family. On behalf of our team and our community members, we really thank you.”

– Ordering Centre customer, Toronto

n The national web listing portal ASO411.ca, a joint partnership with the OHTN and the Toronto HIV/AIDS Network’s Information Access Working Group, has been expanded to include organizations across Canada that provide hepatitis C services and resources. It has been renamed HIV411.ca and HCV411.ca (see page 29).

annual report 2013 / 14 9 300-plus gather at The CATIE Forum to discuss integration

Following the success of CATIE’s first knowledge exchange forum in 2011, The CATIE Forum: New Science, New Directions in HIV & HCV, held September 18-19, 2013 in Toronto, focused on the integration of HIV and hepatitis C programs and services. It provided the more than 300 attendees from across the country with the opportunity to learn about programs related to prevention as well as programs targeting people living with, and at risk of, HIV and hepatitis C.

The CATIE Forum’s agenda took a Program Science approach which applies an integrated strategy to health system programming. Research has demonstrated that more efforts made to ensure engagement and linkages across the full continuum of integrated services, including Building on the previous year’s successful Discussions centred around four aspects prevention, testing, treatment, care and Deliberative Dialogue on Integrated of program integration: biomedical support, will result in more effective client- Approaches to HIV Treatment and information into programming; prevention, centred programming. Prevention, the Forum — CATIE’s largest testing, treatment and care & support conference to date — brought together efforts and approaches; HIV and hepatitis C 320 people from across Canada in health services and systems; and HIV representing a broad range of frontline and hepatitis C services into a broader service providers, researchers, public ‘sexually transmitted and blood-borne health workers, policy makers and people infection’ (STBBI) approach. living with HIV and/or hepatitis C.

10 CAtI E The purpose of the Forum was to: n Enhance understanding of the programming implications of new biomedical research, including new approaches to the integration of prevention, testing and diagnosis, treatment, and care and support services; n Encourage more effective responses to HIV and hepatitis C through the sharing Forum plenaries were telecast and recorded for later viewing on the CATIE website. of promising models of treatment and prevention service integration and CATIE helped Forum participants prepare different communities, including people program collaboration; for the conference by presenting eight pre- living with HIV or HCV, gay, bisexual and Forum webinars, four in English and four other men who have sex with men, women n Increase understanding of HIV and in French, which highlighted aspects of and Aboriginal peoples. hepatitis C service delivery within a broader program integration. Several themes emerged from the Forum sexually transmitted infections/blood- Throughout the Forum’s nine plenary overall. These included: borne infections (STBBI) framework. sessions and 10 concurrent sessions, more than 70 presenters from different n While diverse, all regions of Canada face parts of the country talked about their similar challenges; particular programs through the lens One of the key themes at The CATIE Forum: Partnerships and collaborations will play a of integration. Topics ranged from n Accurate, up-to-date information to guide major role in moving forward with integrated integration for community services; our work is very important; programming approaches. integration for health systems; challenges

of integrating new knowledge of sexual n Meaningful engagement of people living risk into communication of prevention with and affected by HIV and hepatitis C strategies; challenges of integrating Hep C is extremely valuable; and into HIV organizations; testing strategies for reaching people who don’t know n Partnerships and collaborations will play their status; peer mentoring and health a major role in moving forward with navigation programs; nurse and other integrated programming approaches. healthcare provider education; and what integrated services would look like for

annual report 2013 / 14 11 In the coming years, CATIE will continue to take a leadership role in helping the HIV and hepatitis C sectors in Canada learn more about the implications of Program “Hi Joseph [van Veen]. Thanks again for Science and health-system integration. organizing a wonderful forum, and for providing the opportunity for me to attend. It was wonderful A full meeting report from the Forum, the eight pre-Forum webinars, and the video to participate in the forum, and to catch up with recordings and slides from the plenary CATIE staff, and colleagues from across the country! sessions, are all posted for ongoing viewing Kudos to ALL the CATIE staff for facilitating another on the website at www.catie.ca/en/forum. amazing educational experience for those of us in ‘the community’.”

– Br onwyn Barrett, Support Program Coordinator, Positive Women’s Network

Thank you, CATIE Forum partners! The Forum was organized with the Group on HIV and Rehabilitation (CWGHR), collaboration of a number of national Interagency Coalition on AIDS and organizations, including (in alphabetical Development (ICAD), along with a number order) Action Hepatitis Canada (AHC), of pharmaceutical sponsors. We also Canadian Aboriginal AIDS Network partnered with the Ontario HIV Treatment (CAAN), Canadian Association of Network (OHTN) to provide live telecasting Nurses in AIDS Care (CANAC), Canadian of the CATIE Forum plenary sessions. Association of Hepatology Nurses (CAHN), Canadian Association for HIV Research (CAHR), Canadian Institutes of Health Research, Canadian Public Health Association (CPHA), Canadian Working

12 CAtI E hepatitis C treatment scoping exercise to 3rd Canadian Symposium on HCV, which is Community determine how Hep C treatment clinical the annual, national event on HCV research services are being carried out across in Canada. CATIE offered opportunities connections spread each of the provinces and territories. As a for community members from across the news on enhanced result, we identified and added a number country to attend through involvement of Hep C treatment clinics to the Waiting in a CATIE Learning Institute, as well as a Hep C treatments Room Information Program (WRIP) to CATIE-organized “Hep C Patient Journey ensure that the latest Hep C resources Across the Regions” event. CATIE also are made available to their clients. Also, participated in the related Canadian 2013/14 saw the appearance of more we provided new treatment information Association of Hepatology Nurses effective treatments for hepatitis C, with to the community via CATIE’s bi-weekly, (CAHN) Education Day and the Canadian shortened treatment times as well as fewer electronic Hep C Info Updates, updated Association for the Study of the Liver and less severe side-effects, and CATIE the Treatment section of the website to (CASL) Annual Conference, strengthening continued to enhance its efforts to provide reflect the new information, and added our connections with both organizations. timely Hep C information to frontline several new client print resources to the In July 2013, CATIE partnered with local service providers. Ordering Centre. Toronto groups to support a community health fair to mark World Hepatitis Day. CATIE’s Program Delivery department CATIE maintained contact with the pilot-tested and added a Hep C treatment National CIHR Research Training Program CATIE continued to provide Secretariat workshop as one of its core educational in Hepatitis C (NCRTP-HepC) by working support for teleconferences and meetings offerings. In addition, we conducted a closely with the organizers of the of Action Hepatitis Canada (AHC), the re-named Canadian Coalition of Organizations Responding to Hepatitis B and C. Towards year end we agreed to take Cheryl Reitz, a volunteer at Hep C BC and a Member-at-Large of the AHC Executive, and Barb Panter, on an expanded commitment to manage CATIE’s Regional Health Education Coordinator for Ontario, at the Hep C Patient Journey evening during the 3rd Canadian Symposium on Hep C. coordinated fundraising efforts with the pharmaceutical industry on AHC’s behalf. This new energy and organization couldn’t come at a better time, with major changes in treatment options for Hep C now becoming available.

annual report 2013 / 14 13 SHARing.

Collaborating to produce information resources

In the year that our The very act of sharing information helps to create fun, interactive resources flagship publication to build and sustain a community. And on HIV and hepatitis C prevention today, we build community as much — important approaches, especially TreatmentUpdate with bytes, tweets and digital imagery when reaching out to communities reached its milestone than with printed pages and face-to- where there may be language or 200th issue, we are face meetings. communications barriers. given pause to remind Regardless of the medium used, the Our digital tools take on many ourselves that CATIE’s key is that we communicate clearly. different forms: e-mail news bulletins foundational role is Effectively. In 2013/14, our box of to a growing subscriber base; a collecting, analyzing communications tools broadened totally revamped website; suites and sharing information. considerably. In the more traditional print of webinars people can access medium, we partnered with 45 leading at their leisure; a vibrant social That hasn’t (and won’t) HIV and hepatitis C organizations across media platform that is building change. What constantly the country to develop and disseminate an impressive digital community; evolves, however, are the publications that support frontline and partnerships to develop two ways in which we share organizations in educating Canadians online resources that share program on HIV, hepatitis C and sexual health. information among frontline that information. CATIE also made significant movement service organizations and provide toward producing graphic-based, plain- information about the location of language resources for clients, as well frontline services. as partnering with other organizations

14 CAtI E The Positive Side: Giving voice to people with HIV

CATIE’s beloved publication The Positive For example, long-term survivor Robert Side continues to connect people living Bardston shared how his love and talent with HIV with information they’re looking for music took him from the projects of HEALTH INFORMATION & VIEWS winter 2 2 22 for and stories they can relate to. One Louisville, Kentucky to being a virtuoso volume 22 issue 2 loyal reader recently told us that he reads cellist in Medicine Hat, Alberta, where he every issue cover to cover. Another wrote: now advocates for others living with HIV. “Your magazine makes living with the For Bardston, “music made the difference.” consequences of HIV easier.” We also showcased the inspiring stories of three entrepreneurs who launched their This past year, The Positive Side own startups—projects by PHAs, for PHAs. delivered practical information on health supplements, superfoods, screening tests, and how serodiscordant couples

2 2 22 summer 2 are navigating safer sex. We covered cure 22 issue volume MAN OF research and peer navigation programs. Meet virtuoso cellist We offered readers expert advice on how HEALTH INFORMATION & VIEWS Robert to cope with anxiety, cut stress and nurture NOTE Bardston their emotional health. And we continued StartupS HigH anxiety toucHy Feely to tell the stories of remarkable individuals Turning visions Our experts help The benefits living with HIV. into reality you deal of intimacy

“Your magazine makes living with the consequences of HIV easier.” ANCHOREDKath Webster’s path to peace

– The Positive Side reader

AIDS icons Peer power annual report 2013 / 14 15 Posters target stigma The quest for a cure 200th milestone “I think CATIE covers a lot plus HIV drug and is very connected side effects guide “ CATIE has always been to the needs of People GREAT at providing services. head up notable living positive.” Customer care is always at a high standard and materials publications – Anonymous survey respondent arrive quickly.”

– Anonymous survey respondent This past fiscal, CATIE strove to balance a focus on its core strength of providing unbiased, accurate and up-to-date information on HIV and hepatitis C with The organization marked the publication CATIE News and HepCInfo Updates new work that expands our offerings of the 200th issue of TreatmentUpdate, continued to provide rapid, succinct geared toward clients who prefer CATIE’s flagship digest on cutting-edge reports on advances in the fields of graphic-based information and to developments in HIV and hepatitis C HIV and hepatitis C as they unfolded frontline service providers. research and treatment. The issue focused throughout the year. We updated and on what is perhaps the most fundamental expanded our collection of fact sheets change in HIV since the first issue of the to reflect our current understanding of digest was published in 1989 – the long life topics such as pre-exposure prophylaxis, expectancy people with HIV can now often the epidemiology of HIV among youth in look forward to. The issue says studies Canada, HIV viral load, HIV treatment and suggest that a young adult in their 20s sexual transmission of HIV. who is recently infected and diagnosed and who enters care and treatment, and The year also saw the print and online who does not have addiction issues, is launch of a completely updated edition expected to live into their 70s. (For more, of A Practical Guide to HIV Drug Side see TreatmentUpdate reaches 200, pg. 18.) Effects. The resource, which forms the core of our online information on the topic, contains practical information and tips on dealing with short-term side effects that can arise with HIV treatment. We also developed a new series of hepatitis C key messages and updated our web content on living with Hep C.

16 CAtI E shelter staff worker does not need to know if you don’t want them to know.

Privacy and your rights

Under Canadian law you have the right to decide when, how and who you tell your health information to. There are some ex ceptions to your right to keep your health information private. For example, health workers must share test results for some infectious diseases with public health. The this also applies to anal sex or frontal information can also be shared if there is • sex. a risk of your harming someone else or It is not clear how the law applies to if the information is needed for a legal oral sex (with or without a condom or investigation or court case. If you think a dental dam). your health information has been shared - Telling the person you want to have sex without your permission, you may be able with that you have HIV can be hard, but Pre-Fix: to file a complaint. it often gets easier the more you do it. If someone doesn’t want to have sex with Are there times when you have you because you are HIV positive, that to tell people you have Hep C or infected with the Hep C have a legal duty may be hard to hear, but they do have the to disclose to their sex partners before sex. HIV? choice. Just like you have the choice to say no to someone who wants to have sex The criminal law in Canada is also not Yes, if you have HIV, you have a legal with you. for people with Hep C or HIV who inject drugs duty to tell people your HIV status before clear about whether a person has a duty sex. It is not clear whether this legal duty to disclose his or her Hep C infection “You just have to give people the opportunity when sharing drugs and drug equipment. applies to sharing drug injection equip Toto make up their mind about whether they ment when you have HIV. It is also not PIC As far as we know, there has not been a want to haves: sex with you. If they don’t, case where a person with Hep C has been clear whether people living with Hep C Hepthere are C still and other HIV: people Why who will. do I’m at have the same legal duties. criminally charged for exposing someone theythe point matter where my if self-respect you use and self-es to the virus by sharing drugs or drug injectionteem can handle drugs? that rejection. You start to equipment. If you have HIV and are having sex see it as a reflection of the other person, not you,” Cindy In Canada if you have HIV, you have A quick look at living Discrimination and your rights a legal duty to tell your sex partner(s) with Hep C or HIV - If you have HIV and are sharing Discrimination is being treated unfair before having any kind of sex that poses a injection equipment “realistic possibility of transmitting HIV.” ly simply because of who you are. As a person who uses drugs and has Hep C People with HIV have been convicted As far as we know, no Canadian court of serious crimes for not telling their sex - or HIV or both, you may experience has yet decided whether an HIV-positive discrimination because of some or all of partners they have HIV. Based on the law: person who uses street drugs has a legal • these things. Some other reasons you may duty to tell their HIV status to someone be discriminated against include ethnic You with whom they are sharing drug-use your HIVdo status: origin, sexual orientation, gender, gender have a legal duty to disclose equipment (for example, syringes, needles o identity, age or disability. Laws have - and crack pipes or stems). Sharing certain been put in place to prevent people from before having vaginal, frontal drug-use equipment (such as needles being treated unfairly. If you want to file or anal sex without and syringes for injecting) is a high-risk a complaint about discrimination you’ve If you’re only goingo regardless of your viral load; or activity for transmitting HIV. Therefore, experienced in most cases you can usually before having vaginal, frontal or it is safest to assume that police and courts do that with your provincial or territorial anal sex when your viral load is would consider that sharing equipment human rights commission. • detectable (or not low), even a if condom, poses a realistic possibility of HIV trans You you use a condom. to read two things 1 mission, meaning a person would have a Check out Chapter 21. Legal issues from before dohaving not vaginal sex if your viral legal duty to tell his or her HIV-positive the online guide load is low (or undetectable) and Managing Your Health have a duty to disclose status before sharing. use a condom. It is not clear whether for information on privacy, discrimination and HIV transmission and the law. The 1. If you have Hep C Hep C and HIV: Why do they matter guide is available online at www.catie.ca. 1 Frontal sex is what is commonly referred to as vaginal sex. It is a term sometimes used by trans men who feel more comfortable with this language. if you use injection drugs? Under Canadian criminal law, a person For more Hep C legal information, check with a sexually transmitted infection has Hep C (hepatitis C) and HIV are viruses that can make you very sick. Both Hep C and - out online When is a person legally required a legal duty to tell his or her partner about to tell other people about his or her hepatitis HIV are passed from one person to another through the blood, which can happen when you that infection before they have sex if the C infection? at www.hepCinfo.ca. people share needles and other injection equipment to use drugs. (HIV can also pass sex will involve a significant risk of serious from one person to another during sex and from parent to child during pregnancy, birth bodily harm. It is unclear whether people and nursing. This is rare for Hep C.) In Canada, people who inject drugs are more at risk for these infections than people who don’t inject drugs.

Hep C does lots ofis ajobs, virus including that attacks filtering your liver. out thingsYour liverthat isare an bad important for you, partchanging of your the body food that you eat into energy for your body and fighting infections. You can’t live without it. CATIE also made significant movement Sometimes your body can get rid of Hep C on its own, but most often you need treat ment to get rid of it. There is no vaccine for Hep C but there is a cure for it.

toward producing graphic-based, plain- How do you know if you have Hep C or HIV? 9 language resources for clients. The new - edition of Pre-fix, our guide to healthy living with hepatitis C or HIV for people If you’re only going to read two things who inject drugs, took on a bold new 4 form. After updating the original resource to target service providers in 2012, this year we produced two accompanying client resources: What Works, a guide “ I’m not sure how you could to healthy living, and Treat Me Right, the improve your organization, it basics of hepatitis C or HIV treatment. already meets my needs as a Both resources are plain, simple and full healthcare professional.” of graphics, ensuring that key messages are understood by all. Development of – Anonymous survey respondent the client resources included extensive Finally, CATIE continued to expand its community consultation in several offerings for service providers. Two issues regions across the country. of Prevention in Focus offered practical information on a range of topics of Our partnered publication development relevance to workers on the front lines work (see pg. 19) added several fun and of the HIV epidemic. The organization “You and CATIE have interactive resources on HIV and hepatitis C also initiated a partnership with Prof. been wonderful and an prevention—including a board game on Joanne Otis at the Université du Québec honour to work with.” sexual health and cartoon robots who à Montréal (UQÀM) to produce an English know how to avoid Hep C. translation of the facilitator’s guide for – Karen Dennis, Executive Director, their Pouvoir partager/ Pouvoirs partagés Victoria AIDS Resource & project, which engages HIV-positive Community Service Society women in a series of workshops to help them navigate issues and concerns regarding HIV disclosure.

annual report 2013 / 14 17 TreatmentUpdate reaches 200

Through the pages of TreatmentUpdate, information, gave me hope.” He adds: the internationally-recognized research “There is still much to learn and, as drugs newsletter, CATIE’s Science and Medicine improve, more good news to report.” Editor Sean Hosein has chronicled the evolution of HIV/AIDS and the progress of Commemorating TreatmentUpdate’s treatments from a community devastated milestone, Hosein was interviewed by Sean Hosein, CATIE’s Science and Medicine Editor, in 1992; by the disease in the 1980s to one many the Toronto radio station ProudFM and Hosein today. years later living with the complications of PositiveLite.com. a manageable, chronic ailment.

As a volunteer at the Toronto-based “Congrats, Sean, and activist organization AIDS Action Now! thank you for all your in the ‘80s, a 23-year-old Hosein set The 200th issue of TreatmentUpdate and the first, published in 1989. hard work over the years. about doing his research for the news I feel so lucky to still be bulletin. After humble beginnings as a leaflet printed out of his uncle’s basement, here. Your work has been the publication attracted a dedicated instrumental in keeping following, grew over the years, became people like me alive.” a communications vehicle of CATIE’s and reached, during this past fiscal, the – Maggie Atkinson, BA, LLB, LSM, O.Ont, milestone of its 200th issue. Lawyer and AIDS activist.

ReflectingReflecting onon thosethose terrifyingterrifying earlyearly daysdays and the subsubsequentsequent advances he was able to report on, Hosein says: “Somehow, the “ Hi Sean. Congratulations on hitting research and the writing kept me going. this amazing milestone!!!! You I witnessed a lot of misery and loss, but continue to amaze and inspire me!” focusing on what I could find,find, and and what what – Alice Tseng, B.Sc.Phm., Pharm.D., FCSHP, AAVHIP, we could do as a community with that HIV Pharmacotherapy Specialist, Immunodefi- ciency Clinic, Toronto General Hospital

18 CAtI E reports, resources available for order also there were 4,313 orders placed by CATIE Ordering include dynamic games, postcards, posters organizations and individuals and close to and DVDs that cover sexual health topics one million items were distributed. Centre: More than a relevant to specific populations. million resources to An average of 16 orders are processed This year, there were 50 new titles added each day. Frontline organizations that use the front line to the collection: 23 originated from the Ordering Centre include community organizations across the country, two were health centres, clinics, public health units, nationalized in partnership with CATIE, and AIDS service organizations, corrections The CATIE Ordering Centre provides 25 were developed in-house by CATIE. In facilities, schools and universities. resources free-of-charge to AIDS service total, the CATIE Ordering Centre now offers organizations, healthcare providers and more than 300 resources, most of which are other frontline service workers across developed by community organizations. Canada. In 2013/2014, CATIE worked with “Thank you so much! more than 45 leading HIV and hepatitis C The service: CATIE welcomes We use these resources organizations to develop and disseminate organizations to call or e-mail our bilingual all of the time for PD publications that support frontline Resources Coordinator, who is available organizations to educate Canadians on to help them determine which resources sessions for teachers.” HIV, hepatitis C and sexual health. CATIE are best suited to their information needs. – Educator, St. Stephen, NB ensures that the resources available All orders for resources may be placed through the Ordering Centre are current through the CATIE Ordering Centre and produced by organizations with website or by phone. CATIE guarantees expertise in the topic area. All orders delivery of resources within seven to 10 received via the CATIE Ordering Centre business days to any location in Canada. website and phone line are processed by To ensure communication with frontline CATIE’s bilingual Resources Coordinator organizations, CATIE’s Ordering Centre and shipped for free anywhere in Canada. Quarterly Update is sent electronically to more than 2,000 Ordering Centre users to The collection: CATIE’s comprehensive keep them informed of new print resources collection of print resources is designed available for order. to meet the information needs of organizations serving diverse communities Reach: Over the past year, a wide range affected by HIV and hepatitis C across of community stakeholders from across Canada. In addition to brochures and Canada accessed the Ordering Centre;

Brittany Howlett (left) and Melisa Dickie showing resources from the CATIE Ordering Centre.

annual report 2013 / 14 19 Top 10 HIV and Hep C Research News from 2013

What were the most A cure for HIV? New evidence-based notable HIV and hepatitis C Fact and fiction approaches to HIV research stories from and hepatitis C 2013? We compiled a list Media attention in 2013 focused From national guidelines for HIV testing of the year’s top 10 stories 2on reports that a baby had been 3 to best-practice recommendations “functionally cured” of HIV and a claim for harm reduction programs, 2013 from CATIE News, then put that Danish researchers were on the was a good year for evidence-based brink of a cure for HIV — both stories it to a vote on catie.ca to approaches to HIV and hepatitis C. see what ranking readers that had been widely misreported. However, many other stories showed The Public Health Agency of Canada’s chose. Here are their promise in HIV cure research this year, new HIV testing guide included choices: such as the Visconti study in France recommendations to promote HIV testing and other studies covered in Treatment during routine medical care. Quebec’s Update 196. Ministry of Health and Social Services released an interim opinion on pre- exposure prophylaxis. A cross-Canada Hepatitis C team of harm reduction experts produced treatment a set of best-practice recommendations. getting easier And the Canadian HIV Trials Network published treatment guidelines for people In the past year, two new drugs for co-infected with HIV and hepatitis C. 1 use as part of combination therapy for Hep C were approved – sofosbuvir (Sovaldi), and simeprevir (Galexos). Look for more approvals next year. Canadians’4 Sixty-one per cent of Canadians said they had low or medium knowledge of HIV/AIDS according to a survey conducted for awareness of the Public Health Agency of Canada. Only 39 per cent felt they HIV lower than had high knowledge of HIV/AIDS, a decrease from 46 per cent 10 years ago in 2003. The survey found that knowledge of hepatitis C is even lower, with 86 per cent feeling that they are not knowledgeable or moderately knowledgeable about the virus.

20 CAtI E HIV raises heart attack risk by ‘Treatment as 50 per cent PrEP can prevention’ prevent HIV in put to the test In 2013, U.S. researchers concluded7 that HIV increases injection drug the risk of heart attack by 50 users 5Research studies have demonstrated per cent, even among people that effective antiretroviral therapy 9Pre-exposure prophylaxis (PrEP) — who do not smoke tobacco, can greatly reduce viral load in a use substances or have other when an HIV-negative person person with HIV and greatly reduce health conditions. takes antiretroviral drugs prior to their risk of passing on the virus. With a potential exposure — has already this knowledge, the B.C. Centre for shown promising results in reducing Excellence in HIV/AIDS has advocated the risk of infection from a sexual a “treatment as prevention” approach: exposure. But new research in 2013 expanding access to HIV treatment to Syphilis on demonstrated that PrEP is also also reduce the spread of the virus. the rise across effective at reducing the risk of HIV among people who inject drugs. This year, the theory was put into Canada action in many jurisdictions around the world – with some successes and Over8 the past decade (from 2000 to 2010), some lessons learned – and based on syphilis rates in Canada have skyrocketed the results of British Columbia’s own – a 910 per cent increase. The higher rates three-year pilot project in Vancouver of syphilis may be furthering the spread of and Prince George (Seek and Treat HIV, and the epidemic is disproportionately for the Optimal Prevention of HIV, or affecting people living with HIV. Frontline Liver cancer STOP), the program was expanded service providers across the country across the province. responded to these epidemics with among the awareness-raising and testing campaigns. fastest-growing 10 cancers Liver cancer is the second fastest- Experts say baby With an estimated one out of every growing cancer among Canadians, boomers should 33 baby boomers in Canada living with tripling among men and doubling hepatitis C, Canadian liver specialists among women since 1970. The main be tested for recommended the development of risk factors for liver cancer are chronic hepatitis C a national strategy to screen baby hepatitis B and C infections. 6 boomers for hepatitis C.

annual report 2013 / 14 21 WRIP sites expand “ We greatly appreciate all the free materials. I will be making to 89 nationwide a big order soon. Thanks again.”

– Kevin Manders, Peer 2 Peer Coordinator, The goal of CATIE’s Waiting Room “Thanks to you and Vancouver Coastal Health, Robert & Lily Lee Family Community Health Centre, Information Program (WRIP) is to ensure your team at CATIE for Sturgeon Lake Health that HIV and hepatitis C clinics across the making these resources country are able to access and share the available. You made my most up-to-date HIV and Hep C treatment and healthy living print publications for job easier.” their clinical teams and clients. WRIP sites – Education and Outreach Worker, are outfitted with a display stand that Bramalea, ON allows easy access to Ordering Centre publications in waiting rooms. This past year, CATIE has continued to expand the scope of WRIP to hepatitis C treatment clinics across Canada, with five new sites added in hepatitis C clinics. Additionally, three sites were Resource added in HIV clinics, bringing the total to 89 sites nationwide. Partners

A selection of resources produced with various partners through CATIE’s publications-development program. The publications (clockwise from lower- left) are: Legal and Clinical Implications of HIV Non/disclosure [partnered with the Canadian Association of Nurses in AIDS Care]; The Hep C Handbook [YouthCO HIV & Hep C Society]; HIV Disclosure: a legal guide for gay men in Canada [HIV & AIDS Legal Clinic Ontario (HALCO) and Ontario’s Gay Men’s Sexual Health Alliance (GMSH)]; and Who’s got the Condom? [Chee Mamuk, YouthCO and 2-Spirited People of the 1st Nations].

22 CAtI E n Unknown, negative or positive? Prevention in Using knowledge of HIV status as Focus: Spotlight on an HIV prevention strategy What Prevention in programming and n Moving PrEP into practice: an update Focus subscribers say research on research and implementation

Over the past four years, Prevention In 2010 CATIE launched a new publication in Focus has continued to expand its 90% aimed at translating HIV and hepatitis C readership and reach. The number of web reported “topics [are] prevention and programming research for visits to Prevention in Focus increased relevant to them” people who work on the front lines of our by 670 per cent over that period, response to HIV and hepatitis C. Prevention reaching 185,000 visits in 2013/14. E-mail in Focus: Spotlight on programming and subscribership has increased by almost research is an online biannual publication 1,075 per cent since the first issue, with just 98% highlighting evidence-informed prevention over 2,000 current subscribers. In the past reported “an increase in programs and translating research in year alone, web visits went up 35 per cent knowledge of HIV and/or areas such as biomedical approaches to and subscribership increased by 13 per cent. hepatitis C prevention” prevention, testing and population-specific prevention topics. Prevention in Focus will continue as CATIE’s premier knowledge translation and The Spring 2013 issue of Prevention in exchange vehicle for HIV and hepatitis C Almost 90% Focus featured the following topics: prevention and programming research. reported they “used information n HIV home-based testing: Potential to educate a variety benefits and ongoing concerns “ Scott [Anderson], well done on of audiences” the article ‘Staying Safe: what n HIV prevention and trans people: What people who inject drugs know the Trans PULSE Project can tell us about preventing Hep C and HIV.’ I look forward to more Almost 80% meaningful conversations with used information to n New best-practice guidelines for harm injection drug users here in “change programming reduction programs promote needle Yukon thanks to this article.” in their organization” distribution – Lauren Passmore, Rural Partnership Coordinator, Blood Ties Four Directions Source: CATIE online survey, 2012-13 Centre, Whitehorse

annual report 2013 / 14 23 Each program selected will aim to Positive Living B.C.’s Peer Navigation Programming demonstrate one or more forms of Services (Vancouver), ASK Wellness integration — integration of biomedical Centre’s Chronic Health Navigation Connection: knowledge into programming, integration Program (B.C. Interior), and Regina Reshaped to across the four components of the Qu’Appelle Health Region’s Peer-to-Peer continuum of care, and/or integration of Program (Saskatchewan) all work to present themed HIV/HCV services with other services. improve access to healthcare for people living with HIV. case studies The structure of the case studies is also being reviewed to reduce length and Finally, CATIE began work on a series provide clear signposts for ease of reading of research reviews that describe the This fiscal,Programming Connection, while still maintaining the most useful evidence related to the programming CATIE’s online toolkit of case studies content for programmers. Instead of approaches we spotlight. While we highlighting promising programs, releasing case studies individually as we will continue to highlight the available rethought its approach. We sought have done in the past, we will now package evaluation data from individual programs, to apply a more integrated, systemic and promote several case studies together. in future we’ll also compile and review approach to the selection of case studies the international research on similar to support CATIE’s wider organizational This year, we pilot-tested this thematic approaches. The first evidence review, goal of strengthening HIV and HCV packaging with the release of case studies which will outline the research on health programming across Canada. which highlight three support programs navigation programs, will be published using a health navigation approach. in July 2014. In future, case studies will be selected that follow clients along the continuum of care — that is, prevention, testing, treatment, care and support. At each step along this client journey, we will highlight a group of innovative Canadian programs that use different client-centred approaches to reduce health system barriers. Areas of focus will include peer health navigation, HIV rapid testing and “Continue to produce and provide access to current, contact tracing. Between two and four programs will be spotlighted for each creative and relevant materials. We are always approach, allowing programmers to see looking for meaningful, accurate and new ways to how different communities are adapting get information to clients and to keep ourselves similar strategies to their own needs. well informed!”

– Anonymous survey respondent 24 CAtI E 2013/14 survey confirms new website is a hit

Following a major renovation of our website, Visitors also reported that the website has www.catie.ca, we sought user feedback good credibility (97 per cent) and that it “ As a newly diagnosed, I during the past fiscal year to determine provides relevant, up-to-date information just want to let you know what people thought of the new site. (97 per cent). how much I appreciate the resources provided on this In an online survey conducted in the Survey results provided insights into how site. I was almost in tears summer of 2013, visitors noted it was very the new website facilitated knowledge when I started browsing the user-friendly. Specifically, they told us exchange and frontline application. pages. Thank you from the that the website is easy to use, (reported Ninety-four per cent of respondents bottom of my heart.” by 92 per cent of respondents); that the reported increased knowledge of HIV and search tool helps them find the information hepatitis C due to information accessed – K, Vancouver they are looking for quickly (87 per cent), on the website; 96 per cent had used the and that the information on the site is information to educate or inform others organized in a way that helps them find the and 67 per cent had used the information The evaluation also told us that almost information they need quickly (83 per cent). to impact programming. two-thirds of website visitors work from an integrated sexually transmitted and blood- In the last year we made further borne infections (STBBI) framework. This improvements to enhance the Strengthening confirmed the importance of continuing to “I find this website very Programming section of the website by develop the CATIE website by adding more educational for both offering visitors easy access to more hepatitis C information. The site is now guidelines and tools needed to develop truly integrated, providing a one-stop-shop my clients and myself and enhance their programs. for HIV and hepatitis C service providers to better serve them.” and their clients. If you have suggestions to help us make the website even better, – Anonymous survey respondent please contact Zak Knowles, CATIE’s Web Content Manager, at [email protected].

annual report 2013 / 14 25 Strides in social media raise CATIE’s profile

As more Canadians look Growing social media To that end, we are using advertising space online to find health CATIE’s audience has grown exponentially on the Google search-results pages to on the most popular social media raise the profile of CATIE as an information information, and as more platforms in Canada, Facebook and Twitter. source. These ads have brought an use social media to share On Facebook alone, our audience has additional 24,000 visits to the CATIE information with their nearly tripled over the past year. At the website, with over 80 per cent of these networks, CATIE has 2013 CATIE Forum, attendees brought the being new visitors who had never been event live to Twitter, tweeting and re-tweeting to our website before. adapted to this new reality 681 times on the #CATIEforum hashtag. by expanding and improving Evaluating and improving our online marketing. As smartphones increasingly become online campaigns the norm in Canada, there is a growing It’s not easy to quantify the impact of demand for visual content on social an advertisement in a magazine or on media: photos, images and infographics. a billboard. Measuring the success of Working with graphic designers this marketing campaigns has traditionally past year, we transformed our online relied on surveys, estimation and a certain information and print resources into amount of guesswork. With new analytics shareable infographics, images on tools, evaluation of online campaigns has Instagram, and videos on YouTube. become much more precise.

Directing search traffic to the CATIE site We have more information than ever Seventy per cent of Canadian home before on how many people are engaging Internet users search for their health with our online campaigns – liking our information online. With more than posts, clicking through to our website, 80 per cent of searches starting on the and sharing our information with their Google search engine, we want to ensure networks. We are able to identify what that those Internet users seeking health kinds of resources appeal to different information about HIV and hepatitis C are demographics, and we use this information directed to our site where they can find to better reach our target audiences. accurate and unbiased information.

26 CATIE 26 CAtI E Social Media Stats Social Media Comments 2013-2014 compared to 2012-2013

Grow When the reporter asks me Twitter Facebook on my 90th birthday what followers: fans: the secret to my longevity is, I’m going to say CATIE (knowledge is power) and my cackle. It will be heard 2x 4x echoing down the corridors (2,202 up from 1055) (2,836 up from 723) of some old age home!

– David Swan, Vancouver Reach YouTube Google ad views: views: Harm reduction Wish I was at the folks! New best #CATIEforum on new practices from directions in HIV and @CATIEinfo to help hepC prevention. 4x 4x(2,428,315 up from (2,005 up from 510) 602,172) you in your jobs Thankfully, it’s being webcast! – Canadian HIV/ AIDS Engage Legal Network – Chris Boodram, Ottawa Likes on Shares on social media Facebook: posts: First day of school! Time to brush up on your HIV knowledge courtesy of @CATIEinfo

– The CTN – CIHR Canadian HIV Trials Network (3x1,264 up from 385) 4x (2,341 up from 598)

annual report 2013 / 14 27 Improved webinars broaden content scope and enhance delivery

CATIE continued to expand our use of live and recorded webinars to deliver relevant information to select audiences. Key CATIE people overseeing content development for online projects (from left): BACK ROW – Zak Knowles, Recordings of all webinars, along with Web Content Manager; Lara Barker, Manager, Program “What an excellent job PDFs of the slides and additional resource Development; Matthew Watson, Online and Digital Media Editor; FRONT ROW – Erica Lee, Information Specialist; you guys have done lists, have been made available on CATIE’s Brittany Howlett, Resources Coordinator; and Andrew website. Our experience with providing Brett, Specialist, Advertising and Digital Marketing. in the latest edition of successful webinars provided a solid Prevention in Focus beginning to CATIE’s move toward a more The series focused on how these viruses integrated Blended Learning framework, affect the body, how they are diagnosed, and in the webinars on being developed during 2014/15, that and how treatment works. Each webinar HIV transmission and mixes various forms of learning to better was a summary of the key information and communicating risk. I tailor educational opportunities to learners’ content presented in CATIE’s more in- am using [the articles] needs and contexts. depth educational workshops conducted across the country. as a tool with frontline In the Sexual Transmission of HIV webinar workers, public health series, we provided an in-depth overview Other webinars held included five offered of HIV’s biological journey from sexual in both English and French to prepare nurses and community exposure to infection, followed by a participants for The CATIE Forum in organizations. I have also second webinar exploring challenges and September 2013, a webinar promoting suggested them to two approaches to communicating sexual HIV the recently-released best-practice teachers that give a class transmission risk. We also offered CATIE’s recommendations for the delivery of harm Building Blocks webinar series, which reduction programming, and national on STIs. The webinars introduced and explained some of the Hep C-focused webinars that featured a are clear, well explained basic terms and concepts about HIV and report-back from the 2nd Canadian Hep C and cover the topics hepatitis C. Symposium on new developments in Hep C research. brilliantly. Well done!”

– Riyas Fadel, ministère de la Santé et des Services sociaux, Québec 28 CAtI E A resource-sharing “I just want to say thank you so much for your community for wealth of resources. I am a communicable disease Canadian HIV and nurse working with clients with HIV and/or HCV.

Hep C service – Angela Meredith, Vancouver Island Health Authority providers

Sage is a new online tool to help frontline workers build stronger programs in HIV and hepatitis C by sharing information and resources with one another. It was developed in partnership with the Canadian AIDS Society and the Canadian their peers by searching the collection and ASO411.ca, a web portal that uses Google HIV/AIDS Legal Network. connecting with resource contributors. maps-functionality to list healthcare and community-based agencies across Canada Sage is community-driven. Organizations Organizations that are interested in joining serving people living with and at risk of that join Sage can upload resources Sage and adding their resources to the HIV/AIDS. to share with anyone on the Internet collection can visit www.sagecollection.ca. or just with other members. Uploaded The main feature of the website expansion resources might include: client resources included the addition of hepatitis C (such as pamphlets, brochures, videos); Partnership expands services and organizations, for people programming tools (guides, handbooks); living with and at risk of Hep C. The campaign materials (posters, ads); online service resultant bilingual web tool is rebranded conference presentations and proceedings information with as HIV411.ca and HCV411.ca (VIH411 and (slides, posters); research and evaluation VHC411 in French). Other updates included resources (reports, survey instruments); HIV411.ca/HCV411.ca restructuring the database and search promotional material (flyers, media functionality, streamlining the existing releases); policies and procedures drop-down service categories, adding (guidelines, manuals); and organizational CATIE, in partnership with the Ontario easily identifiable icons for those service publications (annual reports, strategic plans). HIV Treatment Network (OHTN) and categories, and introducing an overall the Toronto HIV/AIDS Network’s (THN) facelift to the landing pages and the Frontline workers across Canada can learn Information Access Working Group, main website. from the tools and models developed by committed to broadening the scope of

annual report 2013 / 14 29 leARning. on aging and emotional wellness which included practical strategies to improve emotional wellness and self-care that could be passed along Training service providers to take new information to other staff and volunteers. back to their communities We continued with the popular CATIE Learning Institutes that bring As has been true from the In the past year, CATIE’s Community together frontline workers from across Canada or across regions to very beginning, CATIE’s Facilitation Training program continued to grow, providing more opportunities discuss and synthesize new research fundamental work is for staff members and volunteers that can then be reported back to connecting with people from frontline organizations to learn their communities. Our phone and to share information and more about CATIE’s scope of topics in e-mail inquiry service also provided enhance understanding. workshops and pick up some tips on a needed avenue for both frontline facilitation techniques. These graduates agencies and their clients to ask Ramping up understanding are taking that knowledge back to their questions of our trained educators. applies not only to organizations to review and assess their There is, also, a whole other digital research-based information own workshops. dimension to educational outreach related to the prevention that is beginning to play a more CATIE’s extensive educational outreach prominent role. and treatment of HIV engages frontline workers in many and hepatitis C, but also ways. The very first Prairies HIV It’s important to state that in to various techniques, Conference, held last fiscal, is one whatever way CATIE connects with policy approaches, tools of a number of examples of CATIE individuals and communities, the working directly with agencies to education is very much a two-way and shared insights that develop opportunities for learning street. We all learn from, and are can help build and deliver and sharing with a regional focus. We better for, that knowledge exchange. service programs to clients. held information and training sessions

30 CAtI E A round-up of key 2013/14 educational initiatives

There were many educational events across the country that CATIE either organized or took part in. Here are some of the key ones: n We conducted six sessions under the Community Facilitation Training program, engaging 96 participants across the country. With their enhanced skills in facilitation, group dynamics and program design, these graduates will review workshops in their region and partnership possibilities. n As a result of this training, several new projects and workshops have been developed and delivered. The training program is well-received by both participants and agency managers. Some graduates who have been running workshops and other groups for many years commented that they This newly-created infographic about HIV/AIDS in Canada is a popular educational addition to CATIE’s resource collection, distributed at educational outreach and through the CATIE Ordering Centre. will incorporate new techniques and presentation frameworks into their practice.

annual report 2013 / 14 31 A round-up of key 2013/14 educational initiatives

CATIE’s partnership with B.C.’s Positive We collaborated with HIV Edmonton Women’s Network continues to grow. and Alberta Community Council to In the last year, we were invited to create the two-day Alberta HIV speak at their bi-annual Women’s Skills-Building Educational Conference that brought together Retreats at Loon Lake and Bowen Island. At the over 100 people for 20 workshops that first retreat in the spring, we held an information included an Introduction to harm reduction, session on HIV and emotional wellness, which HIV and Emotional Wellness, and an issues included practical strategies to improve and solutions series exploring barriers emotional wellness and self-care. The women experienced by some of the groups of people participating in the fall retreat appreciated the most affected by HIV and hepatitis C. session on tracing books which are excellent health-tracking tools. Looking ahead, we are excited to continue this partnership with provincial educational outreach in which a series of workshops aimed at service providers and We also teamed up with the In October our Regional Health affected women will be carried out in B.C.’s Saskatchewan Provincial Education Coordinator had the Interior Health Authority. Leadership Team and the Manitoba opportunity to work with a peer HIV Program on developing the very first worker from AIDS Thunder Bay to create a Prairies HIV Conference. The event was plenary presentation on people who have been attended by more than 200 people with newly diagnosed for the Opening Doors CATIE bringing in many participants from Counselling Conference. Wilfred Potts is a rural parts of each province. Expert facilitator for Turning to One Another [a physicians outlined how HIV is impacting provincial program that seeks to increase ASO “We’re grateful to have both Saskatchewan and Manitoba while capacity in including the principles of Greater community members and frontline workers Involvement of People Living with HIV/AIDS Melissa from CATIE demonstrated some of the exciting (GIPA) and Meaningful Engagement of People here today to do a initiatives they’re involved with. with HIV/AIDS (MEPA) in their communities] and co-chairs the facilitation team. He’s been workshop with our instrumental in getting the peer movement in Thunder Bay to where it is today. Working with staff on HIV and aging!” Wil — h e co-facilitated a session with a CATIE Regional Health Education Coordinator — once – HIV Community Link (tweet) again demonstrated the value of incorporating these principles in the work we do.

32 CAtI E CATIE also partnered with the AIDS Committee of Newfoundland and Labrador for a week of training sessions focused on aging and emotional wellness. We presented to directors and managers of long- term care facilities, researchers, students of social work and pharmacy, and to the public.

“ I think you are a great For two years running, CATIE has go-to resource to partnered with AIDS New Brunswick, AIDS Moncton and AIDS Saint John support the programs, for joint staff training. During three days of training and information concentrated learning and discussion this past year, two CATIE educators conducted required in my work. four workshops on topics including Women I appreciate the learning and HIV & Nutrition, HIV Testing and Hep C Treatment. The event provided the ASOs’ staff opportunities provided the opportunity to network and discuss issues from a provincial perspective. through CATIE trainings and participation in local events organized by myself The Quebec Regional Educational de lutte contre le sida (COCQ-SIDA) and a Conference on HIV, Hepatitis C and programming committee with representatives and other agencies in Co-Infection was held at the Centre from COCQ-SIDA and other agencies including my community and St-Pierre in Montreal on March 11 and 12. Mouvement d’information et d’entraide dans la One hundred and twenty participants from lutte contre le sida Québec (MIELS-Québec), Province.” across Quebec attended a series of keynote Centre Associatif Polyvalent d’Aide Hépatite C presentations and workshops on topics (CAPAHC), Groupe d’action pour la prévention – Anon ymous survey respondent including mental health and addiction, de la transmission et l’éradication du sida (GAP- supporting people who are living with Vies), Maison Plein Cœur, Point de repères, co-infection, sexually transmitted and blood- Portail VIH/Sida du Québec and the Commission borne infections (STBBIs) and prevention de la santé et des services sociaux des Premières programs for youth, and new developments Nations du Québec et du Labrador (CSSSPNQL). in HIV cure research. The event was organized This allowed us to continue strengthening in collaboration with the Coalition des partnerships throughout the province. organismes communautaires québécois

annual report 2013 / 14 33 CATIE’s Learning “ I would be lost without Institutes: Bringing CATIE. I have used the “ Keep up the great programs and services work!!!! Fabulous the front line for the last 10 years.” service. Thank you.” together to report – Anonymous survey respondent – Anonymous survey respondent on research.

CATIE Learning Institutes bring together Each Learning Institute follows a different the collaborative work of LI participants frontline workers from across Canada or format reflecting the associated research has been used as the basis for various across regions to discuss and synthesize conference. All, however, require forms of report-backs: the Community new research that can then be reported commitment and energy from Learning Rapporteur Presentation at CAHR 2013, back to their communities. Institute (LI) participants. A typical LI including an Aboriginal perspective; participant day includes critical note- report-backs to home organizations In the past year, CATIE has organized taking during the conference, followed and communities; and newsletter five Learning Institutes at Canadian HIV by an evening discussion led by a articles and webinars. and Hep C conferences: the Canadian researcher elucidating some of the finer Association of HIV Research (CAHR) points of highlighted research findings. Conference, in Vancouver, May 2013; LI participants then discuss the Symposium sur la prise en charge des presentations that they have been “Thanks so much for hépatites virales, Montreal, May 2013; assigned, arguing their importance from the Ontario Gay Men’s Sexual Health a community perspective. Synthesizing including our events in Summit, Toronto, May 2013; the Ontario information into a presentation often leads your mailing [The CATIE HIV Treatment Network (OHTN) Research to lively discussions deep into the night. Exchange]! We really Conference, Toronto, November 2013; and the 3rd Annual Hepatitis C Symposium, LI participants tell us that they leave the appreciate the support.” Toronto, February 2014. conference tired but enthusiastic about a – Kate Alexander, Interagency well-rounded and supportive conference Coalition on AIDS and Development experience. And they also ask to come back year after year and encourage co- workers to attend. Together, participants have produced a comprehensive presentation which each of them can adapt for their own report-backs. In the past year,

34 CAtI E The phones Survey says... keep ringing

This past fiscal, there was a steady flow of phone and e-mail enquiries from The CATIE survey to frontline service providers, across the country in both English and conducted in 2013/14, revealed: French. Many HIV-related calls involved low-risk, high-anxiety callers. Among this group of callers, questions on pre- exposure prophylaxis (PrEP) have come up a few times. Other issues arising in questions posed to our educators included HIV testing technologies, and hepatitis C transmission and treatment.

76% 96% 94% Callers ranged from the general public used information agreed or strongly said that they used to frontline service providers. There from CATIE to change agreed that CATIE information from CATIE to were also a number of enquiries from work practices and/or has increased their educate or inform clients, international destinations, mostly on implement/change their knowledge of HIV health professionals, programming colleagues or members of HIV-related topics. We also had several the public calls from correctional institutions, from both prisoners and corrections staff, related to both HIV and Hep C. 97% 92% 97% agreed or strongly agreed agreed or strongly agreed or strongly agreed that CATIE has increased agreed that CATIE’s that they can use the their knowledge of program services meet knowledge gained from hepatitis C the needs of their CATIE in their work community

annual report 2013 / 14 35 woRking.

Addressing the needs of specific communities It’s an understood rule ‘Listen before speaking’ is the principle communities, facilitating dialogue that in order to effectively we apply in all that we do – from and building networks. Similarly, we choosing the language and design for have devoted considerable effort to communicate, you’ve got an information brochure or an online working with specific ethnocultural to know your audience. resource, to developing educational communities to spread awareness CATIE has built a solid sessions and agendas for conferences. about hepatitis C. reputation on engaging With some projects, the knowledge The communication CATIE has with agencies and the gained about our audience is had with all of these audiences has communities they serve. particularly rich. In the past two been very collaborative. Whether We listen, encourage years, two projects stand out: our Gay it be at a gay men’s focus group in dialogue, so we can Men’s Sexual Health project and our Vancouver, a national knowledge Ethnocultural Hepatitis C Outreach and exchange meeting developed in understand — and Social Marketing project. We know a concert with other gay men’s health answer to — their great deal about gay men and other agencies, a Toronto facilitator- information needs. men who have sex with men (MSM) training session conducted in Urdu because our history as an organization or Tagalog, or a discussion in a has served and celebrated those church hall or mosque, the learning communities — but also because curve has been immense for all CATIE has dedicated resources and of us and we have created close, time to reaching out to gay/bi/queer mutually-beneficial partnerships.

36 CAtI E Reaching out to ethnocultural communities to raise hepatitis C awareness

Over the past four years, CATIE has worked on an Ethnocultural Hepatitis C Outreach and Social Marketing project as part of the Ontario Ministry of Health’s Hepatitis C Strategy. The project has been an amazing opportunity to build new partnerships in migrant health and settlement. 2013/2014 was a year of ongoing engagement, growth and expansion of our community development At the March 21, 2014 Punjabi Community Health Services’ Women’s Day Gala in Toronto (from left): Hywel Tuscano, CATIE’s Coordinator, Hepatitis C Ethnocultural Education and Outreach Program; Baldev Mutta, CEO, Punjabi and outreach. Community Health Services.; Ed Jackson, CATIE’s Director of Program Development; and Fozia Tanveer, Coordinator, Hepatitis C Ethnocultural Education and Outreach We received good news this year that based on the success of the program so Partnering with communities for success In the past three years, we have worked far, the Ministry has now included it in Much of the project’s success has been with 19 facilitators and offered further CATIE’s ongoing hepatitis C base funding, the result of ongoing engagement with capacity building to agencies, including which has enabled Fozia Tanveer to the different newcomer and immigrant providing annual retraining opportunities join Hywel Tuscano, to work full-time as communities. Our project did not simply and content updates incorporating Coordinator of Hepatitis C Ethnocultural drop in to deliver workshops and distribute new research. Project facilitators were Education and Outreach in the province. materials; we consulted each cultural group frequently new immigrants with credentials on the content of our workshops, built the in social work and medicine, and through capacity of organizations and individuals, this program they gained important and then supported them to do this work Canadian work experience while in the in their own languages. service of their communities.

annual report 2013 / 14 37 A growing network of peer-led program — and had the Hep C-savvy organizations opportunity to facilitate for a group of In this project we have worked with immigrant mothers with young children. more than 25 organizations. Many of We provided referrals and content input these have been able to sustain this work as part of the Advisory Committee of the within their own organization and support Canadian Ethnocultural Council’s national clients around the issue of hepatitis C hepatitis C project and, with support from once they had a staff member trained the Public Health Agency of Canada (PHAC), and were connected to resources and are looking at ways to extend the project’s referral services. outreach model to other provinces, in particular B.C., in the future. We also had great response when partnering with religious groups, including Building awareness on many media fronts “ Working with the Hepatitis Catholic, Muslim and Sikh communities Our media outreach strategy and C Ethnocultural Project in Toronto, Windsor, London and Guelph. production continues to grow. For World for CATIE has helped Mosques, gurdwaras and church halls were Hepatitis Day 2013, we ran a third wave of me realize the power of points of strong engagement where we our awareness campaign in print, radio and community education and could reach people in a comfortable setting online vehicles across 14 media outlets. We importance of knowledge and build trust with their faith leaders. also led production on Urdu-language and in order for people to Punjabi-language talk shows that aired on self-advocate for their This year CATIE became a member of community channels, Rawal TV and Sur health. Personally I find the Ontario Council of Agencies Serving Saagar; these remain available online. the experience enriching Immigrants and will explore opportunities as it has allowed me to to bring dialogue about immigrant health In two years, we have distributed more than combine my background and hepatitis C to the settlement sector 16,000 informational pamphlets on hepatitis as a physician and my love across the province. With a lack C in Tagalog, Simplified Chinese, Punjabi for presenting/facilitation of culturally-specific services around and Urdu; our multilingual site averaged and public health in order hepatitis C, we also made an important over 1,000 hits a month. This past year, we to provide a positive and connection to the Chronic Disease Self- also began to translate our resources into fruitful experience for all Management program — a provincial, Vietnamese, Spanish, Bengali, Hindi and the participants.” Tamil, and we are planning on launching new pamphlets in Spanish and Hindi. – Dyan De Guzman, Community Facilitator

38 CAtI E This research has helped to inform Nurturing the development of a comprehensive communities of implementation plan for the Gay Men’s “CATIE has been this Risk Communication Project, which is health unit’s life- practice in gay intended to spark dialogue among gay line for culturally men about new approaches to HIV/STI men’s sexual health testing, treatment and prevention. This competent resources three-year communication and community for over 20 years.” promotion engagement plan began with the engagement of six well-known community – Anonymous survey respondent artists to illustrate the key messages of CATIE has continued to play a strong the plan and will continue with extensive role in gay men’s sexual health promotion consultations with service providers in the Our capacity-building work with service programming across the country. We new fiscal year. providers working with gay/bi/queer/ continued to foster cross-country 2-spirit men and other men who have sex professional networks and knowledge Facilitating discussions with men also continued with a ‘rapporteur’ sharing, and broke new ground by across the country project that brought 10 frontline workers spearheading a national research project, CATIE also actively facilitated national from across the country to participate the first in-house research that CATIE has program development through a two-day in the 2013 Ontario Gay Men’s Sexual taken a lead on. knowledge exchange meeting, bringing Health Summit. together program planners involved with The Resonance Project is a three-year Totally outRIGHT, a leadership program for Numerous plenary presentations and national, community-based research young gay men developed by Vancouver’s CATIE-led discussion panels at events project that seeks to understand what Community-Based Research Centre ensured ongoing visibility and relevance gay men think about new HIV information (CBRC) that is being adopted in regions for CATIE’s role as a key player in gay and how it affects their lives. Fifteen focus across the country. men’s sexual health in Canada. These groups were conducted in Vancouver, presentations were at the BC and Ontario Toronto and Montreal during the past year, gay men’s sexual health summits, the and we will be conducting key informant Pacific AIDS Network Annual Conference, interviews in 2014. The data are being and the Manitoba STBBI Conference. carefully analyzed and we anticipate that Key topics explored included pre- and initial results will be available in 2014. post-exposure prophylaxis for gay/bi men, the Totally outRIGHT leadership program, (From left): John McCullagh, CATIE Board member; Len Tooley, CATIE’s Coordinator, Community Health and new approaches to gay men’s sexual Promotion Programming; and James Wilton, CATIE’s health promotion. Coordinator, Biomedical Science of HIV Prevention Project, have made significant contributions to providing knowledge exchange around sexual health education for, and reaching out to, Canada’s gay men’s communities. annual report 2013 / 14 39 Total Revenue: Public Corporate $4,916,753

Provincial Funders Donors Grants $411,337 April 1, 2013 to March 31, 2014 April 1, 2013 to March 31, 2014

8% Pharmaceutical The development of CATIE’s resources CATIE would like to pay tribute to the Sponsors $265,953 and programs, and the relationships and following corporations whose support 6% partnerships we have established and is helping us to provide all people living 4% Donations and Other Revenues nurtured with many frontline service with HIV and/or hepatitis C with the best $214,183 providers, would not have been possible possible information. without the generous support of our 82% Federal Grants funders. We extend our thanks to: Diamond Donors ($70,000 and over) $4,025,280 AbbVie Corporation n The Public Health Agency of Canada (PHAC) Platinum Donors ($50,000 to $69,000) (None) Total Expenditures: $4,890,035 n Ontario Ministry of Health and Long-Term Gold Donors ($20,000 to $49,999) Care, AIDS and Hepatitis C Programs Gilead Sciences Canada, Inc. Print and Distribute Publications Janssen Inc. $1,879,286 n Canadian Institutes of Health Research Internet Services (CIHR) Silver Donors ($5,000 to $19,999) 38% $266,350 Boehringer Ingelheim (Canada) Ltd. 5% Research and Library n Employment and Social Development Hoffman-La Roche Limited $234,026 M.A.C AIDS Fund 5% Canada (formerly HRSDC) Governance Merck Canada Inc. 7% $330,145

ViiV Healthcare ULC Communications and 7% Social Marketing $331,563 Gifts in Kind 7% Shepell.fgi 31% Administration $332,522

We also extend our thanks to the many Workshops and Treatment Inquiries friends of CATIE who generously support $1,516,143 our work with personal donations and gifts of time and talent. Note: Operational costs have been allocated to individual programs to reflect the actual cost of service delivery.

40 CAtI E AIDS Niagara, Ontario Canadian Hemophilia Society CATIE AIDS PEI Canadian HIV/AIDS Legal Network AIDS Programs South Saskatchewan Canadian Institutes of Health Research AIDS Saskatoon (CIHR) Partners AIDS Thunder Bay, Ontario Canadian Liver Foundation AIDS Vancouver Canadian Mental Health Association 2013/2014 AIDS Vancouver Island (CMHA) ANKORS, British Columbia Canadian Observational Cohort (CANOC) Alberta Community Council on HIV (ACCH) Canadian Society for International Health We thank all our partners for their All Nations Hope AIDS Network (CSIH) generous spirit and commitment. Alliance for South Asian AIDS Prevention, Canadian Public Health Association (CPHA) Ontario Canadian Treatment Action Council (CTAC) 519 Church Street Community Centre, Alliance of Healthcare Professionals of Canadian Working Group on HIV and Toronto Ontario Rehabilitation (CWGHR) Access AIDS Network of Sudbury Asian Community AIDS Services, Ontario Carmichael Outreach, Saskatchewan Access Alliance, Ontario ASK Wellness Centre, British Columbia Casey House, Toronto Action Hepatitis Canada Aurat Health Services, Ontario Central Toronto Community Health Centres African and Caribbean Council on HIV/AIDS BC Centre for Disease Control (BCCDC) Centre Associatif Polyvalent d’Aide Hépatite C in Ontario BC Centre for Excellence in HIV/AIDS (CAPAHC) AIDS Bereavement and Resiliency Program Black Coalition for AIDS Prevention Centre for AIDS Services of Montreal of Ontario (BlackCAP), Ontario (CASM) AIDS Bureau, Ontario Ministry of Health and Blood Ties Four Directions Centre, Yukon Centre for Spanish Speaking Peoples, Long-Term Care Bramalea Community Health Centre, Toronto AIDS Calgary Awareness Association Ontario Centre Hôpital de Gatineau AIDS Coalition of Cape Breton BRAS-Outaouais, Quebec Chee Mamuk, Aboriginal Program, AIDS Coalition of Nova Scotia Burntwood Regional Health Authority, BCCDC AIDS Committee of Cambridge, Kitchener Manitoba CHU Sainte-Justine, Quebec and Waterloo Area Cactus, Montreal CHU Hôtel Dieu, Quebec AIDS Committee of Durham Region, Ontario Canadian Aboriginal AIDS Network (CAAN) CIHR Centre for REACH in HIV/AIDS AIDS Committee of Newfoundland and Canadian AIDS Society (CAS) CIHR Canadian HIV Trials Network Labrador Canadian Association for AIDS Research CIHR Social Research Centre in HIV AIDS Committee of North Bay and Area, (CAHR) Prevention Ontario Canadian Association of Hepatology Nurses Clinique Médicale Quartier Latin, Quebec AIDS Committee of Ottawa Canadian Association of Nurses in AIDS Clinique Médicale l’Actuel, Quebec AIDS Committee of Toronto (ACT) Care (CANAC) Coalition des organismes communautaires AIDS Community Care Montreal Canadian Ethnocultural Council Québécois de lutte contre le sida AIDS Moncton Canadian Federation for Sexual Health (COCQ-SIDA) AIDS New Brunswick Canadian Harm Reduction Network

annual report 2013 / 14 41 Committee of Progressive Human Endeavour, Ontario Nova Scotia Association for Sexual Health Pakistani Canadians Interagency Coalition on AIDS and Oak Tree Clinic, British Columbia Community-Based Research Centre, B.C. Development (ICAD) OASIS Health and Medical, Ontario Correctional Service Canada Jewish General Hospital, Montreal Okanagan Nation Alliance, BC Direction 180, Halifax John Howard Society of Greater Moncton Ontario AIDS Network Downtown Community Health Centre, Inc, New Brunswick Ontario Council of Agencies Serving Vancouver Ki-Low-Na Aboriginal Friendship Society, Immigrants Downtown Infectious Diseases Clinic, Kelowna Ontario HIV Treatment Network (OHTN) Vancouver Klinic Community Health Centre, Manitoba Oshawa Community Health Centre – Edmonton General Continuing Care Centre Lakeridge Health Centre – Downtown Hepatitis Clinic, Ontario Filipino Community Centre Inc., Positive Care Clinic, Ontario Oshawa Community Health Centre – Windsor, Ontario Latinos Positivos, Ontario Main Centre, Ontario First Nations and Inuit Health Branch, Lethbridge HIV Connection Society, Alberta Ottawa Hospital Health Canada Living Positive Resource Centre, British Ottawa Inner City Health First Nations of Quebec and Labrador Columbia Ottawa Public Health Health and Social Services Commission LOFT Community Services, Ontario Pacific AIDS Network (PAN) Gay Men’s Sexual Health Alliance (GMSH), London InterCommunity Health Centre, Parkdale Community Health Centre, Toronto Ontario Ontario Parkdale Intercultural Association, Toronto Group Health Centre, Sault Ste. Marie, MAINS Bas-St-Laurent, Quebec Peel HIV/AIDS Network, Ontario Ontario Manitoba HIV Program Pender Community Health Centre, British Guelph Sikh Society, Ontario Maple Leaf Medical Clinic, Toronto Columbia Hamilton Health Services Immigration MIELS-Québec Philippine Independence Day Council, Services, Ontario Moncton Hospital HIV Clinic Ontario Hassle Free Clinic, Toronto Montreal Chest Institute – Play It Safer Network, Manitoba Healing Our Nations, Nova Scotia Immunodeficiency Clinic Positive Living BC Heart and Stroke Foundation of Ontario Montreal General Hospital – IDTC Clinic Positive Women’s Network, British Columbia Hemophilia Ontario National Collaborating Centre for Positive Youth Outreach, AIDS Committee Hep C BC Hepatitis C Education and Infectious Diseases of Toronto Prevention Society Nine Circles Community Health Centre, PositiveLite.com Hepatitis Outreach Society of Nova Scotia Manitoba Portail VIH/sida du Québec HIM Health Initiative for Men, Vancouver North End Community Health Centre, POWER, Ontario HIV & AIDS Legal Clinic Ontario (HALCO) Halifax Primrose Family Medicine Centre, Ontario HIV Edmonton Northern AIDS Connection Society, Prince Albert Sexual Health and Hepatitis C HIV North Society, Alberta Nova Scotia Clinic, Saskatchewan Hong Fook Mental Health Association, Northern Alberta HIV Program Prisoners with HIV/AIDS Support Action Ontario Northumberland County, Network (PASAN) Hôpital Notre-Dame UHRESS, Quebec Immigration Portal, Ontario Programme National de Mentorat sur le VIH-sida (PNMVS), Quebec

42 CAtI E Public Health Agency of Canada (PHAC) South Riverdale Community Health Centre, University of Toronto Punjabi Community Health Services, Ontario Toronto University of Victoria Purpose Society – Stride Program, British Southern Alberta HIV Clinic Vancouver Coastal Health Columbia Spectrum Health, British Columbia Vancouver Native Health Society Queen Elizabeth II Hospital, Nova Scotia St. Clare’s Mercy Hospital, Newfoundland Victoria Cool Aid Society, British Columbia Queen West Community Health Centre, and Labrador Windsor Essex Community Health Centre, Toronto St. Joseph’s Health Care London, Ontario Ontario Rainbow Resource Centre, Winnipeg St. Leonard’s House, Ontario Windsor Regional Hospital – RAWAL TV St. Michael’s Hospital, Toronto HIV Care Program, Ontario Regent Park Community Health Centre, St. Paul’s Hospital, British Columbia Winnipeg Health Sciences Centre Toronto St. Stephen’s Community House, Ontario Women’s College Research Institute, Regina General, Infectious Disease Clinic Stella, Quebec Toronto Regina Qu’Appelle Health Region Street Health, Ontario Working Women’s Community Health Regional Atlantic AIDS Network (RAAN) Streetworks, Edmonton Centre, Toronto Regional HIV/AIDS Connection, Ontario Sudbury Action Centre for Youth, Ontario Yellow Warriors Society of the Philippines, RÉZO, Quebec Sudbury Regional Hospital, Ontario Ontario Robert & Lily Lee Family Community Health Sunnybrook and Women’s College Hospital, York University Centre, British Columbia Ontario YouthCO HIV & Hep C Society Saint John Regional Hospital Sur Sagar TV Sanguen Health Centre, Ontario The Salvation Army Agincourt Community Saskatchewan HIV Provincial Leadership Church, Ontario Team The Valley Regional Hospital Saskatoon Health Region TheBody.com Scarborough Hospital Organizational Timmins Family Health Team/Hepatitis C, Development and Diversity Office, Ontario Ontario Thorncliffe Neighbourhood Office, Ontario Sex Information and Education Council Toronto Chronic Disease Self-Management of Canada (SIECCAN) Program Sexuality Education Resource Centre, Toronto East General Hospital Medical Manitoba Triage – HIV Clinic Shelter Health Hepatitis C Team/ Wayside Toronto HIV/AIDS Network House Toronto Harm Reduction Alliance Sherbourne Health Centre, Toronto Toronto People With AIDS Foundation SIDA-Amitié Laurentides UHRESS CHUQ-CHUL, Quebec Simon Fraser University Union of Ontario Indians Somerset West Community Health Centre, Université du Québec à Montréal Ontario University of Alberta

annual report 2013 / 14 43 Percentage of frontline workers surveyed who 7, 5 7 8 80% reported using CATIE Number of people services at least monthly 2,481 reached through 167 educational Number of personal sessions and organizational Percentage of frontline workers members surveyed who said they use 94% the information they gain from CATIE to educate others 329 Number of information CATIE by the resources CATIE produced/ Numbers 5.8 M co-produced Number of pages 2.6 M viewed on CATIE’s websites 2013 – 2014 Number of visits to CATIE’s websites 50 976,350 Number of resources Number of new distributed through titles added 708 the Ordering Centre to the CATIE Number of HIV and Ordering Centre hepatitis C questions answered through CATIE’s inquiry 300,602 service 2,106 Number of e-mail contacts 2,202 Number of fans of through which CATIE disseminated Number of followers CATIE’s Facebook information on CATIE’s Twitter page (a 194% accounts (a 120% increase from the increase from the previous year) previous year)

44 CAtI E