Research at the Front Lines - Canadian Harm Reduction Network

Research at the Front Lines
Finding New Solutions in HIV Prevention, Treatment and Support
Abstract Book
HILTON TORONTO
November 16, 17, 2009

101
THE WHEALTH PROJECT: ACCESS TO CARE AND MENTAL HEALTH ISSUES OF HIV-POSITIVE WOMEN
Adriana Carvalhal 1
1-Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
Plain Language Summary: HIV-positive women face complex medical demands and social challenges, including access to care. The risk for
depression is significantly elevated and is associated with poor social support and quality of life. The HIV/AIDS paradigm shift from acute illness
to chronic disease has enhanced the generation of multi-disciplinary care networks, including case management, to address the complex needs of
PHAs.
Objective: wHEALTH is a community-based research project studying how peer-delivered, strength-based case management affects the quality
of life of HIV-positive women. Participants work with peer case managers utilizing their strengths and resources to address life challenges.
Female case managers who understand the challenges faced by other positive women will deliver the intervention. Secondary aims are to
understand how a response to wHEALTH is associated with socio-demographic characteristics, psychological adjustment, coping and social
support. The wHEALTH intervention will be compared to Voices of Positive Women support programming.
Methods: 176 women will be randomized to receive case management or VOPW support. Outcome measures will assess quality of life at
baseline, 6 and 9 months. Qualitative narratives will complement survey data. To date, 74 women from Toronto and Hamilton have enrolled.
This analysis is based on 67 women with complete baseline data.
Results: Women enrolled in wHEALTH (n=67) are 39.7 years (±11.4) and were born in North America (48%), Africa (40%) and the Caribbean
(6%). 30% of women have completed college/university, however 78% are relying on disability or Ontario Works as their main source of
income. 81% of women who chose to enroll in wHEALTH are active users of ASO services, of which 48% have accessed ASOs for over a year.
Baseline physical and mental health-related quality of life was 45.4 (± 12.4) and 44.3 (± 11.1), respectively. 42% of women have been diagnosed
with a mental illness, most commonly citing depression. Only 22% are currently receiving treatment for a mental illness with 33%, 22% and
16% seeking care in the previous 3 months from a case manager, psychiatrist or counsellor, respectively. 79% of the women have seen an HIV
specialist in the last 3 months.
Conclusions: A significant proportion of women in wHEALTH are living with a mental illness, however few women are receiving treatment and
seeking care. wHEALTH's goal is to provide evidence for developing innovative support services for HIV-positive women and to identify
effective ways to improve access to and retention in care.
Contact Information: Adriana Carvalhal, Tel: (905) 522-1155 ext. 35998, Email: carvalh@mcmaster.ca
103
ACTION AS A KEY STAGE OF THE THEORY/PRACTICE CIRCLE: DEVELOPING A NEW INTERVENTION TO TREAT HIV
DIAGNOSIS RELATED TRAUMA.
Carlos Rivas 1
1-AIDS Committee of Toronto (ACT)
Plain Language Summary: As a chronic condition, HIV infection requires psychosocial support on an ongoing base. When resources are
limited and the demand is high, this need posses a challenge in delivering services for all the clients. In order to maximize the results with the
least effort, this presentation explores an innovative way to conceive the psychosocial support for people living with HIV and shows how to start
this new path. Specifically, the results of a pilot intervention, derived from an adaptation of a group intervention are presented. The assumption is
that HIV diagnoses works as a trauma, compromising a person’s ability to cope with the challenges associated with infection. In this vein, once
the trauma is dissolved, the skills to cope restart, and people move forward, learning how to thrive, more than survive, the HIV infection.
The Challenge: An HIV diagnosis represents a milestone in the life of a person living with HIV. Even years after the diagnosis, they can often
remember the episode in a highly disruptive way. In some cases, interruptions of personal growth and career development can be attributed to that
moment.
Our Approach: • Conceptualize HIV diagnosis as a trauma.
• Browse the repertoire of available treatment options for psychological trauma.
• Adapt one of the most effective interventions for trauma to the case of HIV.
• Develop a workshop suitable for people living with HIV.
• Assess workshop’s impact on recovery from the emotional impact of the HIV diagnosis.

Key Findings: • It is possible to drastically reduce the traumatic impact of HIV diagnosis.
• With the proper support, it is possible to move forward from anxiety and depression more quickly.
Impact on Policy and Practice: • It is possible to think of psychosocial support as a journey with some key and concentrated steps (e.g.
recovering from HIV diagnosis related trauma, learning to live with HIV, acquiring coping skills to deal with stigma, disclosure and side effects,
etc.).
• It is possible to develop economical and powerful interventions for any of these steps.
Contact Information: Carlos Rivas, Tel: 416-340-8484 ext. 247, Email: crivas@actoronto.org
104
ENHANCING ACCESS TO HARM REDUCTION MENTAL HEALTH CARE AND TREATMENT: AN HIV PREVENTION
STRATEGY FOR HIGH RISK SUBSTANCE USERS
James Weaver 1 ; Jason Altenberg 2 ; Giselle Dias 2 ; Carol Strike 3 ; Laurel Challacombe 4 ; Raffi Balian 2 ; Walter Cavalieri 5 ; Tim Guimond 3 ; Bela
McPherson 6 ; Peggy Millson 1
1-HIV Social, Behavioural and Epidemiological Studies Unit, Dalla Lana School of Public Health, University of Toronto; 2-South Riverdale
Community Health Centre; 3-Centre for Addiction and Mental Health; 4-Canadian AIDS Treatment Information Exchange; 5-Canadian Harm
Reduction Network; 6-Centre for Research in Inner City Health
Plain Language Summary: This pilot study involved training peers to provide supportive counselling for people who use drugs and have
concurrent mental health issues. The results provide preliminary evidence that peer-based models of health services engagement for substance
users with mental health issues can be effective to address a major gap in Ontario HIV prevention efforts.
The Challenge: An important gap exists in HIV prevention for persons with concurrent substance dependence and mental health disorders.
Evidence suggests that individuals with these concurrent conditions are at an increased HIV risk (beyond either alone). For substance users,
mental health problems can interfere with behaviours that reduce the risk of HIV infection, including modifying drug use or practices, modifying
sexual behaviour, or both. Access to harm reduction services and mental health care are essential to reduce the risk of HIV transmission in this
population.
Our Approach: Starting in October 2008, we hired 12 Health Outreach Workers (HOWs) to participate in a 12-session training program to learn
key components of active listening and harm reduction and basic information about mental health. The training prepared them to provide
supportive counselling and referrals to clients of a needle exchange and crack/cocaine harm reduction program, and a women’s drop-in, at two
Toronto sites. After training, HOWs engaged with the target population, identified their instrumental and mental health/substance use-related
needs, and made appropriate referrals. To assess the HOW program, we evaluated the HOW process and effect of training and work on them, as
well as their impact on clients. Only data related to the HOWs are reported here.
Key Findings: Since training began, reports of marijuana and crack use among HOWs declined. Reports of HIV and Hepatitis C risk behaviours,
including lending and borrowing crack pipes, declined. The HOWs did not report syringe sharing before or after training. Among social support
measures, there was a significant increase in affectionate support. Among quality of life measures, physical functioning increased significantly by
post-training. Of the 12 initial participants recruited, 6 remain active in the program as HOWs; those not working as HOWs may continue doing
other peer work at the agencies involved.
Impact on Policy and Practice: Participants reported training as beneficial regardless of whether they continued to work in the program, and
half are continuing HOW work. This type of training and work is feasible and shows promise. Assessment of client impact and longer term
assessment of impact on the HOWs is necessary before expansion can be undertaken and broader policy recommendations made.
Contact Information: James Weaver, Tel: 416-978-5253, Email: p.millson@utoronto.ca
105
IMPLICATIONS OF MANDATORY HIV SCREENING AS PRE-CONDITION FOR IMMIGRATION TO CANADA
Laura M. Bisaillon 1
1-Population Health Ph.D. Programme, Faculty of Graduate and Post-Graduate Studies, University of Ottawa
Plain Language Summary: Mandatory serologic testing of all applicants for permanent residency to Canada was introduced in 2002. There was
no blanket HIV screening prior to this date (Hoffmaster & Schrecker 2001; Klein 2000) and the current HIV testing policy and its’ implications
have never been systematically documented. This presentation provides results of the first two research phases of a doctoral study in population

health; consisting of community consultations in Ontario and Québec and a review of bilingual, interdisciplinary literatures on HIV and
immigration.
The Challenge: The standpoint of the study is the everyday practices and knowledge of PHA mandatorily tested for HIV by Canadian
immigration. The study is an institutional ethnography (Smith 1990, 2006) that draws on the knowledge and experience with the mandatory
testing policy of four participant groups. The work critically examines the testing policy, situating it within broader socio-political contexts. The
study investigates and makes visible how immigration and health systems coordinate to influence applicants for permanent residency in overt and
covert ways.
Our Approach: The presentation is articulated as a polemic that explores tensions, contradictions and disjunctures that the testing policy presents
(and represents) by answering three questions informed by two research phases. 1) What implications does the policy have on migrants to
Canada? 2) Why is HIV tested for in the immigration medical examination? 3) What is the testing policy’s purpose? Results of community
consultations reveal that PHA, ASO and legal advocacy groups are interested in participating in the study and using results.
Key Findings: Initial results indicate that Canada is one of very few OECD countries to test applicants for HIV as a pre-condition of
immigration. Legal and cultural barriers created by restrictive immigration policies produce obstacles for men and women PHA and their
advocates. Careful examination of the Canadian testing policy reveals that an HIV diagnosis for applicants who are not exempted by their
immigration category and those taking ARVs are likely inadmissible. Canadian government arguments in favour of carrying out testing are cost
containment and domestic disease prevention. Yet, the policy’s goals are inferred rather than stated, which is inconsistent with effective public
health practice (Gostin & Mann 1991). Numerous questions arise about the public and population health messages this policy creates for resident
Canadians.
Impact on Policy and Practice: This study will produce policy advocacy research. It will be the first analysis of the testing policy as situated
within broader debates on social and health policy; responding to immanent critiques (Mykhalovskiy et al 2008) that qualitative research stretch
beyond the micro-politics of the interview setting. The work will produce nuanced awareness of how intersections between gender, health policy,
and migration influence the health of PHA. It will generate contextualized knowledge to be used in AIDS education, advocacy and policy.
Contact Information: Laura M. Bisaillon, Tel: 514 733 6545, Email: islandlaura@yahoo.com
106
“CRIMINALIZATION CREEP”: LEGAL DEVELOPMENTS AND COMMUNITY RESPONSES TO CRIMINAL PROSECUTIONS
FOR HIV EXPOSURE
Alison Symington 1 ; Richard Elliott 1 ; Sandra Ka Hon Chu 1
1-Canadian HIV/AIDS Legal Network
Plain Language Summary: The use of criminal prosecutions in response to those who are unwilling or unable to disclose their HIV positive
status is escalating. This research tracks the trends, analyzes the impacts, and informs strategic responses.
Objective: To track criminal charges for non-disclosure of HIV status, assess the impact of the increasingly expansive use of criminal law with
respect to HIV exposure, and develop an effective community response.
Methods: Review of primary legal sources, legal literature and media reports. Elaboration of plain language information sheets, policy briefs
and resources for advocates. Collaboration with community stakeholders and members of the legal community for knowledge transfer and
exchange and strategic advocacy.
Results: In 2008, several high-profile cases resulted in significant legal developments and re-ignited the public debate about criminal
prosecutions for HIV non-disclosure. The number of people living with HIV who are charged for not disclosing their HIV status to prospective
sexual partners has increased in the last four years. The severity of the charges and sentences has also increased, now including a first-degree
murder conviction. New issues, including the relevance of viral load and treatment, have arisen in recent trials.
Public policy is developing through the application of the criminal law by courts and prosecutors, largely in an evidentiary vacuum. Proponents
argue that such charges are justified on grounds of punishment and deterrence, and that they serve a prevention function. AIDS organizations
have expressed concerns that these prosecutions could undermine HIV prevention efforts and lead to greater public misunderstanding of HIV
transmission and the reality of living with HIV. Community members need to understand the implications of criminal prosecutions for nondisclosure
for their communities and their work. An informed community response is needed. Legal clarity through court decisions on key
issues and prosecutorial guidelines are needed.
Conclusions: There remains a need for research and informed policy discussions about the impacts of criminal sanctions for non-disclosure on
stigma and discrimination against people living with HIV and on HIV prevention efforts. Research and advocacy efforts towards rolling back the
“criminalization creep” are developing.
Contact Information: Richard Elliott, Tel: 416 595 1666, Email: relliott@aidslaw.ca

107
THE CRIMINALIZATION OF HIV NON-DISCLOSURE IN CANADA: A PRELIMINARY ANALYSIS OF TRENDS AND
PATTERNS
Eric Mykhalovskiy 1 ; Glenn Betteridge 5 ; Murray Jose 3 ; Angel Parks 4 ; Ryan Peck 7 ; Shannon Thomas Ryan 6 ; Alison Symington 2
1-Department of Sociology, York University; 2-Canadian HIV/AIDS Legal Network; 3-Toronto People With AIDS Foundation; 4-AIDS
Committee of Toronto; 5-Ontario Working Group on Crimnal Law and HIV Exposure; 6-Black Coalition for AIDS Prevention; 7-HIV/AIDS
Legal Clinic of Ontario
Plain Language Summary: We present an analysis of temporal, regional and demographic patterns in charges, sentences and other features of
criminal cases related to HIV non-disclosure in Canada and Ontario. Our analysis builds on data that the Canadian HIV/AIDS Legal Network has
compiled over the past several years.
The Challenge: There is currently no system for monitoring criminal charges related to HIV non-disclosure in Canada. We respond to that
problem with, what to our knowledge, is the first effort to systematically identify and analyze patterns in criminal charges for a national and
regional jurisdiction.
Our Approach: We identified 18 information fields for data collection including, amongst others, type and year of charge(s); province and city
of charge(s); sentence; sex, age, and race/ethnicity of accused/defendant(s); and whether the defendant was a same or opposite sex partner. We
identified cases and sought out information for our data fields through a range of databases and textual resources including Legal Network files,
Quick Law, Court websites, newspaper articles and Factiva.
Key Findings: We have identified 95 cases in which 89 individuals have been charged with offences related to HIV non-disclosure since 1989
(six individuals have been involved in two cases each). There is a clear trend toward intensification of criminalization with over 55% of cases
(n=50) occurring with the past five years. Criminal cases for HIV non-disclosure are also regionally concentrated: 44% of cases (n=42) have
occurred in Ontario. There is also a pattern of individual defendants facing multiple charges of either one or more criminal code offense. The
most common offense was aggravated sexual assault, with over 56% of cases (n= 54) involving at least one such count. Sentences have ranged
from 8 to 206 months of jail time.
The application of criminal charges for HIV non-disclosure in Canada is also patterned by gender, race and sexual orientation. Cases involving
Black male defendants (n=21 or 24% of defendants) are over-represented as a proportion of HIV infections in Canada. Women account for 9%
of defendants (n=8), while 12% of defendants (n=11) are gay men or men who have faced charges for HIV non-disclosure in situations involving
sex with men. Sixty-five cases (73%) involved charges related to non-disclosure that occurred in contexts of heterosexual sex.
Impact on Policy and Practice: The patterns we have identified suggest important areas of future advocacy work. They also invite explanation,
particularly though efforts that address the organization of policing and criminal justice at the interface of relations of gender, race and sexual
orientation.
Contact Information: Eric Mykhalovskiy, Tel: 416-736-2100 x66405, Email: ericm@yorku.ca
108
IMMIGRANT WOMEN’S EXPERIENCES WITH IMMIGRATION MEDICAL EXAMINATION HIV TESTING
Tamar Rubin 1 ; Wangari Tharao 2 ; Uitsile Ndlovu 2 ; Marvelous Muchenje 2
1-University of Toronto, Faculty of Medicine; 2-Women's Health in Women's Hands Community Health Centre
Plain Language Summary: Female African immigrants to Canada described their experiences with taking an HIV test during their mandatory
immigration medical examination (IME).
The Challenge: Although the policy of mandatory HIV testing for immigrants has been in place for over six years, individuals’ experiences with
testing have never been examined. This qualitative pilot study sought to elucidate black immigrant women’s experiences with mandatory
immigration medical exam (IME) HIV testing.
Our Approach: Semi-structured, in-depth interviews were conducted with 4 African women accessing services at Women’s Health in Women’s
Hands Community Health Centre (WHIWH), as well as a key informant. All women had undergone HIV testing through immigration. Interviews
were analyzed by content analysis to identify key themes.
Key Findings: All women in this study described “negative” experiences with testing. Pre-test factors shaping women’s experiences were prior
knowledge and understanding of HIV/AIDS, and anxiety associated with immigration in general. Intra-test issues shaping their experiences
included lack of understanding of why the IME was being done, lack of pre-test counseling, feeling rushed and anonymous, and subjective

factors. Post-test issues included lack of positive woman-centered counseling after the test, lack of appropriate referral mechanisms to resources,
and perceived breaches of confidentiality. Additionally, and surprisingly, immigrant women seemed to support universal HIV testing for
immigrants, as long as certain conditions were upheld.
Impact on Policy and Practice: Current IME HIV testing practices are suboptimal, but immigrants’ optimism regarding the policy suggests that
with improvements, the practice could become a constructive health promotion tactic. The results of this study formed the basis for
recommendations to WHIWH and might guide CIC on how to optimize service delivery to this unique subpopulation.
Contact Information: Tamar Rubin, Tel: 416-689-8047, Email: tamar.rubin@utoronto.ca
109
VIRAL HEPATITIS TESTING IS DEFICIENT IN HIV SEROPOSITIVE PATIENTS: AN OHTN COHORT STUDY ANALYSIS
Sandra Gardner 1 ; Curtis Cooper 2 ; Marek Smieja 3 ; Mona Loutfy 4 ; Colleen Price 6 ; Anita Rachlis 5 ; Veronika Moravan 1 ; Peggy Millson 7
1-Ontario HIV Treatment Network; 2-University of Ottawa The Ottawa Hospital-Division of Infectious Diseases; 3-Hamilton Health Sciences
Centre; 4-Women’s College Hospital & Maple Leaf Clinic; 5-Sunnybrook Health Sciences Centre; 6-Canadian Treatment Action Council; 7-
Dalla Lana School of Public Health
Plain Language Summary: Chronic infections with hepatitis B and C can cause severe illness and deaths among persons living with HIV. Both
are treatable, and hepatitis B is preventable with immunization. All persons with HIV should be tested for hepatitis B and C, and immunized if
needed. We studied whether participants in the OHTN Cohort Study (OCS) have been tested for hepatitis B and C. We found 43.2% of eligible
OCS participants tested for hepatitis B and 29.9% for hepatitis C within 6 months after their first recorded CD4 test.
Objective: To determine whether OCS participant records indicate testing for hepatitis B and C within the first 6 months of care.
Methods: First CD4 count was used as a marker of entry into clinical care. OCS participants with at least 2 CD4 tests were included. Proportion
tested within 6 months of follow up was estimated using Kaplan-Meier methods for Hepatitis B and C separately, excluding patients with a
positive test prior to first CD4 test. Time to first test was stratified by age, sex, country region of birth, baseline CD4 and risk factor for HIV and
compared using the log-rank test.
Results: 3181 participants were included: 86% males and 14% females. Median age: 37 ; 66% Canadian-born. Among males, HIV infection was
attributed to MSM for 71%, 10% MSM/IDU, 3% blood products, 4% HIV-endemic,13% other; for females: 36% heterosexual contact; 14% IDU;
5% blood products; 34% HIV-endemic, 12% other. For hepatitis B, 308 participants with positive tests prior to first recorded CD4 count were
excluded. For the remaining N=2873, 43.2% (41.4% to 45.0%) were tested within 6 months. For hepatitis C, 77 with positive results prior to first
CD4 count were excluded. For the remaining 3104, 29.9% (28.3% to 31.5%) were tested in the following 6 months Univariate analysis
suggested that Hepatitis B testing was correlated with sex (p=0.03) HIV risk (p=0.0004), region of birth (p=0.0021) and year of entry into care
(p

Methods: Subjects, 18 years and older, who were ART-naïve, normotensive, and not on antihypertensive therapy were enrolled into this
retrospective cohort study. ART-naïve subjects and those initiating for the first time were recruited; ART-initiation was restricted to after Dec.
31, 1998 and regimens were assumed to be taken throughout the study.
Hypertension was defined as a recorded diagnosis of hypertension or receiving antihypertensive therapy. Descriptive, univariable and
multivariable Cox regression analyses were performed and risk of incident hypertension estimated.
In multivariable Cox regression modeling, risk of hypertension was significantly associated with increasing age and current weight,
hyperlipidemia, and current CD4 count

Contact Information: Darrell Tan, Tel: 416-340-4800 x2240, Email: darrell.tan@gmail.com
112
PERIANAL BOWEN'S DISEASE IN HIV-INFECTED MEN WHO HAVE SEX WITH MEN
Jill Tinmouth 1,2 ; Valentina Peeva 6 ; Marie Sano 6 ; Christina Diong 3 ; Janet Raboud 3,4 ; Alice Lytwyn 7,8 ; Irving Salit 2,6
1-Department of Medicine, Sunnybrook Health Sciences Centre; 2-Department of Medicine, University of Toronto; 3-Samuel Lunenfeld
Research Institute; 4-Dalla Lana School of Public Health; 5-Department of Medicine, University of Toronto; 6-Department of Medicine,
University Health Network; 7-Division of Anatomic Pathology, Department of Pathology and Molecular Medicine, McMaster University; 8-
Department of Laboratory Medicine, Henderson Hospital
Plain Language Summary: In a large group of HIV-infected men who have sex with men (MSM) being screened for anal cancer, 7% had high
grade precancerous changes of the external anus, called Bowen's disease. Anal cancer developed in 18% of those with Bowen's disease. Persons
who were younger at age of first intercourse, who were previously diagnosed with anal cancer, who had AIDS or those with a specific appearance
to their Bowen's disease were more likely to get anal cancer.
Objective: Perianal high-grade anal intraepithelial neoplasia, Bowen's disease, progresses to anal cancer in 2-6% of the general population. Little
is known about the natural history of Bowen's disease in HIV+ men MSM The objectives were 1) to describe the characteristics of HIV+ MSM
with Bowen's disease and 2) to determine factors associated with progression to anal cancer.
Methods: We identified patients with Bowen's disease from among 550 HIV+ MSM who were screened for anal cancer. We collected
information on demographics, HIV illness, HPV, lesion appearance, treatment and Bowen's disease progression to anal cancer. Univariate
analyses were done to compare subjects who did and did not develop anal cancer.
Results: Bowen's disease occurred in 38 (7%). Median (range) age, HIV duration and CD4 count were 48 (31-63), 18 (1-27) years and 327 (40-
780) cells/mm3. Seventy seven percent (27/30) had undetectable viral loads and 69% (22/32) were past/current smokers. Internal AIN 2/3 was
found in 82% (31/38) and 100% (36/36) were positive for oncogenic HPV types. Anal canal cytology showed HSIL in 13/35 (37%). Lesions
were pigmented in 50%, pink in 71%, raised in 63% and ulcerated/eroded in 18%. Bowen's disease was treated with imiquimod (79%), local
excision (26%) and thermocoagulation (8%). A second biopsy was done in 29; 72% had persistent disease. Anal cancer developed in 18% (7/36)
over the course of the study. In two patients, this represented cancer recurrence. Factors associated with developing anal cancer included
younger age at first intercourse (p=0.04), previous anal cancer (p=0.02), and diagnosis of AIDS (p=0.04). Lesion appearance (granular, raised
and ulcerated/erosion) was associated with the development of anal cancer.
Conclusions: Because it is common, HIV+ MSM should be screened for Bowen's disease. Bowen's disease is difficult to eradicate and
progressed to invasive AC in a high proportion of our sample. Patients with high risk features for anal cancer should be considered for wide
surgical excision.
Contact Information: Jill Tinmouth, Tel: 416 480-5910, Email: jill.tinmouth@sunnybrook.ca
113
DISORDERED EATING, BODY IMAGE AND SEXUAL RISK AMONG GAY AND BISEXUAL MEN
David Brennan 1 ; Rory Crath 1 ; Trevor Hart 2 ; Tahany Gadalla 1
1-Factor-Inwentash Faculty of Social Work, University of Toronto; 2-Department of Psychology, Ryerson University, Toronto
Plain Language Summary: Gay and bisexual men (GBM) attending Toronto’s 2008 LGBT Pride (n=383) reported high levels of disordered
eating symptomatology (DES) which was associated with barbiturate use, behaviours designed to increase muscularity and a history of childhood
sexual abuse (CSA). Although 1 in 5 men reported sexual risk, DES was not associated with sexual risk.
Objective: The study's purpose was to examine the prevalence of and the association between body image, DES and sexual risk among a racially
diverse (40% non-White) sample of GBM attending Toronto’s 2008 LGBT Pride Festival.
Methods: A cross-sectional survey was administered among GBM attending Toronto’s 2008 Pride Festival. Chi-square and ANOVA tests were
used to examine associations between variables. Logistic regression was conducted to determine whether education, age, race, HIV status,
depression, internalized homonegativity, idealized body image, behaviours to increase muscularity, body mass index (BMI) and sexual risk were
likely predictors of disordered eating symptomatology, measured by the Eating Attitudes Test (EAT-26). A score above 20 is considered potential
risk for DES
Results: Among the sample, 40% identified as non-Caucasian, most (83%) had some college education, 14% were HIV-positive and 48% were <
30 years of age. Sexual risk was reported by 21% of respondents. DES was reported by 14% of respondents. Bivariate analyses showed that DES

was associated with less education, younger age, alcohol use during sex, barbiturate use, internalized homonegativity, depression, an idealized
body image, engaging in behaviours to increase muscle mass and a history of CSA. Results of the logistic regression model indicated that those
who had experienced CSA were twice as likely to report DES as those who did not report CSA (OR 2.04, 95% CI 1.07, 3.90). Those who
reported barbiturate use were 2.7 times more likely to report DES (OR 2.70, 95% CI 1.15, 6.33). Those who reported more behaviours related to
increasing muscle mass were 11% more likely to report DES (OR 1.11, 95% CI 1.05, 1.18).
Conclusions: These findings suggest that one in seven GBM are at risk for disordered eating behaviours and attitudes, and this does not appear to
be associated with sexual risk, age, race, HIV status, BMI, internalized homonegativity, depression or alcohol use. GBM who have experienced
CSA, are current barbiturate users and are working to increase muscle mass may be at risk for DES. Further research is needed to explore the
relationships between childhood sexual abuse, behaviours designed to increase muscularity, barbiturate use and DES
Contact Information: David Brennan, Tel: 416-978-3273, Email: david.brennan@utoronto.ca
114
TOWELTALK: A BRIEF COUNSELLING PROGRAM FOR MEN USING BATHHOUSES
Roy Cain 1 ; Jessica Cattaneo 2 ; Jim Cullen 3,4 ; Le-Ann Dolan 2 ; Trevor Hart 5,6 ; Daniel Lee 7 ; Leo Mitterni 8 ; James Murray 9 ; Marco Posadas 2,10
1-School of Social Work, McMaster University; 2-AIDS Committee of Toronto; 3-Centre for Addiction and Mental Health; 4-Factor-Inwentash
Faculty of Social Work, University of Toronto; 5-Department of Psychology, Ryerson University; 6-Dalla Lana School of Public Health,
University of Toronto; 7-Asian Community AIDS Services; 8-Hassle Free Clinic; 9-Ontario Ministry of Health and Long-Term Care, AIDS
Bureau; 10-Toronto Institute of Psychoanalysis
Plain Language Summary: TowelTalk is a pilot project that places a professionally trained counsellor in four of Toronto’s male bathhouses.
Our presentation focuses on the development of this innovative intervention and the preliminary findings of our evaluation of the effectiveness of
TowelTalk to assist men in addressing the psychosocial issues that impact their sexual health.
The Challenge: The challenge was to develop an effective counselling intervention for a bathhouse environment. This pilot project is a
collaborative effort between several organizations involved in HIV support services and prevention. Since April 2009, a professionally trained
counsellor has offered bathhouse patrons anonymous and brief counselling (10 to 45 minute sessions), as well as referrals to other health and
social services. When a need is identified, the counsellor also provides short-term follow-up counselling (up to 8 sessions) at a community-based
organization.
Our Approach: While there is research evidence to support the implementation of a project of this kind, the effectiveness of counselling in a
bathhouse to assist men in addressing the psycho-social issues that impact their sexual health is not known. The mixed method evaluation
component of TowelTalk seeks input from various perspectives about the development and effectiveness of this intervention.
Key Findings: Drawing from the first six months of our evaluation of TowelTalk we are able to show a good deal of support for a counselling
program in Toronto’s male bathhouses. Bathhouse patrons are indeed accessing the counselling service. The issues discussed in counselling
expand on and differ from the concerns patrons bring to bathhouse outreach workers and volunteers. Guilt and shame associated with the
bathhouse, relationship issues, loneliness and isolation, and homophobia are the most common themes addressed in the counselling sessions.
Other recurring themes include: immigration/settlement, anxiety/stress, family issues, and sexual identity.
Impact on Policy and Practice: Providing a mental health intervention in a highly sexualized environment is challenging. The TowelTalk pilot
and its evaluation will contribute to a growing body of work relating to HIV support programs and prevention interventions that engage with the
broader psychosocial issues that impact the sexual health of gay, bi, and other MSM. The possibility of working with men in a setting that does
not appear conducive to counselling can shed light on how to reach men that would not access services in another way. This work also allows us
to examine the important role bathhouses play in forming social networks for gay, bi, and other MSM in Toronto.
Contact Information: Jessica Cattaneo, Tel: 416 340-8484, ext. 251, Email: jcattaneo@actoronto.org
115
QUALITATIVE FINDINGS FROM THE HEALTH IN MIDDLESEX MEN MATTERS (HIMMM) PROJECT
Todd Coleman 3 ; Daniel Pugh 1 ; Gloria Aykroyd 2 ; Shamara Baidoobonso 3 ; Greta Bauer 3 ; Mark Defend 2 ; Paul McCarty-Johnston 1 ; Rob
Newman 1
1-AIDS Committee of London, London, Ontario; 2-St. Joseph's Infectious Diseases Care Program, London, Ontario; 3-The University of
Western Ontario, London, Ontario
Plain Language Summary: The Health in Middlesex Men Matters Project examines impacts of homophobia, social exclusion, and
communication relating to HIV and health care within gay, bisexual and other men who have sex with men communities of Middlesex County.

Twenty stakeholder interviews helped identify knowledge gaps related to these factors. Results will be used to design a survey and to guide future
HIV prevention efforts.
The Challenge: In 2006, the AIDS Committee of London (ACOL) held a LGBT2SQ Health Forum in London, Ontario to initiate discussion
around health concerns in local LGBT2SQ communities. Three topics emerged: homophobia (internal and external); isolation and social
exclusion; and communication. Little data pertaining to gay, bisexual, and other men who have sex with men (GB-MSM) communities is
available to guide prevention work locally. The Health in Middlesex Men Matters (HiMMM) Project was borne from the Forum to examine
individual/collective impacts of these factors on HIV and health care within regional GB-MSM communities.
Our Approach: Twenty (20) interviews with community members and service providers were undertaken to identify knowledge gaps related to
aforementioned factors. GB-MSM were identified using purposive sampling based on characteristics including age, ethnicity, HIV status,
geographical dispersion, and sexual orientation. Service providers were selected based on their occupations. Interview transcripts were analyzed
using modified grounded theory and NVivo 7.0.
Key Findings: Interviews occurred over six months. Participants’ ages ranged from 17 to 76. Interacting with service providers, GB-MSM were
uncomfortable speaking about sexual health, and felt sexual orientation should only be disclosed if relevant to the issue at hand. The Internet was
commonly used for meeting other GB-MSM and acquiring health information. Men accessed HIV testing through sources other than primary
caregivers (e.g. sexual health clinics). Sex was seen as an important component of health and wellness. Self-defined risky behaviour was
common. Participants believed doctors should be more inclusive when providing care, and women had less difficulty accessing social services.
Many participants believed ACOL was an important health and support resource for GB-MSM. Gay nightclubs and bars were seen as prominent
social bases in the community, despite participants rarely attending these. Respondents relayed that although GB-MSM friends are important,
they are difficult to make.
Impact on Policy and Practice: Interview findings will formulate a quantitative survey delivered to local GB-MSM communities through
respondent-driven sampling. Results from qualitative and quantitative phases of the HiMMM Project will guide local prevention efforts and be
utilized to press for greater focus on sexual orientation diversity in local service provider curricula.
Contact Information: Daniel Pugh, Tel: 519-614-5697, Email: todd.coleman@schulich.uwo.ca
116
DEVELOPING A COORDINATED RESEARCH AGENDA FOR ETHNO-RACIAL MEN WHO HAVE SEX WITH MEN IN
ONTARIO
Alan Li
1,2,6 ; Barry Adam 1,3 ; Jason Globerman 1 ; James Murray 4 ; Devan Nambiar 2,7 ; Maurice Poon 5 ; Haile Fenta 1
1-Ontario HIV Treatment Network; 2-Committee for Accessible AIDS Treatment; 3-University of Windsor; 4-AIDS Bureau, Ontario Ministry of
Health and Long Term Care; 5-York University; 6-Regent Park Community Health Centre; 7-Rainbow Health Ontario, Sherbourne Health Centre
Plain Language Summary: To generate community relevant evidence to inform HIV prevention programs amongst ethno-racial MSM
communities, a multi-stakeholder research working group undertook multi-pronged strategies to engage affected communities to identify
culturally specific and collaborative research agenda. Key priorities were identified and committed partnerships were fostered through this
process to advance evidence based policy and program development.
The Challenge: HIV infection rate has been steadily increasing in all ethno-racial MSM populations in Ontario since 2003, but there is still a
continual gap of adequate evidence based data from these communities to guide HIV prevention work. The AIDS Bureau Ethno-racial MSM
Research Working group (EMSM-WG) was set up in 2005 to foster community driven research to bridge this gap. However, the unique and
complex social, cultural, political and community infrastructural issues affecting each communities resulted in further disparities on both the
readiness to engage and production of research evidence.
Our Approach: Using a multi-pronged community based action research approach, the EMSM-WG undertook several initiatives to facilitate the
development of a coordinated research agenda for Ethno-racial MSM in Ontario. These include a research study involving 10 frontline
prevention workers and 72 ethno-racial MSM from 6 ethno-racial communities to identify factors affecting risk taking behaviors and evidence
gaps; a literature review on recent prevention interventions; ethno-specific planning sessions to identify community specific research needs; and a
multicultural, multi-sectoral think tank of stakeholders from communities, researchers and policy makers for agenda identification and
coordinated planning.
Key Findings: Each of the ethno-racial communities identified both unique and overlapping concerns with others. All groups recognized the
need to pay individuating attention in research in order to meaningfully understand the complexities affecting the diversities within their own
communities, especially older MSM, newcomers, youth, long-term survivors, and women in relationship with non-gay identified MSM. All
groups called for study that further investigates the intersections of racism and homophobia and better evaluation strategies on current prevention
programs. All expressed interest and readiness to engage in intervention research informed by a richer understanding of the identities, attitudes,
knowledge and behaviors that influences risks and resiliencies, both quantitatively and qualitatively.
Impact on Policy and Practice: The elaborate community based research agenda development processes provided an evidence-informed,
culturally relevant, community responsive framework to enable diverse cultural communities to identify unique and collaborative research
agenda. Key priorities were developed with committed partners identified to follow up on a collaborative research agenda to advance evidence
based programming.

Contact Information: Devan Nambiar, Tel: 416-364-2261, Email: alanli@sympatico.ca
117
HIV-HCV CO-INFECTION SERVICE IN ONTARIO: AN EVALUATION OF RESOURCES AND DEFICIENCIES
Curtis Cooper 1,2 ; David Mackie 2 ; Jason Globerman 3 ; Peggy Millson 4 ; Adriana Carvalhal 5
1-University of Ottawa; 2-The Ottawa Hospital Division of Infectious Diseases; 3-Ottawa Ontario HIV Treatment Network, Toronto; 4-Dalla
Lana School of Public Health, University of Toronto; 5-Dept of Psychiatry & Behavioural Neurosciences McMaster University, Hamilton
Plain Language Summary: Providing the best care for people living with HIV-HCV co-infection (CI) is limited by many factors. Few
healthcare services specifically address CI care. Determining what services are available and identifying missing resources is essential to
providing the best care for individuals living with CI.
Objective: The services available and resources that are lacking for HIV-HCV co-infected individuals in Ontario were assessed.
Methods: A survey of CI care, treatment and support services available across Ontario was developed and administered via e-mail to individuals
and organizations providing services for HIV and HCV including AIDS service organizations, community clinics, hospital–based sites and
governmental agencies. To increase the sample and breadth of expertise surveyed, contacts were asked to forward the survey to additional
individuals within their workplace providing HIV and/or HCV services. Survey Monkey was utilized to capture and tabulate responses.
Results: 101 responses were evaluated in this analysis. Respondents identified these key CI management services as essential but limited in
availability: mental health treatment (33%), addictions treatment (30%), social worker expertise (26%), community housing services (25%), peer
support groups (24%), methadone maintenance therapy (23%), and correctional services engagement (21%). Respondents were satisfied with
their access to MD expertise (76%), needle exchange programs (76%), Haemophilia Society support (73%), nurse expertise (72%), HIV drug
treatment expertise (71%), pharmaceutical company financial support (71%), HCV drug treatment expertise (70%), AIDS support services
(66%), street youth support services (65%), primary care support (63%), Aboriginal support services (62%), and MOH financial support (62%).
Key missing clinic expertise included: hepatology (84%), psychology (84%), family doctor (69%), psychiatry (66%), and social worker (55%).
71% of respondents lack a CI peer support network.
Conclusions: A better understanding of the CI service landscape in Ontario is needed to resource a more integrated approach to treatment and
support services. Recommendations informed with this perspective will contribute to a more comprehensive and multidisciplinary approach to
care for individuals living with CI. Work to this end is ongoing.
Contact Information: Curtis Cooper, Tel: 613-737-8924, Email: ccooper@ottawahospital.on.ca
118
A MULTI-DISCIPLINARY APPROACH TO THE DEVELOPMENT OF CANADIAN EVIDENCE-BASED GUIDELINES ON SAFE
PREGNANCY PLANNING FOR HIV-POSITIVE INDIVIDUALS
Shari Margolese 1 ; Mona Loutfy 1,2 ; Mark H. Yudin 2,3 ; Saira Mohammed 1 ; Joanna Wong 1 ; Heather Shapiro 2,4 ; Matt Gysler 5 ; NHPPG
Development Team 1
1-Women’s College Hospital,Toronto, Canada; 2-University of Toronto, Toronto, Canada; 3-St. Michael’s Hospital, Toronto, Canada; 4-Mount
Sinai Hospital, Toronto, Canada; 5-ISIS Regional Fertility Centre, Mississauga, Canada
Plain Language Summary: Improvement in life expectancy and quality of life for HIV-positive individuals coupled with reduced vertical
transmission has led numerous HIV-positive individuals to consider becoming pregnant. However, attempts at pregnancy planning in the setting
of HIV carry the risk of horizontal transmission. Currently, guidelines exist to guide the management of HIV-positive women during pregnancy;
however, no such guidelines exist to assist HIV-positive individuals to conceive safely.
Objective: Our objectives were to comprehensively evaluate the relevant literature and derive evidence-based guidelines for safer pregnancy
planning and conception for HIV-positive individuals based on a multi-disciplinary, community-based, justice-based and evidence-based
approaches.
Methods: A multi-disciplinary team of national experts was identified to form a National HIV Pregnancy Planning Guideline Development
Team. Linkages were made with the Canadian Fertility and Andrology Society (CFAS) via a presentation to the CFAS, Society of Obstetricians
and Gynaecologists of Canada (SOGC), and the Assisted Human Reproduction Canada (AHRC) Tripartite committee. A literature review was
undertaken to identify published manuscripts and presented abstracts relevant to pregnancy planning, conception and fertility for HIV-positive
individuals. Preliminary guidelines were drafted based upon principles outlined in the Appraisal of Guidelines Research & Evaluation (AGREE)
Instrument. The development team met during four teleconferences and one in-person meeting to initiate discussion on specific sections of the
guidelines and begin to develop consensus on the grading of the evidence and recommendations.

Results: A guidelines development team of over fifty Canadian experts including clinical HIV experts, fertility experts, obstetricians, midwives,
pediatricians, community members and policy advisors were assembled for an in-person meeting. A consensus was built on the guidelines
conceptual framework, objectives, target audience, issues not to be addressed, and methods and grading for the guidelines. An in-depth discussion
took place on the topics of legal and ethical issues, psychosocial and mental health issues, ensuring a healthy mother, child and family, ARVs &
other drugs in pregnancy planning, options for reducing risk of horizontal HIV transmission during conception, fertility issues in the setting of
HIV and HIV infection control in fertility clinics.
Conclusions: National guidelines on pregnancy planning for HIV-positive individuals are important to the community and are in the process of
development through linking key national stakeholders from diverse areas of expertise.
Contact Information: Shari Margolese, Tel: 905-334-2072, Email: shari.margolese@rogers.com
119
THE ENGAGING PHYSICIANS PROJECT: IS TO ASSIST GENERAL PRACTITIONERS (GPS) IN CREATING A NON-
JUDGMENTAL AND WELCOMING CLINICAL ENVIRONMENT; TO ALLOW FOR THE SAFE DISCLOSURE OF SEXUAL
PRACTICES AND HEALTH CONCERNS OF MEN WHO HAVE SEX WITH MEN.
Daryle Roberts 1 ; Kevin Saya-Moore 2
1-Executive Director, Living Positive Resource Centre, Kelowna, British Columbia; 2-Project Coordinator: Engaging Physicians Project, Living
Positive Resource Centre, Kelowna, British Columbia
Plain Language Summary: The sexual behaviour of non self-identifying MSM (NIMSM) differs significantly from that of MSM who have a
strong gay identity, with the former being more likely to engage in high-risk activities (Centre for AIDS Prevention, 1995, Graydon, 1998,
Aggleton, Davies & Hart, 1992). NIMSM fear the stigma of homosexuality, particularly for those living in rural areas (Preston, D’Angelli, Cain
& Schulze, 2002); as a result, NIMSM practice a level of anonymous behaviour that renders them all but invisible to the larger community, and
insulates them from traditional prevention programs. Effective prevention strategies for NIMSM must take these behavioral differences into
account, and must include provisions for reaching their partners as well.
Objective: Goal 1: Increase the number of General Practitioners (GPs) within the Interior Health Region that report an increased awareness,
knowledge, and understanding of the health needs of Men who have Sex with Men (MSM.
Goal 2: To increase educational resources for GP and other health care practitioners (regarding the sexual health of Men who have Sex with
Men.)
Methods: Physician Consultation Document was mailed to physicians in each area of the Interior Health Authority. 655 Consultation Tools for
General Practitioners were sent out to a convenience sample and 113 responses were received.
Community Conversation Tool: Questionnaire sent out via email list serves, posted on Project website and referenced in adverts in print media to
elicit feedback from community.
Results: Some responses to the Physician Consultation Tool named above indicated 68% of GPs state they do not have appropriate referrals for
their G/Bi/MSM patients and 13% are not sure if they have appropriate referrals.
Conclusions: By March 2010, the project will:
- Design and pilot one (1) draft Toolkit (including Interior Health Logo) for reducing stigma towards GLBTQ.
- Design and Pilot one (1) focus group to gather feedback on Toolkit and Professional Development Workshop for GPs and other health care
professionals.
- Hold five (5) grand rounds in Nelson, Penticton, Kelowna, Vernon, and Kamloops (with presentation and/or video podcasts).
- Design and pilot one (1) professional development workshop (i.e. curriculum and manual for facilitator/participants).
- Obtain CME credits for Professional Development workshop.
Contact Information: Kevin Saya-Moore, Tel: 1-250-862-2437 ext. 105, Email: ksaya-moore@lprc.ca
120
THE EXPERIENCES OF ONTARIO HIV-DISCORDANT COUPLES (MALE POSITIVE, FEMALE NEGATIVE) IN SEEKING
SPERM WASHING FERTILITY SERVICES.
Sandy Tecimer 1 ; Denise Jaworsky 1 ; Trent Newmeyer 2 ; Stephen Chihrin 3 ; Kevin Gough 4 ; Anita Rachlis 5 ; James Martin 6 ; Saira Mohammed 1 ;
Mona Loutfy 1

1-Women and HIV Research Program, Women’s College Research Institute; 2-Department of Recreation and Leisure Studies, Faculty of Applied
Health Sciences, Brock University; 3-Department of Medicine, University of Western Ontario; 4-Department of Medicine, Division of Infectious
Diseases, St. Michael’s Hospital, University of Toronto; 5-Department of Medicine, Division of Infectious Diseases, Sunnybrook Health Sciences
Centre, University of Toronto; 6-SOFT, Southern Ontario Fertility Technologies, London, Ontario
Plain Language Summary: As people living with HIV (PLWH) have improved life expectancy and quality of life (QoL), there are growing
needs for pregnancy planning options that reduce horizontal transmission risk. Sperm washing is an assisted reproductive technology (ART)
where sperm is isolated from semen in a controlled laboratory environment that aims to eliminate HIV before transferring it to the female partner.
One application of this technique is for HIV-discordant couples where the male is HIV-positive and the female is HIV-negative. This qualitative
study examines the experiences of such couples in accessing sperm washing services in Ontario. Key findings were that access, knowledge of
services, desire to have children and stigma influenced the experiences of these couples.
The Challenge: There is an increasing need to evaluate fertility options available for PLWH. An estimated 63,000 individuals in Canada live
with HIV, the majority being of reproductive age. With improved antiretroviral therapy, prolonged life expectancy and improved QoL,
pregnancy planning has become an important consideration for many PLWH.
Sperm washing is an ART that employs centrifugation techniques to isolate sperm from semen, which can then be used for intrauterine
insemination or in-vitro fertilization. This technique has been used in many HIV-discordant couples (male positive, female negative) in Europe
and North America with no reported cases of HIV transmission. However accessibility and uptake in Canada has been limited as is information
about the experiences of couples pursuing this option.
Our Approach: We present the results of a study that examined the qualitative experiences of HIV-discordant couples (male positive, female
negative) who sought sperm washing services in Ontario. Twelve couples consented to a chart review and to undergo a semi-structured interview
that asked about their experiences with sperm washing and other fertility services. Interviews were transcribed and underwent thematic analysis
using NVivo.
Key Findings: Key issues that emerged included: barriers to access of fertility services (lack of clinics performing sperm washing for PLWH,
cost, travel and time required), limited availability of information about ART for HIV populations, individual and cultural desire for biologic
children, stigma (related to HIV disclosure, use of fertility services), and limited support networks.
Impact on Policy and Practice: Access to sperm washing and fertility services for HIV-discordant couples may be increased by addressing
issues such as limited clinics providing services, inadequate support networks, lack of patient and service provider knowledge, and lack of
financial and educational resources.
Contact Information: Sandy Tecimer, Tel: 416.351.3732 x.2324, Email: stecimer@rogers.com
121
INTERLEUKIN-4 DOWNREGULATES CD127 EXPRESSION ON HUMAN THYMOCYTES AND MATURE CD8+ T-CELLS
Angela M. Crawley 1,2 ; Agatha Vranjkovic 1 ; Charlene Young 1,2 ; Jonathan B. Angel 1,2,3
3-Division of Infectious Diseases, Ottawa Hospital-General Campus, Ottawa, Canada; 1-Department of Molecular Medicine, Ottawa Hospital
Research Institute; 2-Department of Biochemistry, Microbiology and Immunology, University of Ottawa
Plain Language Summary: The development and survival of T-cells is dependent upon signalling via the IL-7 receptor alpha chain (CD127)
which forms a complex with the IL-2R gamma chain shared by other receptors for cytokines (IL-2,-4,-9,-15 and -21). Decreased CD127
expression has been correlated with persistent vireamia in HIV, EBV, CMV and HCV infections. Expression of CD127 is downregulated by IL-7.
Members of the IL-2 receptor gamma-sharing cytokine family share roles in promoting T-cell proliferation and survival, and it is possible that
CD127 downregulation is a common function amongst these cytokines in humans as in mice. Of particular interest is IL-4 which is upregulated in
HIV infection and is a strong promoter of Th2 responses, which are inefficient in the clearance of viral infections.
Objective: This study investigates the role of IL-4 in regulating CD127 expression in thymocyte subsets and mature CD8+ T-cells and its impact
upon IL-7 activity in vitro.
Methods: Thymocytes and CD8+ T-cells were isolated and cultured using established methods. Cells were stimulated with IL-4 and CD127
expression was analyzed by flow cytometry and mRNA transcript expression was measured by PCR. To assess the effect on IL-7 signalling and
activity, cells were pre-treated with IL-4 and then stimulated with IL-7. Signalling (phospho-STAT-5) and cell proliferation were measured by
flow cytometry.
Results: In thymocytes, IL-4 progressively decreased CD127 expression on CD3+ double positive (DP) and single positive CD4 (SP4)
thymocytes, while a much delayed decrease was observed on single positive CD8 (SP8) thymocytes. In mature CD8+ T-cells, the downregulation
of CD127 expression by IL-4 occurred exclusively on naïve (CD8+CD45RA+) T-cells in cultures of PBMCs or isolated CD8+ T-cells. This
effect was also delayed until 48 hrs. IL-4 did not alter the expression of mRNA transcripts encoding the membrane-bound form of CD127. Pretreatment
of thymocytes or CD8+ T-cells with IL-4 inhibited IL-7-mediated phosphorylation of the STAT-5 signalling molecule and decreased
proliferation of mature CD8+ T-cells.

Conclusions: These results indicate that, similar to IL-7, IL-4 downregulates CD127 expression on developing thymocytes and mature CD8+ T-
cells, however distinct subset and kinetic differences were observed. Furthermore, it has been shown that the presence of IL-4 is a functional
impediment to IL-7 activity. These findings are of particular consequence to diseases such as HIV, and potentially other immunodeficiency
diseases, in which CD127 expression is decreased, IL-7 activity is impaired and IL-4 concentrations are elevated. Furthermore, this data
implicates IL-4 as a potential contributor to decreased IL-7 activity and the progressive loss of CD8+ T-cell function in HIV infection.
Contact Information: Angela M. Crawley, Tel: 613-737-8673, Email: acrawley@ohri.ca
122
JAK/STAT SIGNALING MEDIATES REGULATION OF IL-7R EXPRESSION ON CD8 T CELLS BY BOTH TRANSCRIPTIONAL
AND NON-TRANSCRIPTIONAL MECHANISMS.
Elliott Faller 1 ; Feras Ghazawi 1 ; Paul MacPherson 1,2
1-Ottawa Hospital Research Institute, Ottawa, Canada; 2-Division of Infectious Diseases, Ottawa Hospital, Canada
Plain Language Summary: IL-7 signaling is important for CD8 T cell homeostasis, development, survival, proliferation, activation and
cytolytic functions. The fact that IL-7 signaling is so important to CD8 T cells suggests that IL-7 signaling may be impaired in HIV patients who
have poor CD8 T cell function and poor control of viral infection. Our lab has shown previously that IL-7R expression in indeed suppressed in
HIV+ patients. In order to understand the mechanism(s) of impaired IL-7 signaling in HIV+ patients, we are investigating the mechanism(s) that
IL-7 employs to control receptor expression in CD8 T cells.
Objective: To characterize signaling pathways triggered by IL-7 in primary CD8 T cells, and how they relate to regulation of the IL-7 receptor
(CD127).
Methods: CD8 T cells from healthy donors were incubated with various concentrations of IL-7 (10-10 000 pg/ml) over a duration of 30 minutes
to 72 hours in the presence and absence of inhibitors as indicated. CD127 expression and STAT3/5 activation were determined at by flow
cytometry and CD127 transcripts were analyzed by real time PCR.
Results: As expected, IL-7 does signal through the JAK/STAT pathway in primary CD8 T cells through phosphorylation of STAT5. STAT5p
correlated to CD127 surface expression levels and co-incident with increased intracellular Bcl-2. Interestingly, we found no evidence of IL-7
induced STAT3p. STAT5p was detected in the presence of relatively low levels of IL-7, with increasing STAT5p detected from 5-50 pg/ml IL-7
but only slight additional increased STAT5p from 50-10 000 pg/ml. Interestingly, low levels or IL-7 (below 100 pg/ml) were found to produce
small, transient decreases in IL-7 receptor expression at the cell surface by flow cytometry with full recovery by 24 hours. This pattern of surface
expression was coincident with transient STAT5p over 24 hours with low concentrations of IL-7 (50-250 pg/ml) and higher concentrations (1-
10ng/ml) of IL-7 sustaining STAT5 signaling for up to 72 hours. After 12 hours of incubation of IL-7, CD127 transcripts and surface expression
decreased with increasing amounts of IL-7 in a dose dependant manner (0.1-10 ng/ml). This downregulation was completely inhibited by preincubation
with a JAK inhibitor that prevented STAT5 phosphorylation.
Conclusions: IL-7 regulation of CD127 surface expression is mediated by activation of the JAK/STAT pathway. While lower levels of IL-7
appear to be sufficient to cause rapid, transient levels of IL-7 receptor down regulation, increasing amounts of IL-7 also have a significant
suppressive effect on the transcription of CD127 and are required for sustained suppression of CD127 surface expression. We suggest that
regulation of IL-7R expression by IL-7 is thorough both transcriptional and non-transcriptional mechanisms.
Contact Information: Elliott Faller, Tel: 613-864-3414, Email: efaller@ohri.ca
123
THE ROLE OF IL-7 IN THE SURVIVAL AND FUNCTION OF MEMORY CD8+ T CELLS IN HEALTH AND HIV DISEASE
Alison M. O'Connor 2 ; Angela M. Crawley 1,2 ; Jonathan B. Angel 1,2,3
1-Ottawa Hospital Research Institute, Ottawa, Canada; 2-Department of Biochemistry, Microbiology, and Immunology, University of Ottawa,
Ottawa, Canada; 3-Division of Infectious Diseases, Ottawa Hospital-General Campus, Ottawa, Canada
Plain Language Summary: Memory CD8+ T cells proliferate and gain effector function in response to stimulus with antigen. It is possible that
IL-7 may enhance antigen-mediated CD8+ T cell recall responses, since IL-7 is required during a primary immune response. During HIV
infection, CD8+ T cell function and IL-7 activity is impaired, and this could be due to the down-regulation of the IL-7 receptor (CD127) or
reduced IL-7 responsiveness of CD8+CD127+ T cells.
Objective: In the present study, the effect of IL-7 on antigen-mediated proliferation and function of memory CD8+CD127+ T cell subsets will be
evaluated in healthy and HIV-infected individuals.
Methods: CD8+ T cell-depleted peripheral blood mononuclear cells were pulsed with a peptide pool (CMV, EBV, influenza), and co-cultured
with autologous memory CD8+ T cells (CD45RA-CCR7+/-) in the presence or absence of IL-7 (1-50ng/ml). Cellular function (IFN-γ and

CD107a/CD107b) was measured after 6 hours of co-culture, and cell division was analyzed after six days of co-culture by flow cytometry
(CFSE).
Results: In healthy individuals, antigen stimulation increased the proliferation of memory CD8+ T cells in the TCM and TEM subsets compared
to unstimulated cells, and IFN-γ production was increased in the TEM and TEMRA subsets. The addition of IL-7 further enhanced antigenmediated
proliferation in the TCM and TEM subsets in a dose-dependent manner. IL-7 did not significantly alter antigen-mediated CD107a/b
expression or IFN-γ production. In HIV-infected individuals, memory CD8+ T cells did not significantly proliferate or produce IFN-γ in response
to antigen, and IL-7 did not further enhance antigen-mediated proliferation of the memory CD8+ T cells.
Conclusions: The presence of IL-7 increases antigen-mediated proliferation, but has a lesser role in other functions of memory CD8+ T cells in
healthy individuals. There is increasing evidence that impaired IL-7 responses are a feature of decreased memory CD8+ T cell function in
progressive HIV infection. This data indicates that decreased IL-7 responsiveness in HIV infection is not only due to decreased CD127
expression but an inherent impairment of memory CD8+CD127+ T cells. These findings are relevant to the ongoing studies of HIV pathogenesis
and of IL-7 as a therapeutic in HIV infection and other diseases.
Contact Information: Alison O'Connor, Tel: (613) 737-8160, Email: alioconnor@ohri.ca
124
MUTATIONAL ANALYSIS OF THE HIV TAT PROTEIN AND ITS ABILITY TO DOWN REGULATE CD127 ON CD8 T CELLS
Scott Sugden 1,3 ; Iris E 1,3 ; Jessica Steinmöeller 2,3 ; Paul MacPherson 1,2,3
1-University of Ottawa; 2-The Ottawa Hospital, General Campus; 3-The Ottawa Hospital Research Institute
Plain Language Summary: We have previously shown that the HIV Tat protein down regulates surface expression of the interleukin (IL)-7
receptor alpha chain (CD127) on CD8 T-cells resulting in impaired T-cell proliferation and cytolytic capacity. Tat achieves this by binding
directly to IL-7R’s cytosolic tail, at the inner leaflet of the plasma membrane, and inducing the accelerated internalization and proteasomal
degradation of the receptor. The purpose of this study is to determine which domain(s) of Tat are responsible for its effect on CD127.
Wild-type and deletion mutations each lacking one of Tat’s six functional domains have been generated as histidine-tagged protein and purified
over nickel columns. We show that the N-terminal acidic and cysteine-rich domains as well as the basic domain of Tat are essential for protein
stability and/or function.
Objective: The purpose of this work is to identify the domain(s) of the HIV Tat protein responsible for Tat-mediated down regulation of CD127
from the surface of CD8 T-cells.
Methods: Mutant Tat proteins were generated by sequentially deleting each of Tat’s six functional domains. These mutants were expressed as
six-histidine-tagged protein in bacteria and purified over nickel columns. Wild-type Tat and Tat variants were then incubated with CD8 T-cells
isolated from HIV-negative volunteers and surface CD127 expression was analyzed by flow cytometry.
Results: While deletion of the core (aa. 38-46), glutamate-rich (60-72), or carboxyl-terminal (aa. 72-86) domains had no effect, removal of the
basic domain (aa. 48-59) completely abrogated Tat’s ability to down regulate surface expression of CD127. Interestingly, removal of the two
amino-proximal domains, the acidic (aa. 1-21) and cysteine-rich domains (aa 22-37), resulted in Tat protein instability.
Conclusions: The basic domain of Tat is required for CD127 down regulation from the surface of primary human CD8 T-cells. Whether this
domain is required only for entry into the cell or is involved in binding CD127 or components of the endocytic machinery requires further
investigation. The 37 N-terminal amino acids of Tat are required for protein stability.
Contact Information: Scott Sugden, Tel: 613 255 6016, Email: ssugd012@uottawa.ca
125
PROVIDING AFFORDABLE HOUSING AND IMPROVING THE QUALITY OF LIFE OF AFRICAN-CANADIAN WOMEN
LIVING WITH HIV/AIDS IN ONTARIO
Edna Aryee 1
1-University of Toronto
Plain Language Summary: Affordable housing protects and stabilizes not only individuals, but also their families and communities. African-
Canadian women living with HIV/AIDS in Ontario are overwhelmed by a sense that in the midst of plenty, their lives seem barren. They are
hungry for better housing that will nourish their soul and body. Now that we are providing almost all the needed medical intervention for these
women, we must also pay more attention to the factors (Affordable Housing) that affect their quality of life. Five African-Canadian women from

Ontario participated in a qualitative study that examined housing and quality of life in the context of Africa-Canadian women living HIV/AIDS.
They completed a three-phase face-to-face interviews and results revealed that living in affordable housing would improved their quality of life as
well as provide protection from exposure to a number of psycho-social threats including internalized stigma and suicidal ideations.
Objective: The study examined the impact of affordable housing on the quality of life in the context of Africa-Canadian women living
HIV/AIDS. The study also examined affordable housing and quality of life before HIV and since HIV diagnosis. I also examined changes in their
employment status since diagnosis in addition to other factors that put their housing at risk. Further, I explored how affording housing affects
their experience of internalized stigma and discrimination. Finally, I examined their coping strategies amidst their housing challenges.
Methods: Five African-Canadian women living with HIV/IDS in Ontario were interviewed in a qualitative study. The participants were selected
through the Voices of Positive Women in Toronto. Participants were asked questions related to quality of life before HIV, since their HIV
diagnosis; changes in their employment since diagnosis; other factors that put their housing at risk; experience of internalized stigma and
discrimination as well as coping strategies. Interviews were transcribed and thematic analysis was conducted with the NIVO.
Results: Qualitative findings revealed that participants who live in affordable houses experienced significant improvement in their quality of life.
Participants who could not afford decent housing experienced daily negative psycho-social impact on their quality of life. Overall, findings also
showed that most of the women lost their employment after diagnosis, thus affecting the affordability of decent housing and quality of life.
Conclusions: Affordable housing is crucial to living well. Because it is a neglected area in HIV/AIDS intervention and research, it is a critical
contribution of virtue ethics to our understanding of how affordable housing can improve the quality of life of African Canadian women living
with HIV/AIDS. Finally, there is a need to develop housing policies and strategies that would address the unique needs and quality of life of
African Canadian women living with HIV/AIDS in Ontario.
Contact Information: Edna Aryee, Tel: 647-347-3858/647-822-7798, Email: naakorkoraryee@gmail.com
126
YOU’RE BREAKING MY HAART: HIV AND VIOLENCE AMONG A COHORT OF WOMEN ON ANTIRETROVIRAL THERAPY
IN BRITISH COLUMBIA, CANADA
Alexandra Borwein 1,2 ; Eirikka Brandson 1 ; Alexis Palmer 1 ; Erin Ding 1 ; Cari Miller 2 ; Kimberly Fernandes 1 ; Julio Montaner 1,3 ; Robert Hogg 1,2
1-British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; 2-Faculty of Health Science, Simon Fraser University,
Burnaby, BC, Canada; 3-Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Plain Language Summary: Past violent abuse has been linked with the development of adverse health outcomes, including depression, mental
health disorders, drug and alcohol addictions, and other negative treatment and quality of life outcomes. The results of this analysis show that
women with recent violent experiences are more likely to report sub-optimal adherence to antiretroviral therapy and that housing may play a
critical role in woman’s ability to remain safe.
Objective: To examine the rates and predictors of violence among HIV-positive women on highly active antiretroviral therapy (HAART) in
British Columbia, Canada.
Methods: The Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort is a prospective study of HIV-positive
persons on HAART. Participants are ≥19 years of age and recruited from the Drug Treatment Program (DTP) at the BC Centre for Excellence in
HIV/AIDS. Explanatory variables are collected through an interviewer-administered questionnaire. Clinical variables are obtained through
linkages with the DTP. Bivariate analyses compared differences between women who ever experienced violence and those who have not, in
addition to recent violence (within the last 6 months) with ever experiencing violence. A multivariable logistic regression model was used to
examine predictors of recent violence.
Results: As of January 2009 there were 573 LISA participants, of whom 151 (26%) are women. Eighty-three percent of women reported ever
having experienced violence. Recent violence was reported by 25% of women and 61% reported violence before the age of 16. Half of the
women who have experienced violence reported more than 5 violent episodes. Mental health disorders (p=0.007) and perceived stigma (p=0.001)
were more common in women who have ever experienced violence, as well as a history of marijuana (p=0.004), tobacco (p=0.025) and illicit
drug use (p=0.024). Women with recent violent experience were more likely to be current illicit drug users (p=0.004) and to live in unstable
housing (p=0.001) than those who had experienced violence more than 6 months ago. The multivariable model showed that recent violence was
associated with self-reporting adherence to HAART below 95% on the past month (Adjusted odds ratio (AOR) 0.36, p=0.048). The model also
showed stable housing to be protective of recent violence (AOR 0.22, p=0.003).
Conclusions: The women in this cohort are experiencing high levels of violence. Stable housing could make a critical difference in a woman’s
ability to escape violence, remain safe, and improve treatment outcomes.
Contact Information: Alexandra Borwein, Tel: 604-682-2344 ext. 66067, Email: amb3@sfu.ca

127
A HOUSE IS NOT A HOME: THE IMPACT OF GENDER, RACE AND STIGMA ON THE HOUSING EXPERIENCES OF
AFRICAN AND CARIBBEAN MOTHERS LIVING WITH HIV
Saara Greene 1 ; Lori Chambers 2 ; Amrita Ahluwalia 2 ; Khatundi-Irene Masinde; Chantal Mukandoli; Doris O'Brien-Teengs
1-School of Social Work, McMaster University; 2-Fife House Foundation, Toronto, Canada
Plain Language Summary: The Families, HIV and Housing study is a community based research study aimed at investigating the housing needs
and experiences of parents living with HIV/AIDS in Toronto. Based on seventeen in-depth qualitative interviews with HIV positive African and
Caribbean mothers, this paper will argue that although HIV positive mothers experience a number of shared housing related issues and concerns,
these challenges are exacerbated for HIV positive mothers from African and Caribbean communities. This is due to the multiple systemic issues
that marginalize mothers as a result of their cultural, ethnic and racial history and their current social positioning as HIV positive women from
racialized communities in Canada.
The Challenge: HIV positive mothers from African and Caribbean communities in Toronto face a number of economic, social and
environmental challenges that put them at risk for housing instability and homelessness. These challenges are exacerbated as a result of the
intersecting issues of gender, racism, sexism, AIDS related stigma and discrimination, and poverty.
Our Approach: In-depth, semi-structured interviews were conducted with 35 HIV positive parents, of which 17 were HIV positive mothers who
identified as African or Caribbean. Interview questions explored the housing experiences of HIV positive parents as it related to their identity,
role, and needs; experience of accessing housing and housing related services and supports; factors that resulted in housing security and/or
housing instability; and the impact that their housing situation had on their children. As part of our community based research approach, the
interviews were conducted by 3 research assistants who closely identified with the study participants. The research assistants were involved in
developing the interview questions and were trained in qualitative data collection and analysis.
Key Findings: Findings from the interviews highlighted the importance of the meaning and experiences of what constitutes ‘home’. Factors that
shaped the meaning and experience of ‘home’ included: the impact of racism, gender and poverty on the participants’ overall housing experiences;
the impact of HIV related stigma and discrimination; and the need for culturally appropriate supportive housing services for themselves and their
children.
Impact on Policy and Practice: There is a need for cross sectoral, anti-racist, anti-oppressive education and training for both practitioners and
policy makers. Involving parents living with HIV from African and Caribbean communities in developing practice and policy based interventions
for racialized families will be of particular importance to future developments in addressing housing instability and homelessness.
Contact Information: Lori Chambers, Tel: 416-693-5465, Email: lorichambers@fifehouse.org
128
TITLE: HIV PREVENTION AND WOMEN IN CANADA: A META-ETHNOGRAPHIC SYNTHESIS OF CURRENT KNOWLEDGE.
Jacqueline Gahagan 1 ; Randy Jackson 2 ; Tracey Prentice 3 ; Derek Leduc 4
1-Dalhousie University; 2-McMaster University; 3-University of Ottawa; 4-Dalhousie University
Plain Language Summary: The aim of this project was to systematically review qualitative literature on HIV prevention related to Canadian
Aboriginal and non-Aboriginal women published between 1996 and 2008. The specific objectives of the project were to (1) Identify where
specific knowledge of HIV prevention needs is lacking or where there is a lack of consensus, (2) Generate a synthesized understanding of the
conceptual frameworks expressed in the literature, (3) Connect findings to the policy response at the federal, provincial and territorial levels, and
(4) Produce new knowledge and identify wise practices and gaps in existing knowledge that can be used to inform future research directions.
The Challenge: Despite increases in HIV infections among women in Canada, there continues to be a limited focus on: the diversity of womenspecific
primary and secondary HIV prevention issues; women outside of “normative” contexts (i.e., pre-natal) or contexts of risk (i.e., injection
drug use); or the deeply gendered aspects of HIV prevention.
Our Approach: This study systematically selected 38 articles for review and analysis based on a set of criteria established at the outset. The
papers had a broad ethno-cultural focus with a significant proportion (40%) addressing issues related to Aboriginal women and HIV.
Key Findings: During preliminary analysis it was found that most articles treated women as a homogenous group and lacked a critical
perspective on the diversity of women’s experiences in relation to primary and secondary HIV prevention. A limited number of articles addressed
issues of sexual orientation or gendered sexual dynamics in HIV prevention. The focus has remained on empowerment of women, specificially
through increasing HIV prevention training in isolation from political, economic and structural factors. Historically, there has been a lack of
systematic monitoring and evaluation of HIV prevention efforts which creates challenges in determining wise practices in both policy and
programming sectors.

Impact on Policy and Practice: There is a need to attend to the diversity of women’s experiences in HIV prevention research, policy-making
and practice. There is also a need to include HIV-positive and HIV-negative women in shaping research questions, methods, priorities and
approaches. Reframing HIV prevention policies will ensure greater recognition of the complexities of women’s lives and identities and the
cumulative impact of race, class, age and colonialism on the unequal distribution of disease.
Contact Information: Tracey Prentice, Tel: (902) 494-1155, Email: jacquelinegahagan@hotmail.com
129
GENDER AND ETHNICITY DIFFERENCES IN BODY CHANGE AND DISTRESS OF HIV-POSITIVE INDIVIDUALS TAKING
ANTIRETROVIRAL THERAPY IN ONTARIO
; Nisha Andany 1 ; Janet Raboud 1,2,3 ; Maggie Li 3 ; Sean Rourke 1,4 ; Anita Rachlis 1,5 ; Sharon Walmsley 1,3 ; Rodger D. MacArthur 6 ; Louise
Binder 7 ; Ron Rosenes 7 ; Ahmed Bayoumi 8 ; Nicole Mittmann 5 ; Nancy Risebrough 5 ; Wendy Wobeser 9 ; Mona Loutfy 1,10
1-Faculty of Medicine, University of Toronto, Toronto, ON; 2-Dalla Lana School of Public Health, University of Toronto, Toronto, ON; 3-
University Health Network, Toronto, ON; 4-Ontario HIV Treatment Network, Toronto, ON; 5-Sunnybrook Health Sciences Centre, Toronto,
ON; 6-Wayne State University, Detroit, Michigan; 7-Canadian Treatment Action Council, Toronto, ON; 8-St. Michael's Hospital, Toronto, ON;
9-Kingston General Hospital, Toronto, ON; 10-Women's College Hospital, Toronto, ON
Plain Language Summary: Antiretroviral therapy (ART) has resulted in dramatic reductions in HIV-associated morbidity and mortality, but is
associated with many adverse events. Lipodystrophy, a syndrome resulting in changes in body shape including peripheral fat loss and/or central
fat accumulation, is a feared complication of antiretroviral treatment that can potentially impact quality of life, treatment adherence, and survival.
This study compared rates, severities, and types of lipodystrophic changes between patients of different genders and ethnicities.
Objective: To assess gender and ethnic differences in prevalence, type, and severity of antiretroviral-associated lipodystrophy in HIV-positive
patients who were enrolled in the OHTN Cohort Study (OCS) and completed the extended questionnaire as of April 2009.
Methods: Demographic and clinical data were extracted from the OCS Database. Lipodystrophy was assessed in the OCS with the ACTG body
image questionnaire. Presence of lipodystrophy was defined as having at least one major or two minor changes of peripheral lipoatrophy and/or
central lipo-accumulation. Prevalence, type, and severity of lipodystrophy were compared by gender and ethnicity (Black or non-Black) using
Chi-square tests and Cochrane-Armitage tests for trend.
Results: 746 patients on antiretroviral medications were included. 85% of patients were male and 85% were non-Black. Median age was 48
years (IQR 42, 55), and median duration of HIV infection was 13 years (IQR 7, 18). Overall prevalence of lipodystrophy was 58%; there were
no differences in prevalence between men and women, or between Blacks and non-Blacks. Men were more prone to peripheral lipoatrophy than
women (31% vs. 11%; p

HIV infected and uninfected participants; in fact, we find that these populations recover completely in participants who start on therapy before the
CD4 count fell below 350/ul. The implications of this work and our planned “next steps” will be discussed.
Objective: To characterize the impact of antiretroviral therapy (ART) on Treg and Th17 CD4+ T cell subsets in blood and gut mucosa (sigmoid
colon).
Methods: Participants consisted of (1) HIV-uninfected; (2) chronically HIV-infected, ART-naïve (CI); and (3) long-term suppressed (LTS) men
with an undetectable plasma viral load [VL] on ART for >4 years. The CI group was divided into early and late disease, based on a CD4+ T cell
count /

Janet Raboud 1,2 ; Maggie Li 2 ; Tony Antoniou 4,7 ; Sharon Walmsley 1,2 ; Sean Rourke 1,4,5 ; Sergio Rueda 1,4,5 ; Anita Rachlis 1,6 ; Nicole Mittmann 6 ;
Curtis Cooper 9 ; Marek Smieja 8 ; Evan Collins 1,5 ; Mona Loutfy 1,3,7
1-University of Toronto; 2-University Health Network; 3-Women's College Hospital; 4-St. Michael's Hospital; 5-Ontario HIV Treatment
Network; 6-Sunnybrook Health Sciences Center; 7-Maple Leaf Medical Clinic; 8-McMaster University; 9-Ottawa Hospital
Plain Language Summary: Taking medication as prescribed or adherence to antiretroviral therapy (ART) among HIV-positive individuals is
known to be important to minimize the amount of the HIV virus in the blood and for the prevention of development of resistance. There have
been very few studies looking at ART adherence in the new era of reduced pill burden in HIV care. Predictors of adherence to ART included
gender, region of birth, education, high use of alcohol and level of social support.
Objective: To determine the rates of adherence to ART and to determine predictors of improved adherence.
Methods: Participants of the Ontario Cohort Study (OCS) who were currently taking ART were included in the analysis. The primary measure
of adherence was whether participants had missed ≥1 dose of ART in the previous 4 days.
Results: 783 OCS participants completed the extended questionnaire and were taking ART at the time of the survey. 115 participants (15%)
reported missing at least one dose of ART in the past 4 days and 76 (10%) reported missing at least one dose during the past weekend. Only 235
(30%) patients reported never skipping doses. The probability of missing ≥1 dose in the past 4 days varied by region of birth and gender: Africa
(F 19%, M 31%), Caribbean (F 8%, M 19%) and North America and Europe (F 23%, M 12%); by age (≤30 48%, 30-40 years 17%, 40-50 years
15%, >50 years 12%,p

Conclusions: The demonstration that HIV-1 RNAs have a protein composition distinct from most host mRNAs suggests that they have distinct
patterns of regulation, supported by their selective inhibition by Sam68∆C. We determined that this unique composition confers insensitivity to
cell stress responses likely to occur in response to HIV infection. The unique properties of HIV RNPs and their selective regulation indicate that
this stage of virus replication could serve as a target for therapeutic intervention.
Contact Information: Alan Cochrane, Tel: 416 978-2500, Email: alan.cochrane@utoronto.ca
134
HIV-1 AND GONORRHEA CO-INFECTION: A DISCONNECT BETWEEN RESPONSES IN CELL LINES AND PRIMARY CELLS
Wendy N. Dobson-Belaire 1 ; Alan Cochrane 1 ; Mario Ostrowski 2,3 ; Scott D. Gray-Owen 1
1-Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada; 2-Department of Immunology, University of Toronto,
Toronto, Ontario, Canada; 3-St. Michael’s Hospital, Toronto, Ontario, Canada
Plain Language Summary: While early clinical and epidemiological studies suggested that gonorrhea promoted HIV replication and
transmission, more recent studies indicate that Neisseria gonorrhoeae can inhibit HIV replication and allow the immune system to mount a more
vigorous attack on HIV-infected cells. This study aims to explain these apparently contradictory effects. While in vitro studies have clearly
demonstrated that N. gonorrhoeae infection stimulates HIV replication in cancerous human cell lines, we observed that HIV replication was
instead inhibited when cells from the blood of human volunteer donors were co-infected with N. gonorrhoeae. Further analyses demonstrated
that the bacteria can directly and indirectly activate T cells in a manner that increases HIV expression, they also cause the release of IFN-alpha, a
known anti-HIV factor, from a white blood cell subset known as plasmacytoid dendritic cells. This IFN-alpha response effectively inhibits HIV
replication in primary CD4+ T cells but not in cell lines. These findings have important implications for co-infection studies and high-throughput
HIV assays used for drug development.
Objective: To explain the contradictory response of T cell lines and primary T cells with regard to bacterial-induced effects on HIV replication.
Methods: Jurkat CD4+ T cells or primary CD4+ T cells were infected with replication competent HIV-1 strain NL4-3 or replication incompetent
but receptor unrestricted pseudo-typed HIV-1. These cells were exposed to supernatants from gonococcal-infected PBMCs or purified IFN-alpha
at various levels. The levels of IFN-alpha and proinflammatory cytokines present in the gonococcal-infected supernatants were also measure by
ELISA.
Results: Supernatants from gonococcal-infected supernatants consistently stimulated HIV-1 expression from Jurkat cells while inhibiting HIV-1
expression from CD4+ T cells. The supernatant was found to contain high levels of proinflammatory cytokines that promote HIV-1 replication,
as well as the HIV-inhibitory IFN-alpha. While the T cells all responded to the proinflammatory cytokines, the immortalized cell lines were
insensitive to IFN-alpha while this cytokine effective stopped HIV replication in the primary T cells.
Conclusions: Combined, these results indicate that N. gonorrhoeae elicits immune-modulating cytokines that both activate and inhibit HIVproduction;
the outcome of co-infection will depend upon the balance between these opposing signals. Considering the prevalent use of cell lines
in studies aimed at determining the effect of pathogens, immune modulators or other molecules on HIV replication and transmission, this study
also emphasizes the importance of interpreting experimental outcomes in the context of the system employed.
Contact Information: Wendy Dobson-Belaire, Tel: 416-978-6118, Email: w.dobson@utoronto.ca
135
EFFECT OF A NOVEL, NEISSERIA-SPECIFIC IMMUNE-STIMULATORY FACTOR ON HIV-1 EXPRESSION AND
LYMPHOCYTE ACTIVATION
Rebecca J. Malott 1 ; Nancy S.Y. So 1 ; Scott D. Gray-Owen 1
1-Department of Molecular Genetics, University of Toronto
Plain Language Summary: Common co-infecting STIs promote HIV-1 transmission. Our work aims to understand how N. gonorrhoeae, the
causative agent of gonorrhoea, mediates these effects at the molecular level. We isolated a novel, Neisseria-specific factor that induces HIV-1
expression in CD4+ T cells and show that it mediates its effects through generalized lymphocyte activation.
The Challenge: Previous studies established that N. gonorrhoeae infection stimulates HIV-1 expression. This study aims to characterize the
inducing factor and to determine its mode of action.
Our Approach: A systemic biochemical approach was used to characterize the Neisseria-specific immune stimulatory factor (NISF). A
purification protocol for NISF was established based on the determined biochemical characteristics. The effect of NISF on HIV-1 expression was
evaluated using models of HIV-1 expression in CD4+ T cells, and its overall effect on lymphocytes was measured using human CD4+ T cells and
B cells.

Key Findings: To determine if NISF is a common bacterial trait, three non-pathogenic Neisseria species, N. meningitidis and six more distantly
related bacterial pathogens were tested for inducing activity using a Jurkat CD4+ T cell line containing a stably integrated luciferase HIV-1 5’-
LTR reporter. While all neisserial strains were able to induce HIV-1-LTR expression to comparable levels of N. gonorrhoeae, the other genera
did not display this effect. Preliminary biochemical characterization of NISF, including enzymatic digests and organic solvent extractions,
indicated that the inducing factor is not lipid, protein or nucleic acid in nature. C18 reverse-phase and gel filtration chromatography indicated
that the factor is highly polar and less than 700 Da in size. A purification protocol was developed based on these traits, and demonstrated that the
purified factor is sufficient to induce HIV-1-LTR expression of in a dose-dependent manner. Since latent HIV-1 expression occurs in activated T
cells, the effect of the NISF on T cell activation was assessed by flow cytometry using CD69 as a marker. CD69 was expressed in response to the
factor in a dose-dependent manner suggesting that it effects HIV-1 LTR expression by activating the T cell. To further characterize the immune
effects of this factor, primary human B cells were exposed to NISF and activation, represented by CD86 expression, was observed, indicating that
the NISF is a broad immune activator.
Impact on Policy and Practice: Further elucidating how N. gonorrhoeae stimulates HIV expression will lead to developing strategies to
intercept this process. Disrupting the synergy between HIV-1 and gonorrhoea will have a large impact on the HIV pandemic.
Contact Information: Rebecca Malott, Tel: 416-978-6118, Email: rebecca.malott@utoronto.ca
136
CLK SR PROTEIN KINASES AND DRUGS MODULATING ALTERNATIVE SPLICING DEMONSTRATE POTENT INHIBITION
OF HIV-1 VIRAL REPLICATION
Raymond Wong 1 ; Alan Cochrane 1
1-Dept. of Molecular Genetics, University of Toronto, Toronto, ON
Plain Language Summary: In exploring new approaches in controlling HIV-1, we are investigating host factors for their ability to enhance or
inhibit viral replication. One such family of factors are the serine/arginine-rich splicing factors (SR proteins), which are highly involved in
regulating pre-mRNA splicing—a process HIV-1 is strongly dependent upon to generate its full regimen of proteins and replicate. The activity of
SR proteins is regulated by protein kinases such as the Cdc2-like kinases (Clk). We reveal potent inhibition of HIV-1 gene expression by one of
the Clk kinases. We further demonstrate inhibition of HIV-1 by two FDA-approved drugs known to modulate alternative splicing through SR
proteins.
Objective: To determine how modulating SR protein activity could alter HIV gene expression by overexpression and inhibition of Clk kinases 1-
4.
Test if available drugs known to modulate alternative splicing can effect HIV-1 replication.
Methods: The protein levels of HIV-1 were quantified by enzyme-linked-immuno-assay (ELISA) of p24 capsid concentration, while its
messenger RNA levels were quantitated by real-time polymerase chain reaction (qRT-PCR). Immunofluorescence microscopy was used in
determining the subcellular localization of Clk/SR proteins.
Results: We discovered a wide variation in the effects of Clks on HIV-1 protein expression and mRNA levels, despite high sequence identity and
structural conservation among Clk family members. Clk1 and Clk1T enhanced HIV-1 gene expression over 2-fold, while Clks 2, 3, and 4
suppressed expression. Most notable was a dose-dependent 5-fold inhibition of expression by Clk2.
To address these different effects, we examined the subcellular localization of multiple SR proteins in response to Clk overexpression. We
observed that overexpression of Clks 1-4 each disrupted the subnuclear distribution pattern of the SR protein, SC35. Treatment of these cells with
TG003—a specific inhibitor of Clks 1 and 4—blocked the changes in SC35 distribution induced by Clks 1, 2, and 4.
To further understand Clks and their SR-mediated effects on HIV, we evaluated drugs known to modulate alternative splicing via effects on
specific SR proteins. We discovered that chlorohexidine, an antiseptic, and digoxin, a drug used in the treatment of heart failure, dramatically
inhibited HIV-1 gene expression over 10-fold in a dose-dependent manner.
Conclusions: These results demonstrate that Clks and their SR protein targets play an influential role in HIV replication. Surprisingly, the ability
of Clk2 and two currently marketed drugs to strongly suppress HIV-1 gene expression suggests that they are targeting substrates critical for viral
replication.
Contact Information: Raymond Wong, Tel: 4169782500, Email: rw.wong@utoronto.ca
137
HOW CAN YOUTH HAVE MEANINGFUL ENGAGEMENT IN COMMUNITY-BASED RESEARCH? THE SAFE N’ SEXY
PROJECT EXPERIENCE.

Matthew Allen 1 ; Jazmyn Hallman 1 ; Moiya Forrest 1 ; Sandra L. Bullock 2 ; Michelle Vibert 1,2 ; Adrian R. Betts 1 ; Jose Franco 1 ; Deborah Stinson
1 ; Bridget Marsdin 1
1-Hamilton AIDS Network ; 2-University of Waterloo
Plain Language Summary: There is a large body of research on youth; however, youth are underrepresented in the research planning/process.
Despite offering personal health information, youth receive limited benefits from the research and are rarely notified of outcomes.
The Challenge: To involve youth throughout the research process in a meaningful way; from the development of meaningful research questions,
interpretation and dissemination of research findings.
Our Approach: The Safe n’ Sexy Project, a community-based research project, was built with three objectives. To: 1) give youth opportunities to
gain skills in research, 2) use input from youth to structure how we delivered the project and its findings, and 3) gather information on sexual
health needs and knowledge of street-involved youth in Hamilton. A partnership between youth, service providers and academics was the
foundation of the project. Six youth were hired as peer recruiters and interviewers to work on the project; they also consulted with additional
street-involved youth throughout the research process. Youth gave the project coordinators insight on appropriate recruitment and interview
locations, incentives, asking questions with respect—specifically sexual-health questions—and youth-oriented ways of communicating findings
back to the community. A one-day Youth Service Fair entitled “Fusion” will be held to communicate research findings back to youth, and unite
youth and service providers in dialogue, information exchange, program planning and fun.
Key Findings: Community research is only valuable if the community is involved in every aspect. Youth involved in the Safe n’ Sexy project
received practical research experience, and youth who provided input throughout the process ensured the research was relevant and delivered
respectfully. Without the support of our hired youth and dialogue with street-involved youth, the project would have been as successful.
Impact on Policy and Practice: When doing research on this population, youth involvement and input is vital to the success of the project; more
importantly creates rapport and outlets for effectively communication and use of the findings. This project creates future opportunities for a
population that is continually underestimated and can be a model for projects looking to include youth and enhance their involvement and
investment in their community. Key to the focus of the OHTN’s 2009 conference, youth are ideal individuals to convey prevention education and
support, specifically in terms of sexual health. Long term goals of this project will see youth as peer mentors for sexual-health education in
Hamilton, specifically around HIV awareness.
Contact Information: Jazmyn Hallman, Tel: (905)628-6184, Email: mvibert@uwaterloo.ca
138
PREDICTORS OF HIV TESTING AMONG STREET-INVOLVED AND HOMELESS YOUTH IN HAMILTON, ONTARIO: THE
SAFE N’ SEXY PROJECT RESULTS.
Sandra L. Bullock 1 ; Michelle Vibert 1,2 ; Adrian R. Betts 2 ; Jose Franco 2 ; Bridget Marsdin 2 ; Deborah Stinson 2 ; Youth Interviewers 2 ; Advisory
Committee 2 ; Safe n’ Sexy Collaborator 3
1-Dept. of Health Studies and Gerontology, University of Waterloo, Waterloo; 2-Hamilton AIDS Network, Hamilton; 3-Safe n' Sexy Community
Collaborators, Hamilton, ON, Canada
Plain Language Summary: Street-involved youth in large cities have been shown to practice high-risk sexual behaviour and have high HIV
rates. Little is known of street-involved youth in smaller cities in Ontario. The Safe n’ Sexy Project, a community-based project, assessed the
sexual-health needs and knowledge of street involved youth in Hamilton. The team aims to understand predictors of risk behaviour and modify
programs to help decrease sexual risk.
Objective: To understand predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario.
Methods: Quantitative interviews were conducted with 100 street-involved and homeless youth aged 14-24 years, living in Hamilton, Ontario.
Preliminary bivariate analyses have been conducted on 70/100 interviews. The presentation will include updated multivariate logistic regression
analysis on the full sample of 100.
Results: Participants did engage in sexual-risk behaviour; 78.1 % had sex without a condom with a regular partner, 21.9% had sex without a
condom with a hook-up (3 months), 40% had an unplanned pregnancy, and 10% experienced at least one STI. However, 43 participants (61.4%)
had been HIV tested; none reported being HIV+; although, a small number had not obtained their test results. Significant bivariate predictors of
HIV testing included: NOT experiencing unstable housing (p=0.027); graduating high school (p=0.001); sex without a condom with a regular
partner; having had an STI (p=0.045), or an unplanned pregnancy (p

Conclusions: Participants did engage in sexual-risk behaviour, with 40% having had an unplanned pregnancy and 10% had at least one STI; but
only 1/3 had HIV tested. These street-involved youth are not regularly accessing the few Hamilton sexual health services that do exist, and many
referrals were made at the completion of interviews. Understanding who has been accessing services and who, and who has not been and why
will help the youth, service providers and researchers to make sexual health more attainable to this often neglected and highly vulnerable
population.
Contact Information: Sandra Bullock, Tel: 519 888-4567 ext 32378, Email: sbullock@health.uwaterloo.ca
139
HIGH-RISK YOUTH, DRUG USE AND HEPATITIS C IN KINGSTON, ONTARIO
Ron Shore 1 ; Brenda Melles 2
1-Director, Urban Health and Research, Kingston Community Health Centres; 2-Independent Consultant
Plain Language Summary: The Kingston Community Health Centres conducted a rapid assessment and response (RAR) process on high-risk
youth, drug use, and hepatitis C. Findings include patterns of drug use, tattooing, piercing and self-harm; level of knowledge about hepatitis C;
and adequacy of available services.
The Challenge: A lack of youth-specific prevention and education services may render young people at greater vulnerability for infections such
as hepatitis C and HIV. The Kingston Community Health Centres collected and analysed information about drug use and hepatitis C risk
behaviour among substance-using high-risk youth from age 16-24 in Kingston in order to develop effective youth-specific responses.
Our Approach: A Rapid Assessment and Response process (RAR) was conducted over 17 weeks. Methods included review of existing data;
structured interviews with high-risk young people (65); semi-structured interviews with service providers (17); and self-administered
questionnaires for high-risk youth (17).
Key Findings: The total sample of high-risk young people was 82. Approximately 30% had completed their high school diploma, 40% had been
in jail and 70% had been in their current housing for six months or less.
Average age at first use of illicit drugs was 13. The most commonly reported illicit drugs used by young people in Kingston were: marijuana,
cocaine, ecstasy, oxycodone and percocet.
18% (n=14) had injected drugs; 14% had shared needles and 71% had shared equipment such as spoons, cookers, water, filters, swabs or ties.
72% had snorted drugs, and 74% had shared straws or bills, most with high frequency. More than half (57.3%) had a tattoo, with almost two
thirds done outside of professional parlours. The large majority reported that tattooing equipment (including ink) was not shared. 79% had a body
piercing, with more than half homemade. Just under half had cut themselves on purpose, and almost no one had ever shared the object they used
for cutting with someone else.
Most young people reported limited to moderate knowledge about hepatitis C. More than a quarter believed there is a vaccination for hepatitis C,
and almost half believed there is no treatment. Many were unsure about risks associated with sharing straws and bills, pipes, or injection
equipment other than needles.
Impact on Policy and Practice: Using a youth engagement approach, program recommendations include alternative activities to engage the
creativity of young people, fostering relationships and connection through consistent outreach, creating peer support networks, and linking highrisk
young people who face multiple barriers to health to a range of appropriate services and supports.
Contact Information: Ron Shore, Tel: 613-542-2949, Email: rons@kchc.ca
140
“DID YOU SPOT THE BANANA? AN EVALUATION OF A SEXUALLY TRANSMITTED INFECTION CAMPAIGN FOR
OTTAWA YOUTH”.
Zhaida Uddin 1 ; Andrew Hendriks 2
1-Ottawa Public Health - Special Initiatives Team, Healthy Sexuality and Risk Reduction Program, Ottawa, Canada; 2-Ottawa Public Health -
Healthy Sexuality and Risk Reduction Program, Ottawa, Canada
Plain Language Summary: In response to increasing rates in sexually transmitted infections (STI’s) among Ottawa’s young men and women
aged 15 to 24, Ottawa Public Health (OPH) and Planned Parenthood Ottawa (PPO) partnered to deliver the three-year “get the test” spotted

anana campaign. This campaign was designed to increase public awareness and promote regular testing for STI’s as part of a routine health
check-up for sexually active people.
The campaign featured a poster with a picture of a spotted banana and the tag line: "Get tested. Not all sexually transmitted infections are this
easy to spot."
Objective:
- To promote regular STI testing, by influencing one’s decision to incorporate STI testing as a routine part of their overall health checkups.
- Testing and treatment to help prevent further spread of STI’s.
- To bring young men and women into contact with health care professionals who can provide information on ways of reducing the risk for STI's.
Methods: A semi-structured questionnaire was the primary data collection tool. Data collection occurred over 10-week periods between
February 7 to May 6, 2005, February 20 to April 30, 2006 and February 19 to April 29, 2007.
An evaluation of each year of the campaign informed subsequent phases.
Results: Overall, the evaluation of the initiative showed an increase in awareness of STI’s among respondents. The volume of testing offered for
STI screening increased during the three-year period in which the campaign was implemented.
Conclusions: Continue building on the success of this sexual health promotion campaign by exploring different strategies to reach youth in
general, including the use of new technologies and social networking trends in communications/marketing. Work with community partners to
develop the next phase of the campaign, that includes increasing the use of health care providers as intermediaries; increasing advertising at
schools/universities and developing specific campaign ads to resonate more with the female population.
Contact Information: Zhaida Uddin, Tel: (613)5802424 x20136, Email: zhaida.uddin@ottawa.ca
141
STIGMA AND DISCRIMINATION AMONG CANADIANS OF SOUTH ASIAN DESCENT IN TORONTO
Carol Vlassoff 1 ; Firdaus Ali
1-Dept. of Community Medicine and Epidemiology, University of Ottawa, Ottawa, Canada; 2-Alliance for South Asian AIDS Prevention
(ASSAP), Toronto, Canada
Plain Language Summary: It has long been recognized that stigma and discrimination are major obstacles to a strong community response to
HIV. In Canada, efforts to address stigma and discrimination in mainstream populations, such as in the majority white population and groups at
high risk for HIV infection, have been fairly successful. However, in more marginalized populations, such as Canadian Aboriginals, visible
minorities and immigrants, little is known about the impact of stigma and discrimination on access to HIV information, testing, treatment and
support. This is particularly true of people of South Asian origin, due to cultural taboos against the open discussion of sexual issues, not only
between men and women, but also in society at large. This study addresses these questions by focusing on South Asians living with HIV in the
Greater Toronto Area (GTA).
Objective: To determine whether questions related to HIV stigma and discrimination used in the rural Indian context could also be used among
people of South Asian descent in Canada, and, through asking these questions and others, to understand the nature and extent of stigma and
discrimination among people of South Asian origin in the Greater Toronto Area.
Methods: A stigma question module that had been tested and applied successfully in rural India, based on a short "vignette" or fictional story
about a woman who was HIV positive, was adapted for use among South Asians in the GTA context. The questions were used with two focus
groups comprising staff of the Alliance for South Asian AIDS Prevention (ASAAP), HIV positive clients of ASAAP, support group members and
volunteers; and two focus groups with non-HIV affected South Asian women of different ages. A total of 35 participants were involved in the
focus group discussions. Theses discussions were taped and transcribed by the interviewers.
Results: The overall consensus among participants was that the adapted questions were appropriate for Canadians of South Asian origin living in
the GTA. The study found that South Asian Canadians living in the GTA received information about HIV/AIDS from many sources, but there
was very limited discussion on the topic within families. Moreover, South Asians did not access services related to sexual health or healthy
relationships in general. Young respondents reported discomfort in discussing sexual matters with their parents. A widespread observation was
that people living with HIV were highly stigmatized by the broader South Asian community in Toronto, and that families generally treated HIV
positive members with prejudice and contempt. Respondents felt that stigma was higher among Canadians of South Asian descent than in other
communities in Canada. A common coping mechanism mentioned by HIV positive respondents was not to disclose their HIV status to family and
friends, leading to further challenges in their access to support and services.
Conclusions: The paper concludes that concerted efforts are needed to break the silence surrounding HIV among Canadians of South Asian
origin, and recommends ways of addressing the problem of stigma and discrimination in this population.
Contact Information: Firdaus Ali, Tel: 416-599-2727 ext. 224, Email: ed@asaap.ca

142
THE WAY FORWARD: AFRICAN, CARIBBEAN AND BLACK CANADIAN HIV/AIDS RESEARCH THINK TANK
LLana James 1 ; Wangari Tharao
1- Incwell Consulting Services; 2-ACCHO, WHIWH
Plain Language Summary: The 2009 African, Caribbean and Black Canadian HIV/AIDS Research Think Tank underscored the importance of
people of the African Diaspora leading the way, defining the issues and identifying the the processes and pathways to constructive action and
outcomes, in collaboration with allies and partners. The Think Tank was initiated by the African and Caribbean Council on HIV/AIDS in Ontario
(ACCHO) and planned in collaboration with our partners CIHR, OHTN, AIDS Bureau, ICAD, CAAT, Public Health, Women’s Health in
Women’s Hands CHC. The purpose of the Think Tank was to; share knowledge and information on the current and ongoing research, determine
research needs, gaps and set priorities.
The Challenge: The challenge was to accomplish our ambitious objectives within three days with depth and commitment to anti-racist, antioppression
principles (ar/ao). As well as insuring that the African Diasporic people living with and affected by HIV remained central.
Our Approach: The Think Tank built upon the successful African and Caribbean 2006 Research Summit. The participation was by invitation to
ensure a balanced attendance among the various knowledge brokers from various areas such as basic science, clinical, epidemiology, sociobehavioural,
community based/initiated research etc. The participants self-selected the roundtable working group they would contribute to. Each
roundtable was required to present to all attendees at the end of the three days of exercises, providing an opportunity for cross fertilization and
improvement on roundtable discussions.
Key Findings: The four roundtables found similar and divergent priorities, provided brand new insights and a call to action which will be
presented in further detail. A brief summary of the key outcomes included the following as non-negotiable; that the research must be grounded in
the lived experiences of the African Diaspora, with the African Diaspora people as the primary drivers of the research program(s), that allies and
collaboration are important, that issues of significant importance often require an intersectional approach and transdisciplinary response.
Impact on Policy and Practice: Key decision makers at federal, provincial as well as community based and academic institutions; who inform
and direct policy agreed to move the recommendations from the report onto their organization agendas, to facilitate uptake of actionable items
identified as short, medium and long-term, and to be accountable to the populations by reporting back. Researchers both emerging and
established agreed to move the items identified in the Think Tank. African Diaspora Researchers Network will emerge as a result of the Think
Tank as a demonstration of the commitment to centralizing the lived experience and as an organization to collaborate with allies.
Contact Information: LLana James, Tel: 416-716-4771, Email: incwell@rogers.com
143
MIGRANT FARM WORKERS IN ONTARIO: HEALTH AND HIV
Noulmook Sutdhibhasilp 1 ; Miya Narushima 2 ; Kerry Preibisch 3 ; Brian Lester 4 ; Winston Husbands 5 ; Steve Byers 4 ; Chris Ramsaroop 6 ;
Shannon Ryan 4 ; Romyen Tangsubutra 7 ; Marilyn Wyler 4 ; Jose Cadano-Mellado 4
1-Asian Community AIDS Services (ACAS), Toronto, Canada; 2-Department of Community Health Science, Faculty of Applied Health
Sciences, Brock University, Canada; 3-Department of Sociology and Anthropology, Guelph University, Canada; 4-AIDS Service Organizations
(AIDS Niagara, BlackCap, AIDS Committee of Windsor, AIDS Committee of London, AIDS Program - Centre for Spanish Speaking People),
Canada; 5-African and Caribbean on HIV/AIDS Council in Ontario (ACCHO), Toronto, Canada; 6-Justice for Migrant Workers; 7-Thai Society
of Ontario
Plain Language Summary: Rising numbers of migrant farm workers (MFW) to Canada, as well as changes in the programs that bring these
temporary migrants to the country, present new challenges for HIV-prevention and support services. Research with MFW shows that while this
mobile population can access public health care free of charge in most provinces, access is compromised by language barriers, lack of
information, poor rural transportation, and extended workdays. Their migratory status as temporary visa workers acts as a further barrier to HIV
prevention and support services, as confidentiality, disclosure, and fear of deportation are major concerns. There are 20,000 MFW from Mexico,
and the Carribean. A fast growing segment of MFW are from Thailand.
The working group organized a 1.5 day symposium with 30 participants to develop a better understanding of sexual health needs, HIV and
healthcare issues of MFW; identify barriers to services and ways to improve access to these services.
Objective: In mid 2008, a group of AIDS service organizations in Ontario, academics, and non-profit organizations that provide services to
MFW, got together to discuss about the issues of MFW in Ontario, Health, and HIV and how we could work and support each other. The working
group has identified this group as high risk. We have also identified a complete lack of service, action, and HIV prevention strategies to deal with
this mobile population.

Methods: After an initial discussion, we realized that there is a big gap in understanding of the health and work conditions of MFW among the
majority of AIDS service organizations. The working group agreed to organize a 1.5 day symposium to develop a better understanding of sexual
health needs, HIV and healthcare issues of MFW; identify barriers to services and ways to improve access to these services. And to identify in
HIV-policy related research agenda. The symposium brought 30 participants who work and volunteer in the field of health, sexual health,
HIV/AIDS prevention and support, labour rights, and research to develop a better understanding of sexual health needs, HIV and healthcare
issues of MFW. They identified barriers to services and ways to improve access to these services; and developed future HIV-policy related
research agenda.
Results: Most AIDS service organizations that participated in the symposium have none or limited contacts with migrant agricultural workers.
They had limited knowledge of the background of the migrant farm workers. The group identified language barriers, isolation, no arbitration
process, and the service providers' lack of knowledge about migrant farm workers'lives are major barriers to services.
Conclusions: Presently, there is no concerted service, action, and/or provincial strategies to deal with this mobile population. A gap in policy and
the lack of front-line services to this group of emerging mobile population could pose a long-term health and social effects. Advocating for them
to attain the access to primary healthcare where migrant farm workers temporary work would help with non-governmental groups' efforts in
promoting HIV/STI prevention. New HIV prevention strategies, research studies and policy at provincial and national levels should be developed
to work with this mobile population.
Contact Information: Noulmook Sutdhibhasilp, Tel: 416-963-4300, Email: ed@acas.org
144
LIVING IN "TRANSNATIONAL SPACES": AN EXPLORATION OF THE INFLUENCE OF THE HOME COUNTRY ON THE HIV
RISK FACING RECENT CHINESE IMMIGRANTS IN CANADA
Y. Rachel Zhou 1 ; William D. Coleman 2 ; Basanti Majumdar 3
1-School of Social Work, McMaster University; 2-Balsillie School of International Affairs, University of Waterloo ; 3-School of Nursing,
McMaster University
Plain Language Summary: The People’s Republic China has been the premier source country of Canadian immigration since the early 1990s,
and it is also one of the Asian countries most seriously affected by HIV/AIDS. Although the relationship between migration and HIV/AIDS
receives increasing scholarly attention, thus far we know little about the impacts of the immigration process on the HIV risk to this group. This
paper, as part of a larger CIHR-funded study, examines the influence of the home country on this group’s vulnerability to HIV.
The Challenge: AIDS stigma was a salient barrier inhibiting eligible individuals from participating in this study.
Our Approach: The data used in this paper were collected through in-depth individual interviews with 34 recent Chinese immigrants (18 men
and 16 women) who self-perceived that they might face HIV risk in Toronto and Hamilton, Ontario.
Key Findings: The results of our preliminary data analysis reveal a sharp contrast between Chinese immigrants’ risky sexual activities on one
hand, and their silence and unwillingness to discuss risk of HIV infection on the other. Changes in living environments (e.g., socioeconomic
status, housing, relationship, culture, and individual autonomy and privacy) resulting from downward social mobility in Canada have exposed
them to risk factors that they may not have faced in China. In contrast, their awareness of HIV risk and knowledge about this disease were largely
influenced by values, beliefs and attitudes developed in China, contributing to a disconnect between their knowledge and their risky sexual
practices in Canada. In addition, we have found that Chinese immigrants are living in “transnational spaces” rather than “national spaces” alone.
While settlement challenges (e.g., language competency, employment barriers, racism, economic hardship) make them feel alienated from
mainstream society, these immigrants are able to remain in very close contact with China through the internet, access to Chinese mass media and
frequent travel “home”. It is concluded that, against the background of advances in transportation and telecommunication technologies, social and
cultural practices in China may continue to play a dynamic and important role in constructing their HIV-related beliefs and behaviours in Canada.
Impact on Policy and Practice: These findings suggest the urgent need to take into account the role of the home country in studying recent
Chinese immigrants’ vulnerability to HIV and in developing more responsive HIV/AIDS policies for, and interventions among, this group, as
well as other immigrant groups.
Contact Information: Y. Rachel Zhou, Tel: 905-525-9140 ext. 23787, Email: zhoura@mcmaster.ca
145
TORONTO DRUG USERS WILLINGNESS TO USE A SUPERVISED CONSUMPTION SITE AND THEIR PREFERRED SERVICE
MODELS
Jennifer Jairam 1 ; Laurel Challacombe 2 ; Shaun Hopkins 3 ; Carol Strike 4,5 ; Ahmed Bayoumi 1,4 ; Peggy Millson 4

1-Centre for Research on Inner City Health, St. Michael’s Hospital; 2-Canadian AIDS Treatment Information Exchange; 3-The Works, Toronto
Public Health; 4-University of Toronto; 5-Centre for Addiction and Mental Health, Toronto, Canada
Plain Language Summary: A supervised consumption site (SCS) is a facility where pre-obtained drugs can be injected or smoked under staff
supervision. We analyzed data from the 2006 Toronto I-Track survey to estimate drug users’ willingness to use a SCS and their preferred service
models. A high proportion of users are willing to use a SCS but they want separate facilities for smoking and injecting, and will not travel far to
use a SCS.
Objective: To describe Toronto drug users’ willingness to use a supervised consumption site (SCS) and their preferred service models.
Methods: We analyzed data from the 2006 Toronto I-Track Survey, which included 257 injection drug users and 220 crack smokers (not
currently injecting) at 5 needle exchange programs.
Results: Among injectors 93% also reported smoking crack and 52% of smokers had injected in the past. More injectors were willing to use a
supervised injection facility than crack smokers who had injected (79% vs. 68%, absolute difference of 11%, 95% Confidence Interval 0 to 21%).
In contrast, injectors who smoked crack were less willing to use a supervised smoking facility than crack smokers (58% vs. 70%, difference -12%
[-3 to -21]). The primary reasons why drug users would use these facilities are to be safe from crime (81% and 63% for injectors vs smokers,
respectively), to be safe from police (85% and 68%), and to use drugs in private (73% and 49%). The most important services for all drug users
at a SCS were nursing staff (80%), food (69%) and toilets (67%). More than half of all injectors (72%) and smokers (70%) were willing to take
public transit to a facility, but only 47% of injectors and 44% of smokers could afford to do so. High proportions of injectors and smokers
reported they would not travel more than 1 kilometer to a SCS (72% and 60%, difference 12% [3 to 21]). Both injectors and smokers indicated a
high acceptance rate for most SCS models, but mobile vans and outreach to places where drugs are used were the least preferred alternatives,
each ranked first by

prevention interventions for people who smoke crack. More evidence-based evaluation data are needed for newer interventions, including drug
consumption sites and crack kit distribution programs.
Contact Information: Pamela Leece, Tel: 416-312-1771, Email: pamela.leece@gmail.com
147
WHERE DO INJECTION DRUG USE AND CRACK SMOKING OCCUR IN TORONTO?
Peggy Millson 1 ; Jennifer Jairam 2 ; Laurel Challacombe 3 ; Shaun Hopkins 4 ; Carol Strike 1,5 ; Ahmed Bayoumi 1,2
1-University of Toronto; 2-Centre for Research on Inner City Health, St. Michael’s Hospital; 3-Canadian AIDS Treatment Information Exchange;
4-The Works, Toronto Public Health; 5-Centre for Addiction and Mental Health, Toronto, Canada
Plain Language Summary: Designing HIV and Hepatitis C prevention and harm reduction programs that respond to the needs of drug users
requires a thorough understanding of what drugs are used and where they are consumed. We analyzed data from the 2006 Toronto I-Track survey
to inform a study of the feasibility of supervised consumption sites in Toronto, where drug use occurs in many locations. Most drug use occurs in
private, but public crack smoking is more visible than public injection. A significant proportion of crack smokers report using drugs in parks or
schoolyards.
Objective: Drug use is an important risk factor for HIV and Hepatitis C infection. We described where drug use occurs in Toronto and which
drugs are used.
Methods: We analyzed data from the 2006 Toronto I-Track Survey, which included 257 current injectors and 220 crack smokers (not currently
injecting) at 5 needle exchange programs. Participants were asked about their drug use in the past 6 months, including: types, mode of
consumption and locations of use.
Results: Among injectors, the most commonly injected drugs were cocaine/crack (47% of participants) and opiates (43%). The most commonly
used non-injection drugs for current injectors were cocaine/crack (58%) and oral or transdermal opiates (14%). Among crack smokers, 39%
reported a drug other than cocaine/crack as their most common non-injected drug. Other drugs were used at least once by many participants,
including alcohol (82% of all users), marijuana (80%), and amphetamines (18%), with similar patterns among injectors and smokers. Compared
to smokers, injectors were more likely to report their most common area of use as home or other private location (67% vs. 53%, absolute
difference 14%; 95% confidence interval 5 to 23) or public place (13% vs. 5%, difference 8% [3 to 13]) but less likely to report the street as their
most common area for using drugs (10% vs. 31 %, difference -21% [-29 to -13]). Crack smokers were more likely to have used drugs at least
once during the previous 6 months in a schoolyard (30% vs. 13%, difference 17% [9 to 25]) or park (70% vs. 37%, difference 33% [24 to 43]).
Conclusions: Drug users in Toronto often use multiple drugs. Injection drug users more often consume drugs indoors and in private, crack
smokers often reported consuming drugs in public places, including parks and schoolyards. These results suggest that a supervised consumption
site in Toronto for crack smoking may be particularly valuable.
Contact Information: Peggy Millson, Tel: n/a, Email: p.millson@utoronto.ca
148
A PLACE TO SMOKE TOO: IDENTIFYING CHALLENGES FOR THE DESIGN OF SUPERVISED CONSUMPTION SITES
(SCSS) FOR CRACK SMOKERS
Tara Marie Watson 1 ; Jennifer Jairam 2 ; Gillian Kolla 1 ; Janine Luce 1 ; Naushaba Degani 2 ; Patricia O'Campo 2 ; Peggy Millson 3 ; Ahmed Bayoumi
2 ; Carol Strike 1
1-Centre for Addiction and Mental Health; 2-St. Michael's Hospital; 3-University of Toronto
Plain Language Summary: Supervised consumption sites (SCSs) are facilities in which pre-obtained drugs can be smoked or injected under
staff supervision, with primary goals of reducing HIV transmission and preventing overdose deaths. Our study examines the challenges of
designing SCSs for crack smokers in Toronto and Ottawa.
Objective: Canada has one well researched SCS for injection drug use (IDU), but less is known about how SCSs could be designed to help
prevent transmission of HIV and Hepatitis B (HBV) and C (HCV) among crack smokers. As part of a larger study examining the potential impact
and cost-effectiveness of SCSs in Toronto and Ottawa, we ask drug users and other stakeholders what SCS service design issues are important for
crack smokers.
Methods: We conducted 11 focus groups with current IDUs and crack smokers (n=79). We also completed 2 focus groups and 14 key informant
interviews with other stakeholders (e.g., health care providers, emergency services, police, firefighters). Thematic qualitative analytic methods
will be used. Data collection continues in both cities until the end of 2009.

Results: Preliminary analyses suggest that people who use drugs, as opposed to other stakeholders, identify a broader range of issues important
for the design and implementation of SCSs for crack smokers. Participants recommended that SCSs address a similar complement of health needs
(e.g., HIV prevention), social needs (e.g., support), and safety (e.g., respite from the street) for both IDUs and smokers. People who use drugs
also recommended separate consumption rooms for IDUs and smokers. IDUs spoke about not wanting to share a consumption room with crack
smokers because they did not want to be exposed to crack smoke or to the erratic, paranoid, aggressive drug seeking and untrustworthy behaviour
they attribute to crack use. Alternatively, crack smokers noted that they wanted a separate room because they did not want to see drugs being
injected. Also, participants who use drugs noted that mixing the two groups could negatively influence their highs (stimulants versus sedative)
and likely discourage clients from using the site and benefiting from its prevention and other services. Participants who reported both injecting
and smoking drugs noted that separate facilities would be inconvenient for their needs.
Conclusions: Preliminary findings suggest that SCSs which permit crack smoking would need to carefully consider the opinions and preferences
of potential clients to ensure that the facilities are designed to attract, retain, and engage crack smokers in services that can lead to HIV, HBV and
HCV prevention.
Contact Information: Tara Marie Watson, Tel: 416-535-8501 ext. 6575, Email: tara_watson@camh.net
149
MATURATION OF DENDRITIC CELLS BY LIPOSOMAL-DELIVERY OF MULTIVALENT HIV ANTIGENS
Danylo Sirskyj 4 ; Amin Saad 4 ; Haitham Ghunaim 1 ; Francisco Diaz-Mitoma 2,3,4 ; Ashok Kumar 1,2,4 ; Thanh Le 3 ; Ali Azizi 1,2
1-Infectious Disease and Vaccine Research Center, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth, Ottawa, ON, K1H 8L1,
Canada; 2-Department of Pathology and Laboratory Medicine, University of Ottawa, 451 Smyth, Ottawa, ON, K1H 8M5, Canada ; 3-Variation
Biotechnologies Inc., 1740 Woodroffe Ave, Building 400, Ottawa, ON, K2G 3R8, Canada; 4-Department of Microbiology and Immunology,
University of Ottawa, 451 Smyth, Ottawa, ON, K1H 8M5, Canada
Plain Language Summary: We have previously developed a polyvalent peptide HIV-1 vaccine that has been shown to induce a broadly reactive
peripheral immune response in mice and macaques. Our group recently developed a lipid-bile vesicle as an oral vaccine delivery system for the
induction of mucosal immunity within mucosal tissues. In this study, we take advantage of this technology to entrap our Variosite-based HIV-1
vaccine into this lipid-based vesicle by a chloroform method. We then evaluated the ability of our vaccine formulations to induce maturation of
mouse dendritic cells (DCs). Dendritic cells are unique antigen-presenting cells which play important functions such as priming T cells,
expressing cytokines, chemokines, and costimulatory molecules to initiate an immune response. The capability of DCs to regulate immunity is
dependent on their maturation. During this conversion (immature to mature cells), DCs undergo a number of functional changes including
decrease in antigen internalization, secretions of chemokines, cytokines and proteases and upregulation of costimulatory molecules. Our in vitro
experiments have shown our liposomally-delivered candidate vaccine to be effective in inducing the maturation of mouse dendritic cells, as
demonstrated by increased cell surface CD83, CD80 and CD86 expression
Objective: To determine if our liposome-entrapped HIV-1 antigen is able to maturate and consequently activate dendritic cells.
Methods: B6 mice were sacrificed and bone marrow from femur, tibia and humerus was collected. Marrow cells were then cultured in the
presence of IL-4 and GM-CSF for 5 days before being loaded with HIV-1 antigens to induce maturation. The presence of cell surface markers
related to dendritic cell maturation was then evaluated by flow cytometry.
Results: Stimulation of immature bone marrow-derived murine dendritic cells with liposomally-delivered HIV peptides induces maturation of
these cells, as determined by increased expression of cell-surface markers CD83, CD80 and CD86. Stimulation of immature dendritic cells by
lipid vehicle alone was also able to induce maturation, but to a lesser extent.
Conclusions: The data indicate that the incorporation of multiple HIV-1 Variosites into a lipid based delivery system is effective in inducing the
maturation of immature murine dendritic cells. Our findings suggest that not only a liposomal-based delivery system may act as a vehicle delivery
system, but also it could act as a potent adjuvant to activate innate immune responses.
Contact Information: Ali Azizi, Tel: 613-322-9009, Email: aazizi@uottawa.ca
150
TRAPPIN-2/ELAFIN IS ASSOCIATED WITH ANTIVIRAL ACTIVITY AND REDUCED PRODUCTION OF PRO-
INFLAMMATORY FACTORS IN HUMAN GENITAL EPITHELIAL CELLS
Anna Drannik 1 ; Xiao-Dan Yao 1 ; Jennifer Newton 1 ; Bethany Henrick 1 ; Sumiti Jain 1 ; Kenneth L. Rosenthal 1
1-Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
Plain Language Summary: Recent studies in a group of highly-exposed uninfected sex workers in Africa have identified a molecule in genital
fluids associated with resistance to HIV infection. This molecule is called trappin-2/elafin, but how it protects against sexual transmission of HIV
is not yet known. We are trying to understand how trappin-2/elafin works. We have found that trappin-2/elafin has anti-viral activity and reduces

the release of factors from female human genital cells grown in the test tube that cause inflammation and increased susceptibility to HIV
infection.
Objective: To characterize the role of trappin-2/elafin in modulating the release of pro-inflammatory mediators as well as innate antiviral
responses using poly(I:C), a synthetic mimic of viral dsRNA. Antiviral activity of trappin-2/elafin was also tested against HSV-2 and HIV-1.
Methods: Adenovirus(Ad)-mediated delivery of trappin-2 and treatment with human recombinant protein were assessed in antiviral responses
elicited by poly(I:C) using human endometrial carcinoma (HEC-1A) cells in vitro. Expression of pro-inflammatory mediators and antiviral innate
factors was assessed by ELISA and quantitative RT-PCR. Poly(I:C)-induced antiviral state was assessed by VSV-GFP plaque reduction assay.
The effect of trappin-2/elafin on expression and induction of innate viral sensors was assessed using quantitative RT-PCR, Western blotting, and
nuclear translocation of transcription factors by confocal microscopy.
Results: Ad-mediated delivery of trappin-2 resulted in reduced levels of IL-8, TNFα, and IL-6 in supernatants of HEC-1A cells treated with
poly(I:C). This was associated with reduced activation of AP-1 and RIG-I and MDA-5 but not TLR3. Moreover, poly(I:C)-induced antiviral
state was enhanced in presence of trappin-2 and was associated with higher IRF3 nuclear translocation. However, neither IFN-β-mediated effect
of IRF3 nor its direct effect on activation of interferon-stimulated genes (ISGs) IRF7, ISG-15, and ISG-56 could explain enhanced antiviral
protection in presence of trappin-2. Furthermore, adenoviral augmentation of trappin-2 as well as pretreatment of HEC-1A cells with human
recombinant trappin-2/elafin prior to challenge with HSV-2 and HIV-1 in a transcytosis model resulted in reduced viral shedding 24h post
infection and lower levels of IL-8 and TNFα.
Conclusions: Trappin-2/elafin appears to enhance antiviral activity in human genital epithelial cells while maintaining anti-inflammatory
properties. Additionally, trappin-2 triggers a potentially novel effect on IRF3 activation, which may result in lower HSV-2 and HIV-1 mucosal
transmission across human genial epithelial cells independent of IFN-β.
Contact Information: Anna Drannik, Tel: 905-524-1850, Email: drannik@mcmaster.ca
151
TARGETING GP41 AS A STRATEGY TO INDUCE MUCOSAL HUMORAL IMMUNITY AGAINST HIV-1
Sumiti Jain 1 ; Kenneth Rosenthal 1
1-Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario
Plain Language Summary: An important goal for vaccine approaches against HIV is to induce protective antibodies (Abs) against conserved
regions of the virus to effectively prevent infection, particularly at mucosal surfaces which are the predominant site of transmission and
persistence of the virus. We have designed a vaccine model that successfully elicits high levels of Abs against select regions of HIV and are
currently assessing the quality and function of these Abs.
Objective: To characterize the systemic and mucosal antibody response generated against highly conserved gp41 epitopes that are expressed in
chimeric HIV gag virus-like particles (VLPs) in vivo using an optimized vector delivery regimen in mice.
Methods: We have strategically designed a chimeric VLP expressing multiple copies of gp41-epitopes fused to full-length HIV Gag with the
goal to elicit epitope-specific Abs. C57BL/6 mice were immunized with DNA and adenovirus (Ad) vectors expressing the VLPs and
subsequently generated antibodies (IgG/IgA) were measured by a peptide-specific ELISA from the serum and mucosal samples (vaginal washes
and fecal pellets). Vectors were administered in an optimized prime-boost regimen, intra-muscularly (i.m.) or intra-nasally (i.n.) along with
adjuvants (CpG). One set of DNA+Ad vectors expressed the membrane-proximal external region (MPER) epitopes of gp41 while a second set
expressed a highly conserved IgA-inducing gp41 epitope, QARVLAVERY, which elicits unusually high IgA systemically and mucosally. We
have characterized the immune responses elicited by these constructs in our model, especially the QARVLAVERY-specific IgA due to its
potential mucosal significance.
Results: We have systematically shown that a heterologous DNA-prime (i.m., 3-times, 3-weeks apart with CpG and muscle electroporation)
followed by an adenovirus-boost (i.n., 2-times, 2 weeks apart) was the optimal strategy to induce the highest titres of gp41-specific IgG and IgA
in the serum and mucosal secretions. Furthermore, higher IgA was induced against QARVLAVERY compared to the MPER epitopes, which also
generates ~1:1 ratio of IgG:IgA in the serum of different strains of mice, independent of delivery routes.
Conclusions: Our construct design and immunization model has shown the potential to elicit high titres of gp41-specific IgG/IgA compared to
various other approaches that have attempted the same. Currently, the functionality of these Abs is being characterized in classical and transwell
assays in vitro. Furthermore, we have characterized a novel epitope which could have important implications in future mucosal vaccine strategies
since it induced unusually high IgA. Currently, we are elucidating the nature of this response to determine if QARVLAVERY activates innate
mucosal B-cells via T-cell independent pathways to generate such an IgA response.
Contact Information: Sumiti Jain, Tel: 905-528-1506, Email: jains4@mcmaster.ca

152
COMPREHENSIVE ELIMINATION OF GLOBALLY DIVERSE HIV PRIMARY ISOLATE INFECTIONS BY HERV-K-SPECIFIC
CD8+ T CELLS
Brad Jones 1 ; Shariq Mujib 1 ; Vesna Mihajlovic 1 ; Eric Martin 1 ; Diana Hunter 1 ; Sara Holditch 1 ; Cole Stanley 1 ; Colin Kovacs 4 ; Douglas Nixon 2 ;
Mario Ostrowski 1,3
1-Department of Immunology, University of Toronto; 2-Division of Experimental Medicine, UCSF; 3-Li Ka Shing Knowledge Institute, St.
Michael's Hospital; 4-Maple Leaf Medical Clinic, Toronto
Plain Language Summary: The goal of HIV vaccination is to train the immune system to recognize parts of the virus, and to mount a response.
The diversity of HIV presents a barrier to achieving this goal, both by making it difficult to predict what an infecting virus will look like, and by
enabling the virus to quickly change in order to hide from the immune system. We are developing a novel approach to HIV vaccination which
trains the immune system to recognize a stable surrogate marker of infected cells, rather than the HIV virus itself. These surrogate markers, called
human endogenous retroviruses (HERVs), are the remnants of ancient infectious viruses contained in our genomes, and are specifically activated
in HIV-infected cells. Here we show that a type of killer T cells which recognize HERVs specifically respond to, and kill, cells infected with
diverse HIV viruses from around the world.
Objective: To provide an in vitro proof of concept for a novel approach to CTL-based HIV vaccination which targets human endogenous
retroviral (HERV) antigens as surrogate markers of HIV-infected cells.
Methods: A CD8+ T cell response to a HERV-K-Env epitope was identified in an HIV-infected individual who had maintained an undetectable
viral load for > 7 years (an elite controller). CD8+ T cell clones specific for this epitope were obtained from this individual. Using flow cytometry
based methods, we assessed the ability of this clone to respond to, and kill, autologous CD4+ T cells infected with a diverse panel of HIV-1 and
HIV-2 isolates. We also assessed the ability of this clone to suppress HIV replication in vitro by p24 ELISA.
Results: The HERV-K-Env-specific CD8+ T cells specifically responded to cells infected with each virus in the panel in an HLA-restricted
manner, resulting in their elimination and suppression of viral replication. HIV-Gag-specific CD8+ T cell clones showed a restricted breadth of
recognition, and CMV-pp65-specific clones - tested as negative controls - did not respond to HIV-infected cells.
Conclusions: These data support that the induction of HERV-K expression in HIV-infected cells constitutes a marker of infection that can be
targeted by HERV-K-specific CD8+ T cells. As it is the HERV antigen, rather than HIV itself, which is recognized by these T cells, elimination
of infected cells occurred irrespective of HIV sequence variability. This provides a foundation for a novel strategy to therapeutic and prophylactic
HIV vaccination which elicits cellular immune responses against HERV antigens.
Contact Information: Brad Jones, Tel: 416-946-0277, Email: bjones.ut@gmail.com
153
THE IMPORTANCE OF PROVIDER ENDORSEMENT TO VOLUNTARY HIV COUNSELING AND TESTING FOR OLDER
MINORITY WOMEN
Shelley Craig 1
1-Factor-Inwentash Faculty of Social Work, University of Toronto
Plain Language Summary: Voluntary Counseling and Testing (VCT) has long been the cornerstone of HIV prevention initiatives (Valdiserri et
al, 1997). Although previous research has been conducted on the correlates of VCT for Latino migrant farm workers (Fernandez et al., 2005) and
older adults of all races (Ebrahim, 2004), such inquiry has not been focused on older (> 45) minority women.
Objective: The aim of this study is to create a profile of personal and health related characteristics of older Latina women in order to assess
whether these characteristics relate to VCT.
Methods: Following IRB approval, data for the sample consisted of 135 older (>45) Latinas was obtained for use in the secondary analysis.
Primary measures utilized included health service, sexual risk and acculturation. Minimal missing data was identified. Logistic regression using
structural equation modeling (SEM) techniques were used to test multivariate relationships of variables on VCT. SPSS, AMOS and MPlus
software assisted in analysis to obtain the best fitting model.
Results: A surprising majority (61%) of older Latinas had been tested for HIV/AIDS. Participant ages ranged from 45 to 88 (M = 55.32, SD =
8.15) with the vast majority born outside the United States (87%). Most (65%) reported low annual incomes of less than $15,000. Of those that
had received VCT, most had been tested at a community clinic (66%). The final model of good fit for the SEM had values of x2 (14, p = > .725)
= 10.497; CFI = 1.00; GFI =.986; RMSEA = .000 with a p-value of close fit of .904. The strongest predictor of VCT was provider endorsement
with an odds ratio of 6.375(p < .001). Although present, sexual risk factors were not found to significantly predict VCT. Of the multi-dimensional
measure of cultural identity, only linguistic acculturation was found to be predictive of VCT with an odds ratio of 1.256 (p

Conclusions: The Centers for Disease Control has recommended that VCT should be part of routine medical care (CDC, 2006). This study
supports such integration with findings that assert that VCT testing for older Latinas should be advocated in medical settings and should include
be sensitive to age, culture and discrimination. Implications for further research and practice recommendations will be offered to effectively
target VCT efforts among older minority women.
Contact Information: Shelley Craig, Tel: 416-414-3076, Email: shelley.craig@utoronto.ca
154
HEALTH AND SOCIAL SERVICE EXPERIENCES OF ELEVEN OLDER ADULTS LIVING WITH HIV/AIDS IN THE NATIONAL
CAPITAL REGION
Charles Furlotte 1
1-HIV and HCV Prevention Research Team, Epidemiology and Community Medicine, University of Ottawa
Plain Language Summary: There is a paucity of research on the health and social service experiences of older adults living with HIV/AIDS in
Ontario. The present study interviewed eleven PHAs over age 50 living in Ottawa better explore what types of services they use, what gaps and
barriers they encounter, and the quality of service they experience.
Objective: The primary objective of this study was to conduct an exploratory qualitative analysis of the health and social services experiences of
eleven older adults living with HIV in the national capital. This small study will help to inform the development of future research in this area.
Methods: Participants were recruited through posters placed strategically at an ASO in Ottawa, and referral referred by the case manager at a
local ASO. Participants were asked to provide informed consent, and complete a demographics/ descriptive information questionnaire and several
measures of service use, barriers to care, and mental health. Following this, participants took part in an audio-recorded interview in which they
were asked to talk openly about their experiences with health and social services. The author conducted a thematic analysis of participant’s
stories.
Results: This study consisted of interviews with eleven older adults living with HIV living in Ottawa, Ontario. The mean age of the participants
interviewed was 60 years; the youngest participant was 52, the oldest participants were 67. The group consisted of two females (18%), and nine
males (82%), and no one identified as transgendered or inter-sex. The participants were mostly white, European, English-speaking, well-educated
people of varying sexual orientation (gay, bisexual, straight, and two-spirited), relationship status and income. These participants came from
various educational and occupational backgrounds. All but one participant identified as ‘retired’. Five participants reported receiving Ontario
Disability Support Program (ODSP) benefits and four reported receiving Canada Pension Plan or Quebec Pension Plan (CPP/QPP) benefits.
Qualitative data was analyzed to give a rich voice to the participants’ experiences. Participants’ stories revealed some older PHAs feel lack of
recognition, uniqueness, and confusion in their services. Some participants also reported several discriminatory service experiences, and spoke of
professional, institutional, and PHA power.
Conclusion: Overall, Ottawa participants’ stories included phenomena articulated in previous literature on HIV and aging. Preliminary findings
from exploratory interviews suggest the need for further investigation into the intersection of HIV and aging in relation to health and social
services in Ontario. Participants’ experiences point to what works and what is lacking in terms of programming and policy planning for this
growing population. To best respond to the needs of older adults living with HIV/AIDS, Social workers in this niche will need to do
interdisciplinary work with other professionals, as well as act trans-disciplinarily with PHA community members.
Notes: This thesis project was carried out with the assistance of a grant from the OAN/OHTN.
Contact Information: Charles Furlotte, Tel: 613 608 2429, Email: cfurlott@uottawa.ca
155
HIV AND AGING – AN EMERGING LANDSCAPE FOR CONSIDERATION AND CARE
Judy Gould 1 ; Cathy Cameron 1 ; Kelly O'Brien 2 ; Patty Solomon 2 ; Annette Wilkins 1 ; Elisse Zack 1
1-Canadian Working Group for HIV and Rehabilitation; 2-School of Rehabilitation Sciences, McMaster University
Plain Language Summary: Living longer with HIV is a new phenomenon. A review of the research literature was conducted to illuminate the
emerging issues/gaps arising from both becoming an older Canadian citizen (generally defined in the HIV community as over 50 years of age)
and the impact of HAART and/or HIV on health and how those ‘aging’ disablements can occur earlier for PHAs (People Living with HIV/AIDS).

The Challenge: People over the age of 50 make up roughly eight per cent of new HIV diagnoses in Europe and 11 per cent in the United States.
In the U.S. nearly 27% of all PHAs are over 50 years. In 2004, the Public Health Agency of Canada reported that because HIV/AIDS is assumed
to be a young person's disease, little focus has been given to this issue among older Canadians. In 2006, a scoping review on HIV and
rehabilitation was undertaken. One of the main findings was the need to better understand HIV and aging. This work extends from that initial
review.
Our Approach: Journal articles focused upon on HIV, aging and rehabilitation were culled from Medline, EMBASE, Psychlit and CINAHL
(articles were excluded if they focused specifically on drug rehabilitation, developing countries, and pharmacological studies). The articles were
categorized into three sub-areas: disablement needs, interventions, and roles of rehabilitation professionals and were then analyzed for their
content as well as for gaps in content.
Key Findings: Early analysis reveals that as individuals age with HIV, many experience early or premature onset of concurrent health conditions
such as heart disease, cancer, neurocognitive dysfunction, and bone and joint disorders (osteoporosis, osteoarthritis, inflammatory arthritis). Little
research exists about the interactions of HIV/HAART and these common comorbidities. The review also illuminated that older PHAs are more
likely to endure psychosocial challenges such as increased isolation, depression and stigma. Very few articles focus on how to assist individuals
with these disablement challenges and rehabilitation needs.
Impact on Policy and Practice: Researchers, programmers and policy-makers must consider the physical and psychosocial impact of aging with
HIV, concurrent health conditions, impacts of interactions and side effects of medications and the added complexity of disablement that may arise
from these conditions as they accrue over time. The knowledge generated by the literature review will be used as a springboard to discuss these
issues with stakeholders from the HIV, gerontology and episodic disability communities leading to greater engagement of communities across
sectors and jurisdictions and strengthen communication about this information amongst the HIV community.
Contact Information: Judy Gould, Tel: 416-465-4225, Email: judygould@rogers.com
156
SEXUAL RISK-BEHAVIOUR AMONG CANADIAN SNOWBIRDS WHO WINTER IN FLORIDA: WHO IS HIV TESTING?
Katie Mairs 1 ; Sandra L. Bullock 1 ; Nancy Pearce 1 ; Linda Jessup 1
1-University of Waterloo, Department of Health Studies & Gerontology
Plain Language Summary: Little is known about HIV risk-behaviour and testing among older adults. American research indicates that rates of
HIV and risk-behaviour for those aged 50+ in the United States are highest and increasing in southern Florida (17% of all HIV cases), a location
where many Canadian seniors winter. A small-scale pilot study was conducted to examine the social interactions and sexual risk-behaviour of
Canadian snowbirds in Florida as well as their communication with physicians specific to sex and HIV risk. A greater understanding of HIV
testing is necessary in order to determine whether there is an increased risk for HIV among Canadian seniors.
Objective: To identify the predictors of HIV testing among Canadian snowbirds (aged 50+ years) who winter in Florida.
Methods: A broad cross-section of snowbirds were surveyed (N=299). Eligible participants were: aged 50+, visited Florida in the past 12 months
and stayed for 1+ months on their latest trip, and live in Canada for at least six months each year. Multivariate logistic regression analysis was
used to assess factors associated with HIV testing.
Results: In total, 47 snowbirds (17.7%) reported ever having been tested for HIV (test results were not surveyed). 23.1% of the snowbirds
reported dating in the past five years, and 45.5% had dated at least one Floridian. Odds of HIV testing were increased for the unmarried
(OR=4.09), those aged 50-65 years (OR=1.84), and those who had talked to a doctor about sexual risk-behaviour since age 50 (OR=5.14). A
gender-by-dating interaction was observed, with dating males more likely to test than non-dating males (OR=1.95). Dating females were not
more likely to test (OR=0.166) than non-dating females; and males who dated were 10.1 times more likely to test than females who dated. HIV
testing was unrelated to: dating specifically in Florida vs. Canada, number of dating or sexual partners, frequency of intercourse, condom use, STI
diagnosis, social desirability and other general health-related variables.
Conclusions: Research indicates that only a small proportion of Canadian seniors have ever been tested for HIV. Therefore, the true HIV rate
within this population is unknown. Measures of HIV/STI risk, including sexual risk-behaviour (e.g., number of sexual partners and condom use),
were not significantly associated with HIV testing. This research supports the need for a large-scale study to further understand the social and
sexual interactions of Canadian snowbirds to determine whether they are at increasing risk of HIV similar to that seen in Floridian seniors.
Contact Information: Katie Mairs, Tel: 519-740-0332, Email: kmairs@uwaterloo.ca
157
IMPLEMENTING AN ANONYMOUS CODE IN A NEEDLE EXCHANGE/SAFER INHALATION PROGRAM: WHAT WE HAVE
LEARNED.
Rob Boyd 1 ; Catharine Vandelinde 2

1-Oasis Program Sandy Hill Community Health Centre, Ottawa, Canada; 2-Harm Reduction Program, Somerset West Community Health Centre,
Ottawa, Canada
Plain Language Summary: Presentation of one year of data gathered in a pilot to introduce a unique anonymous code into the needle
exchange/safer inhalation programs at the Sandy Hill and Somerset West Community Health Centres in Ottawa.
The Challenge: Needle Exchange/Safer Crack Use Programs are low threshold, anonymous programs. This creates challenges in program
development and evaluation as we have little understanding of service utilization patterns such as frequency of contact, number of needles or
pipes per person per month, and number of people using the service.
Our Approach: In July 2008, the Sandy Hill Community Health Centre and Somerset West Community Health Centre piloted a new data
collection tool that created an anonymous code for service users. This code allows us to identify the number individuals in contact with our
Needle Exchange/Safer Inhalation Program over time and across programs. Service users are also asked if they “smoke, inject, or both?” to get a
better understanding of shifting methods of drug consumption, with particular concern in characterizing the potentially higher risk people who
both smoke and inject their drugs.
Key Findings: Our pilot demonstrated that you could introduce more data collection into a needle exchange/safer inhalation program without
impact on service utilization. We also demonstrated a high (90%) participation rate from service users in providing data.
We now have a clearer picture of who our clients are (age, gender, number of years using drugs, drug of choice, method of consumption) and can
identify potential differences in profile based on location of service and mobile versus “fixed” sites.
We can also demonstrate different utilization patterns frequent contacts within sites and across the system, the number of stems or needles per
client per month etc..
Impact on Policy and Practice: More sophisticated prevention messaging may be developed taking into account the unique needs of injectors,
smokers and “dual users”.
The “cycling through” of health promotion messaging can be planned (eg. How long does it take to reach 80% of your target audience?)
Improved understanding of program reach and expansion can be properly evaluated
Important sentinel data on changing local utilization patterns is available at the community level such as shifts from smoking to injection, from
oxycontin to fentanyl injecting, etc.
Asking different questions leads to different conversations in the harm reduction intervention improving understanding of risk factors.
Contact Information: Rob Boyd, Tel: 613 569-3488, Email: rboyd@oasischc.on.ca
158
PUBLIC HEALTH, CONDOMS AND BATHHOUSES: A COST-EFFECTIVENESS ANALYSIS OF PROVIDING CONDOMS TO
REDUCE THE SPREAD OF SYPHILIS AT BATHHOUSES IN TORONTO
Nicole R. Greenspan 1 ; Audrey Laporte 2
1-Policy and Planning Division, Toronto Public Helath; 2-Department of Health, Policy Management and Evaluation, University of Toronto
Plain Language Summary: Free condom distribution is a cornerstone of HIV prevention, but there is little information about its impact. An
economic evaluation of condom distribution to bathhouses in Toronto, in light of the syphilis outbreak, was conducted. The cost to Toronto
Public Health and the impact on reducing syphilis among men who have oral sex in bathhouses were calculated. A conservative estimate of the
cost per syphilis case averted was relatively low (CDN$174/case averted). The cost for treatment per case of syphilis in Toronto is unknown, but
published literature from the US is higher (USD$572/case). This study suggests that even if the provision of free condoms in bathhouses is
having a very small effect on the increase of condom use during oral sex it is a relatively cost-effective intervention.
The Challenge: Toronto Public Health (TPH) has a long history of mass distribution of condoms. There is a lack of research to support planning
and evaluation of condom distribution programs. Oral sex and sex at bathhouses have been implicated in the current syphilis outbreak among
men who have sex with men (MSM) in Toronto.
Our Approach: A cost-effectiveness analysis was conducted to determine the cost per syphilis case averted. The distribution of condoms to
bathhouses was evaluated in terms of the cost to TPH and the impact of this program on reducing syphilis related to oral sex in bathhouses in
Toronto in 2007. Estimates of behaviours were collected from the literature and recent local behavioural surveys; these were discussed and
verified with local sources. Estimates of syphilis cases averted were derived by mathematical modelling. Sensitivity analyses were conducted.
Key Findings: A conservative estimate of the cost effectiveness of TPH’s provision of free condoms in bathhouses is $174/syphilis case averted.
If the program was assumed to be least effective under plausible conditions, the cost remained relatively low at $496/syphilis case averted.
Impact on Policy and Practice: The cost associated with treating syphilis in Toronto is unknown; however, literature from the US suggests that
the average directs cost per case of syphilis was $572 USD. While this study had several limitations, it does suggest that even if the provision of

free condoms in bathhouses is having a very small effect on the increase of condom use during oral sex it is relatively cost-effective. TPH’s
partnerships with community-based organizations that conduct outreach activities related to oral sex contribute substantially to the impact on
syphilis transmission due to oral sex that may be occurring at bathhouses.
Contact Information: Nicole Greenspan, Tel: 416.871.3026, Email: ngreens@toronto.ca
159
CAPTURING CONVERSATIONS: IMPLEMENTING A COMPREHENSIVE SERVICE REPORTING SYSTEM FOR MSM
BATHHOUSE OUTREACH
Jessica Cattaneo 1 ; Le-Ann Dolan 1 ; Duncan MacLachlan 1 ; Ian Woodruff 1
1-AIDS Committee of Toronto
Plain Language Summary: We developed a comprehensive service reporting system for the agency’s City of Toronto-funded Bathhouse
Outreach Program. We combined routinely collected measures with coded information from outreach conversation fieldnotes. This combined
database can now be used to more fully explore relationships between variables, identify issues and trends over time, as well as enhance program
monitoring and evaluation
The Challenge: The challenge was to codify qualitative fieldnotes, so that the richness of this additional information could be combined with
existing quantitative information, into a single data model.
During each outreach shift, outreach volunteers record data on a variety of sociodemographic variables such as age and ethno-racial category, as
well as conversation topics and referrals made. This existing quantitative data was mainly used as a “volume reporting” measure at specific
organisational time points.
Volunteers also write supplemental fieldnotes, providing additional information and content of their conversations with bathhouse patrons, to
augment the check-off sections on the bathhouse outreach form.
Our Approach: We reviewed all fieldnotes for the twelve month period from April 2008 to March 2009 (n = 711). Through an iterative process
of mind mapping and content analysis, we created a coding frame comprising 54 unique patron issues that could be reliably identified, and
entered into a database as discreet variables. These 54 issues were further clustered around 8 broad sexual health themes.
The coding frame was applied to generate numerical codes for all issues found in each patron’s fieldnotes. These codes were then merged with the
patron’s existing socio-demographic, conversation topics, and referral codes, to create patron-centred “cases” in an SPSS database.
Key Findings: The coding frame could unambiguously code issues, carried a low collection burden, and demonstrated strong face validity when
reviewed by bathhouse outreach volunteers.
The database highlighted relationships between variables adding considerably to program monitoring and evaluation.
As examples, we found a U-shaped relationship between age and several variables (including referral to community services and “intensity” of
outreach exchange) as well as distinct differences in service need across ethno-racial categories.
Impact on Policy and Practice: The system is now a routine component of program monitoring; providing information on service volumes,
relationships between variables (e.g. age-band and HIV test-referral rate) and more readily identifying emerging trends in the bathhouse outreach
population. It has already stimulated strategic change in training and service delivery
Contact Information: Duncan MacLachlan, Tel: +1 (416) 340 2437, Email: iwoodruff@actoronto.org
160
PREDICTORS OF EMERGENCY DEPARTMENT USE BY INDIVIDUALS ON HAART
Chelsey Rhodes 1 ; Nadia O'Brien 2 ; Wendy Zhang 2 ; Alex Smith 5,6 ; Chris Fraser 5 ; Alexis Palmer 2 ; Eirikka Brandson 2 ; Julio Montaner 2,4 ; Robert
Hogg 2,3
1-University of Waterloo, Waterloo ON; 2-British Columbia Centre for Excellence in HIV/AIDS, Vancouver BC; 3-Faculty of Health Sciences,
Simon Fraser University, Burnaby BC; 4-Faculty of Medicine, University of British Columbia, Vancouver BC; 5-Cool Aid Community Health
Centre, Victoria BC; 6-University of Victoria, Victoria BC
Plain Language Summary: Few studies have examined Emergency Department (ED) use by HIV-positive individuals since the advent of
HAART and the re-conceptualization of HIV/AIDS as a chronic, manageable disease. It would be expected that ED use should be decreasing for
HIV-related acute illnesses and infections. This study explores the sociodemographic, behavioural, and clinical factors related to ED use by a
cohort of HIV-positive individuals. Our results indicate that ED use remains high, and is associated with low socioeconomic status, history of
mental illness, and a variety of poor clinical factors including high viral loads. This suggests that marginalized populations are not able to
adequately manage their HIV infection, and are still experiencing severe clinical events that require emergency care.

Objective: Our objective is to examine factors related to Emergency Department utilization within a cohort of HIV-positive individuals on
HAART.
Methods: The Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort is a prospective study of HIV-positive
individuals 19 years of age or older on HAART. Explanatory variables are collected through a comprehensive interviewer-administered
questionnaire and clinical variables are collected through a linkage with the Drug Treatment Program at the BC Centre for Excellence in
HIV/AIDS. Bivariate analyses compared individuals who used an ED in the past 3 months with those who did not. Multivariate analysis
identified independent predictors of using the ED.
Results: Of 457 LISA participants, 121 (26%) reported visiting the ED in the past 3 months. Bivariate analyses revealed that ED-users were more
likely to be unemployed (p=0.043), to have unstable housing (p=0.049), to have income 250copies/ml (p

Gillian Kolla 1,2 ; Raffi Balian 3 ; Jason Altenberg 3 ; Ray (Butch) Silver 3 ; Élise Roy 4 ; Neil Hunt 5 ; Peggy Millson 2 ; Carol Strike 1,2
1-Centre for Addiction and Mental Health; 2-Dalla Lana School of Public Health, University of Toronto; 3-COUNTERfit Harm Reduction
Program, South Riverdale Community Health Centre; 4-Université de Sherbrooke; 5-Centre for Research on Drugs and Health Behaviour,
London School of Hygiene and Tropical Medicine
Plain Language Summary: The transition to injection drug use is a complex process that is influenced by social contexts and personal
relationships (peer, romantic and familial ties) with injectors. Reducing the transition to injection can prevent HIV transmission, but little is
known in Canada to inform interventions.
The Challenge: The majority of first-time injectors receive help with their first injection from an experienced injector, yet little information
exists on the process by which first-time injectors learn how to inject from experienced injectors.
Our Approach: Fifteen participants who reported helping another with their first injection on a quantitative survey were asked to participate in a
semi-structured interview, where they described their experiences helping others to inject for the first time. Thematic qualitative techniques were
used to analyze the data.
Key Findings: Participants reported a high frequency of behaviours susceptible to influencing non-injectors, such as speaking of the “amazing”
high from injecting, encouraging injection for economic reasons and injecting in front of non-injectors. Participants also described a strong
reluctance to help another with their first hit, as well as social pressure within the community of injectors not to help someone to inject for the
first time. While a minority of participants described encouraging novices, participants overwhelmingly reported that novices approached them
for help injecting. Participants reluctant to assist described pressure from novices, which was perceived to be more intense if the injector was
emotionally close to the novice. Hesitancy to assist was often overcome when novices offered drugs to experienced injectors in exchange for
giving them their first hit. Despite strong reluctance to give novices a first hit, experienced injectors also expressed that a person determined to try
injecting should be taught to inject properly in order to prevent the transmission of HIV and HCV.
Impact on Policy and Practice: Our data point to the need for integrated interventions that target three areas. First, discourage injectors from
speaking positively about injection or injecting in front of non-injectors. Second, strategies to help injectors develop skills to resist pressure to
give a first hit are needed. Finally, safe injection education training is necessary for those who may continue to help novices with their first hit.
Combined, these efforts have the potential to reduce the incidence of initiation into injection and increase use of safe injection materials when
initiating injection, thereby reducing the number of people susceptible to HIV transmission through injection drug use.
Contact Information: Gillian Kolla, Tel: 416-535-8501 ext. 4325, Email: gillian_kolla@camh.net
163
IF WE BUILD IT, WOULD THEY COME? THE FEASIBILITY OF A SUPERVISED INJECTION FACILITY IN OTTAWA
Lynne Leonard 1 ; Emily De Rubeis 1 ; Kate Smith 1 ; Sue McWilliam 1 ; Aideen Reynolds 1 ; Andree Germain 1
1-HIV and HCV Prevention Research Team, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario
Plain Language Summary: We examined drug-related issues specific to Ottawa and the characteristics of people in Ottawa who inject drugs to
determine whether the provision of a supervised injection facility would be a “good fit” to enable the city to respond to the diverse needs of
people in Ottawa who inject drugs and the needs of the wider community.
Through interviews with 250 people in Ottawa who inject drugs it became clear that a SIF could potentially aid in the reduction of public drug
use, improve the overall health of people in Ottawa who inject drugs and assist in reducing the harm associated with their injection drug use
Objective: To characterize the drug-related issues specific to Ottawa and the characteristics of people in Ottawa who inject drugs in order to
assess the potential benefit of a supervised injection facility (SIF) for the city.
Methods: During August and September 2005, 250 street-recruited women and men in Ottawa who inject drugs participated in one-on-one
structured interviews. Descriptive and multivariate analyses were completed.
Results: Community-level drug-related issues included the high prevalence of injecting in public areas, a behavior associated with negative
health consequences for the individual and the evocation of safety concerns for the public; 64% had injected in public in the 6 months prior to
interview, the vast majority injecting in the downtown core. In terms of individual-level behaviors; the multi-person use of needles and injection
equipment was common and occurred twice as often among women than men, with the majority of participants explaining this behavior in terms
of lack of resources. The prevalence of abscesses, liver and circulation problems, depression, and sepsis were high among participants and 43%
of participants had ever overdosed and 40% of those had last overdosed in the downtown core.
Conclusions: The profiles of community and individual level behaviors and practices suggest that the resources offered by a SIF could play a
substantial role in reducing HIV- and HCV related behaviors and improving the overall health among people in Ottawa who inject drugs
primarily through the provision of sterile injection and drug preparation equipment, low threshold health care, and overdose intervention. In
addition, providing a secure, private environment in which to inject may decrease engagement in public injecting in Ottawa and could lead to an
enhanced sense of public safety and a lower likelihood of infection and disease transmission as a result of injection drug use.

Contact Information: Kate Smith, Tel: (613) 562-5800 x8286, Email: lleonard@uottawa.ca
164
GIVING SOMEONE THEIR FIRST HIT – IMPLICATIONS FOR HIV PREVENTION PROGRAMMING
Carol Strike 1,2 ; Gillian Kolla 1,2 ; Raffi Balian 3 ; Jason Altenberg 3 ; Karen Burton 4 ; Brian Lester 4 ; Ray (Butch) Silver 3 ; Neil Hunt 5 ; Elise Roy 6 ;
Peggy Millson 2
1-Centre for Addiction and Mental Health; 2-Dalla Lana School of Public Health, University of Toronto; 3-COUNTERfit Harm Reduction
Program, South Riverdale Community Health Centre; 4-AIDS Committee of London; 5-Centre for Research on Drugs and Health Behaviour,
London School of Hygiene and Tropical Medicine; 6-Université de Sherbrooke
Plain Language Summary: Initiation of injection drug use is a learned behaviour, often dependent on the assistance of an experienced injector
for the first ‘hit’. Reducing opportunities to learn this behaviour can help to prevent HIV transmission, but little is known in Canada about this
process.
Objective: To assess the frequency of injection initiation related behaviours, including giving a novice injector their first ‘hit’ or injection
Methods: Using a stratified convenience sampling technique, we collected questionnaire data from IDUs who had injected in the past 30 days
and attended COUNTERfit needle exchange in Toronto and Counterpoint needle exchange in London, ON. Participants were asked about
injection and initiation-related behaviours. Data were analyzed using descriptive statistics and logistic regression.
Results: When around non-injectors, participants (n=201; 65% men) reported: speaking positively (48%) and negatively (77%) about injection;
discouraging (86%) and encouraging (15%) injection; injecting in front of non-injectors (61%); showing/explaining how to inject (49%); and
giving someone their first hit (25%). The mean number of people in the past 12 months reported to have been shown or explained how to inject
drugs was 3.8. Selected correlates of showing/explaining injecting to a novice include: speaking positively about injection (OR=4.4); speaking
negatively about injecting (OR=3.1); encouraged injecting (OR=3.4); injected opiates (OR=3.82), cocaine (OR=2.71), crack (1.79),
methamphetamine (OR=2.0), speedball – any type (OR=4.30). Men reported injecting in front of more non-injectors than did women (mean=7.6
vs. 3.0). Selected correlates of injecting in front of a non-injector included: speaking positively about injection (OR=2.5); encouraging someone
to inject (OR=5.5); injected opiates (OR=5.8), crack (OR=2.5), speedball –any type (OR=2.89). More men than women reported ever giving
someone their first hit (27% vs. 21%). Selected correlates of ever initiating someone else included: speaking positively about injection
(OR=5.08); encouraging someone to inject (OR=6.52); ever shown or explained injection (OR=7.31); injected opiates (OR=3.4),
methamphetamine (OR=2.1), speedball – any type (OR=2.9).
Conclusions: Many but not all IDUs engage in behaviours that may help non-injectors to learn how to inject drugs. Intervening to reduce the
occurrence and frequency of teaching injection skills may reduce the number of drug users who transition to injecting and become at-risk for
injection-related HIV transmission. Nevertheless, some novices will continue to transition to injection and will be in need of safe injection
education from those giving the first hit.
Contact Information: Carol Strike, Tel: 416-535-8501 x. 6446, Email: carol_strike@camh.net
165
UNDERSTANDING THE EPIDEMIC AND STRENGTHENING PREVENTION EFFORTS IN CHINA: CONDOMS USE AND
KNOWLEDGE AMONG MIGRANTS IN SHANGHAI
Liviana Calzavara 1 ; Laiyi Kang 2 ; Hui Fang 2 ; Hongwei Wang 3 ; Lei Xu 4 ; Meixia Yang 5 ; Canada-China Project Team
1-Dalla Lana School of Public Health, University of Toronto, Canada; 2-Shanghai Municipal Center for Disease Control and Prevention, China;
3-Huangpu CDC, China; 4-Nanhui CDC, China; 5-Xuhui CDC, China
Plain Language Summary: China is experiencing a rapid increase in sexually transmitted infections (STI) and HIV infections. The Canada-
China Project is an international collaboration aimed at reducing HIV and STI transmission through the development and evaluation of
intervention programs targeting migrant workers, female sex workers (FSW), men who have sex with men (MSM), and people living with
HIV/AIDS (PHA). As part of a survey with male and female construction workers in Shanghai, we asked about condom use and knowledge. We
found that knowledge about the effectiveness of condoms was high but use was low. Intervention programs will need to focus on condomapplication,
negotiation-skills, and increasing condom use.
Objective: To assess the level of condom use, knowledge, and perceptions among migrant construction workers in Shanghai, China. This
baseline information will be used to develop, implement, and test the effectiveness of HIV/STI intervention programs.

Methods: HIV and STI testing and baseline-survey was conducted with 1,871 male and female construction workers, randomly selected from 18
construction sites in Shanghai. Descriptive statistics were used to examine condom knowledge and use, and any gender and age differences.
Results: Condom use was low; 36% had ever used a condom. Younger workers (

HIV, SEXUALLY TRANSMITTED INFECTIONS AND MEN WHO HAVE SEX WITH MEN (MSM) IN SUB-SAHARAN AFRICA -
THE CASE OF NIGERIA
Sylvia Adebajo 1,2 ; Ted Myers 1 ; Dan Allman 1,3 ; Robert Remis 1,4 ; Liviana Calzavara 1 ; Sade Ogunsola 2 ; Paul Sandstrom 5
1-HIV Social, Behavioural and Epi Studies Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON; 2-University of
Lagos, Lagos, , Nigeria; 3-Centre for Research on Families and Relationships, University of Edinburgh, Edinburgh, United Kingdom; 4-Ontario
HIV Epidemiologic Monitoring Unit, Toronto, ON; 5-Public Health Agency of Canada, Ottawa, ON
Plain Language Summary: In Nigeria, male same-sex sexual behaviour is criminalized, and the existence of such behaviour is often denied to
exist. When identified men are often the victims of violence, stigmatization and marginalization. The epidemiology of HIV/STIs among MSM
remains understudied in much of sub-Saharan Africa. This report presents the results of the first sero-epidemiological study of MSM in Nigeria
and factors associated with HIV, syphilis and HBV and HCV prevalence.
Objective: The purpose this presentation is to characterize a population of MSM in Nigeria, to estimate the prevalence of HIV, Syphilis,
Hepatitis B and C, and to determine variables associated with HIV infection.
Methods: Men who self-identified as MSM were recruited from the two most populous metropolitan cities in South West Nigeria using
Respondent Driven Sampling. Data were collected using interviewer-administered standardized questionnaires. For men who consented, venous
blood was collected and tested for HIV, syphilis, HBV and HCV.
Results: 1125 MSM were recruited between April and July 2006. The median age of first sex with a woman was 16.7+/-3.5yrs and 17.7+/-3.9yrs
with a man. Prevalence of HIV was 13.4%, and the prevalence of syphilis, HBV and HCV were 0.3%, 11.7% and 3.2% respectively. HIV
positive men were significantly older (27.4+/-5.31) than uninfected MSM (22.9+/-4.2) (p

Contact Information: Stephanie Nixon, Tel: 416-946-3232, Email: stephanie.nixon@utoronto.ca
169
UNPACK THE BLACK: EXPLORING BLACK YOUTH SEXUAL BEHAVIOURS IN THE TDOT
Helena Shimeles 1,3 ; Sarah Flicker 1 ; Jason Pole 3
1-Faculty of Environmental Studies, York University; 2-Dalla Lana School of Public Health, University of Toronto; 3-African and Caribbean
Council on HIV/AIDS in Ontario (ACCHO), Toronto, Canada
Plain Language Summary: The purpose of this study was to provide a more sophisticated approach to conducting research on Black
communities, taking into consideration the diversity found within Black communities in Toronto. The study draws from the responses provided
by the Black youth who participated in the Toronto Teen Survey which was conducted between 2006-2008.
The Challenge: There is a dearth of Canadian-specific research focusing on capturing lived realities and experiences of adolescents from across
Black communities. Much of public health literature is informed by stereotypic and hegemonic representations of Black adolescents as criminal,
hyper-sexualized, and as 'bodies of contagion'.
Our Approach: The purpose of this tudy is to conduct a more in-depth analysis of the Black youth respondent data from the Toronto Teen
Survey in order to: (1) disaggregate the categorical variable of 'Black'; (2) Conduct a demographic analysis to assess the sociala nd sexual
behavioural characteristics; and (3) Analyze the predictors of penetrative sex across factors such as time in Canada, gender, age, ethnicity,
parental education level, religion and sexual orientation.
Key Findings: Five hundred thirty five (44%) of the Toronto Teen Survey Respondents identified as Black. These respondents were further
categorized as African (24%), Caribbean (62%), Canadian (11%), Pan-Black (6%), and Mixed (13%). For Black youth across all five categories,
62% reported having college or university level educated parents. The majority (44.5%) reported not having engaged in sexual intercourse at all.
Furthermore, 83.6% of Black youth respondents overall reported that they had never been or gotten anyone pregnant. Lastly, belonging to any of
the five Black youth categories did not significantly predict sexual intercourse.
Impact on Policy and Practice: Disagreggating and examining the Black youth respondent dataset from the Toronto Teen Survey has led to the
findings in this paper that debunk many assumptions about the realities and sexual behaviours of youth from Black communities. The findings
which suggest low sexual activity, low pregnancy involvement, high parental education, and high involvement in religious groups among Black
youth respondents also contradicts the wider statistics which paint a very different picture about the disproportionate burden of HIV/AIDS
incidence and prevalence shouldered by Black communities in Ontario. Further research is required in order to understand why we are seeing this
disconnection. One possible explanation could be that there are protective factors for Black youth who are engaged in community organizations
in comparison to youth or adults who experience multiple levels of isolation from social or cultural community networks.
Contact Information: Helena Shimeles, Tel: 416.263.4917, Email: shimeles@yorku.ca
170
UNPACK THE BLACK: EXPLORING ACCESS TO CLINICAL SEXUAL HEALTH SERVICES FOR BLACK YOUTH IN THE
TDOT
Helena Shimeles 1,3 ; Sarah Flicker 1 ; Jason Pole 2
1-Faculty of Environmental Studies, York University; 2-Dalla Lana School of Public Health , University of Toronto; 3-African and Caribbean
Council on HIV/AIDS in Ontario (ACCHO)
Plain Language Summary: There is very limited research that explores how youth from Black communities perceive their access to clinical
sexual health services. This paper revisits the Toronto Teen Survey Black youth respondent dataset, to further understand the barriers and
facilitators to accessing clinics for sexual health services. The findings suggested that African youth respondents particularly reported low rates of
access to clinics for sexual health services.
The Challenge: Despite the abundant sexual health resources and personnel available at most clinical settings in Western countires, many studies
describe the under-utilization of these resources by adolescents. The Toronto Teen Survey Report "SexPress" recently revealed that 83% of the
youth had never visited a clinic for "sexual health stuff". The report also cited that along with Aboriginal and Asian youth, Black youth were the
least likely to access sexual health serivces. Due to multi-layered experiences of racism and dehumanization as a result of their high visibility and
legacy of slavery, Black youth are particularly vulnerable to poor access to vital sexual health services.
Our Approach: This paper examines the Black youth respondent dataset from the Toronto Teen Survey in order to understand: 1) What diverse
Black youth want in a clinic; 2) The perceived barriers preventing diverse Black youth from accessing clinics for sexual health services; and 3)
How diverse Black youth rated their last visit to a clinic for sexual health services and information in comparison to White youth.

Key Findings: The majority of Black youth respondents across all five categories of African, Caribbean, Canadian, Pan-Black and Mixed have
'never been' to a clinic for sexual health related reasons. African respondents reported the lowest rates of clinical attendance with only 34%
having been to a clinic for sexual health reasons. 'Racism' presented itself in four out of the five 'Black' respondent groups as a top barrier to
accessing clinics. Mixed respondents were the only group that did not share the same perception. White youth respondents indicated more
favourable ratings of their last clinical visits in comparison to youth from the 5 'Black' respondent categories.
Impact on Policy and Practice: Our findings suggest that when it comes to sexual health care, Black youth respondents were attentive to the
clinical environments (waiting rooms) and staff/health care providers' attitudes. This suggests that clinicians and health care providers should reexamine
protocols to take into consideration how existing structures may be impeding access to and qualty of care for youth from Black
communities.
Contact Information: Helena Shimeles, Tel: 416.263.4917, Email: shimeles@yorku.ca
171
WHY DO TORONTO YOUTH LEARN SO MUCH AND YET NOT KNOW SO MUCH ABOUT HIV/AIDS? RESULTS AND
RECOMMENDATIONS FROM THE TORONTO TEEN SURVEY
Susan Flynn 1 ; Sarah Flicker 2 ; June Larkin 3 ; Robb Travers 4
1-Research and Program Development, Planned Parenthood Toronto; 2-Faculty of Environmental Studies, York University; 3-Women and
Gender Studies Institute, New College, University of Toronto; 4-Department of Psychology, Wilfrid Laurier University
Plain Language Summary: Recent literature indicates an increase in sexually transmitted infection (STI) rates among youth, and a decrease in
youth's knowledge of HIV/STIs. Conscious of the potential for the increased spread of HIV/STIs among youth, the goal of Toronto Teen Survey
(TTS) was to develop strategies for improving youth sexual health outcomes by increasing access to appropriate services.
The Challenge: Improve current HIV/AIDS education and prevention based on youth feedback and desire for further information on HIV/AIDS.
Our Approach: A community based participatory research approach was used with peer researchers who conducted 90 community workshops
with youth and collected 1,216 surveys. Qualitative focus groups with 80 service providers and 108 youth followed. In the survey youth were
given a list of sexual health topics and asked to identify what they had learned thus far and what they would like to learn. The findings from the
survey were explored further in the focus groups with service providers and youth from communities that shoulder a disproportionate burden of
poor sexual health outcomes and/or heightened barriers to accessing appropriate health care.
Key Findings: Our sample was diverse in multiple dimensions: 85% were non-white; 33% were born outside of Canada; 17% report a disability;
7% identified as LGB2QQ; 1% as transgender. Eight percent reported they had learned nothing about sexual health, including HIV/AIDS. Youth
provided feedback on what they thought of the way they received sexual health information in school and from service providers. One of the
more interesting findings was that HIV/AIDS was the top priority identified by youth that they wanted to learn more about however is was also
identified as being one of top topics that they said they were already learning about!
Impact on Policy and Practice: Youth are hearing about HIV/AIDS through education and health care services but at the same time they are
asking for more information on HIV/AIDS. It is clear that while education on HIV/AIDS is widely available to youth, the content and/or
approach is not meeting their needs. The TTS offers many recommendations from youth for improving policy, public health, clinical care, sexual
health education, and community-based service provision. These recommendations provide valuable insight into how information and prevention
related to HIV/AIDS can be communicated more effectively to youth.
Contact Information: Susan Flynn, Tel: 416-961-0113 x 158, Email: sflynn@ppt.on.ca
172
INVOLVING YOUTH IN DETERMINING EVALUATION NEEDS FOR YOUTH SEXUAL HEALTH PEER EDUCATION
PROGRAMS
Denise Jaworsky 1,2 ; Gobika Sriranganathan; Leah Erlich; Lisa Campbell 8 ; Jerri Clout 7 ; Dan Stadnicki; Susan Flynn 5 ; Sarah Flicker 4 ; Jesse
Janssen 6 ; June Larkin 3
1-Faculty of Medicine, University of Toronto, Toronto, Canada; 2-LetsStopAIDS, Toronto, Canada; 3-Gendering Adolescent AIDS Prevention,
Women and Gender Studies Institute, University of Toronto, Toronto, Canada; 4-Faculty of Environmental Studies, Toronto, York University; 5-
Planned Parenthood Toronto, Toronto, Canada; 6-Faculty of Medicine, University of British Columbia, Vancouver, Canada; 7-Youth 4 Youth,
North Bay, Canada; 8-Trip Project, Toronto, Canada
Plain Language Summary: We present the findings of a qualitative study examining the evaluation needs and challenges of youth sexual health
peer education programs. One focus group and sixteen semi-structured interviews were conducted with youth sexual health peer educators in
Ontario who were recruited through community organizations. To facilitate youth involvement in all components of the study youth researchers

were trained to do literature reviews, transcribing, data collection and analysis and other project tasks. Our findings provide information on the
value and best approaches for building evaluation into sexual health peer education programs that service youth.
The Challenge: Community organizations engaging in youth sexual health peer education programs as well as the funding bodies that support
these organizations often struggle to determine if peer education is an effective method of sexual health education for youth. This study collected
data to inform the development of program evaluation tools by identifying key evaluation criteria and examining peer social relations and
lifestyle factors as determinants of sexual health.
Our Approach: Data were collected from eighteen participants in one focus group of two participants and sixteen semi-structured interviews of
youth (16-29) sexual health peer educators in Ontario. Community-based research principles were employed throughout this study and youth
were trained and involved throughout the protocol development, data collection and data analysis phases of this project.
Key Findings: Thematic analysis of the transcribed data revealed four key themes that relate to the evaluation of youth sexual health peer
education. The first theme was that there is great diversity in youth sexual health peer education programs and their goals. The second theme was
that participation in these programs was very beneficial to the youth working or volunteering as peer educators. The third theme was that many
different methods were being used to evaluate these programs. The final theme was that one of the greatest challenges faced by groups
conducting youth sexual health peer education is the lack of program evaluation capacity among many community organizations.
Impact on Policy and Practice: Based on these findings, recommendations for building evaluation into peer education programs include: (i)
supporting organizations in developing program evaluation methods that address the specific program goals; (ii) including evaluation of the
impact on peer educators in process and outcome evaluations; (iii) encouraging the use of mixed methodology in program evaluation and (iv)
building program evaluation capacity among community organizations through workshops, mentorship and toolkits.
Contact Information: Denise Jaworsky, Tel: 416-931-9011, Email: denise.jaworsky@utoronto.ca
173
MANDATORY PRENATAL HIV TESTING AND THE OPT-IN VS OPT-OUT DEBATE: AFRICAN/CARIBBEAN WOMEN
DIAGNOSED WITH HIV DURING PREGNANCY WEIGH IN…
Mira Mehes 1,8 ; Uitsile Ndlovu 1,3,5 ; Wangari Tharao 1 ; Stanley Read 2 ; Notisha Massaquoi 1 ; Félicité Murangira; Frank McGee 6 ; Mark Yudin 7 ;
Rupert Kaul 3 ; Andreé Gruslin 4 ; Lindy Samson 9 ; Lynne Leonard 10
1-Women's Health in Women's Hands Community Health Centre, Toronto, Canada; 2-Hospital for Sick Children, Toronto, Canada; 3-University
of Toronto, Toronto, Canada; 4-Ottawa General Hospital, Ottawa, Canada; 5-The Ontario HIV Treatment Network, Toronto, Canada; 6-Ontario
Ministry of Health and Long Term Care, AIDS Bureau, Toronto, Canada; 7-St. Michael's Hospital, Toronto, Ontario; 8-York University,
Toronto, Canada; 9-Children's Hospital of Eastern Ontario, Ottawa, Canada; 10-University of Ottawa, Ottawa, Canada
Plain Language Summary: Mandatory prenatal HIV testing and opt-in vs. opt-out testing are HIV prevention policy options for reducing
Mother-to-Child Transmission (MTCT) and encouraging early diagnosis and treatment of pregnant women. This topic is especially relevant
among African/Caribbean & Black women who are at a significant risk of contracting HIV during their childbearing years. We examined these
controversial issues by reviewing the opinions and experiences of African/Caribbean & Black women who learned of their HIV positive status
during their pregnancy. Most women favored mandatory HIV testing for all pregnant women. When asked to choose between opt in or opt out,
most preferred routine (opt-out) testing. Regardless of their policy preferences, all emphasized the need for more comprehensive counseling and
support throughout prenatal care.
Objective: To highlight the views surrounding mandatory HIV testing and the opt-in vs. opt-out debate of African/Caribbean & Black women
who tested positive for HIV through prenatal testing in Toronto.
Methods: Information was drawn from individual interviews conducted with African/Caribbean & Black women in Toronto, as part of the
Ontario Prenatal HIV Testing in Ontario (OPHTIO) Study. To participate, women had to have accessed prenatal care in Ontario since 1999 and
be unaware of their HIV status prior to receiving prenatal care. Analysis consisted of a thematic review of the interview transcripts.
Results: All participants (n=14) were immigrants to Toronto from diverse countries (Ethiopia, Jamaica, Kenya, Nigeria, Sierra Leone, St.
Vincent, Swaziland, Zambia, Zimbabwe), arriving in Canada between 1996 and 2008. Their marital status varied: (single 43%, married 22%).
36% had some university education, while 21% had not completed high school. Household income for 79% fell within $0-24,999 range.
Altogether, they had 28 living children and 1 was pregnant at the time of their interviews which were conducted between Dec 2006 – Aug 2009.
All agreed that all pregnant women should be offered HIV testing. The majority (n= 13, 94%) favored mandatory prenatal testing and the baby’s
health and prevention of MTCT was given as the primary reason. When given a choice between opt-in and opt-out testing options, most women
(n=12; 86%) preferred the opt-out option. The popularity of the opt-out alternative was attributed to encouraging testing in pregnant women,
despite the fear of receiving a positive result and socio-cultural implications. All women felt that pre-test counseling should be provided,
emphasizing the benefits of treatment and successful reduction of MTCT.
Conclusions: Mandatory prenatal HIV testing is a controversial topic that raises issues surrounding public health benefits, MTCT and
reproductive agency. The findings suggest that African/Caribbean & Black women who discovered their HIV positive status through prenatal-

testing in Toronto support a mandatory or routine (opt-out) testing policy for all women. The women’s recommendations also suggest that a
greater focus on pre-test counseling and information surrounding MTCT and treatment options should be included in all prenatal care.
Contact Information: Uitsile Ndlovu, Tel: 416-593-7655 ext. 4918, Email: uitsile@gmail.com
174
INVESTIGATION OF AN INCREASE IN INFECTIOUS SYPHILIS CASES IN ONTARIO, 2009
Wendy Bhanich Supapol 1 ; Michael Whelan 1 ; Jennifer Pritchard 1 ;
1-Ontario Ministry of Health and Long-Term Care (MOHLTC), Toronto, Canada
Plain Language summary
Infectious syphilis is a sexually transmitted infection that can have serious health consequences if not treated. Toronto has had an ongoing
infectious syphilis outbreak since 2002, primarily among men who have sex with men. Infectious syphilis increases the risk of acquiring and
transmitting HIV infection. Among HIV-infected persons, the consequences of syphilis infection can be more severe than in uninfected persons.
The Ontario Ministry of Health and Long-Term Care (MOHLTC) investigated a recent increase in infectious syphilis cases in Ontario.
The Challenge
During the first eight months of 2009, the number of infectious syphilis cases reported by Ontario’s public health units to the MOHLTC increased
by 84% over the number reported during the first eight months of 2008. The MOHLTC investigated the recent increase in cases in order to
characterize the increase and to identify populations at risk.
Our Approach
Using the integrated Public Health Information System (iPHIS), we characterized the population involved by analyzing the distribution of
demographic characteristics such as sex, age, location, and risk factors of infectious syphilis cases. We assessed the prevalence of coinfection
with HIV and the incidence of infectious syphilis reinfection.
Key findings
Infectious syphilis remains primarily a male disease occurring primarily among men who have sex with men (MSM). Infectious syphilis is
reported most frequently among men aged 40 to 44 years old. However, young men aged 15 to 24 years had the largest percent increase in
number of infectious syphilis cases. Toronto has by far the largest number of infectious syphilis cases and highest rate of syphilis infection.
Ottawa has the second highest number of cases while Hamilton has the second highest rate of infection. Other health units around the GTA have
recently observed an increase in the number of infectious syphilis cases. This suggests the presence of a multi-jurisdictional infectious syphilis
increase in Ontario. Forty-five percent of infectious syphilis cases in 2009 are coinfected with HIV. Twenty-three percent of infectious syphilis
cases in 2009 had been previously infected with syphilis.
Impact on Policy and Practice
The epidemiologic analysis undertaken will assist the MOHLTC, public health units, and other stake-holders in the development and
implementation of programs to address the increase in infectious syphilis. The MOHLTC would also welcome feedback and suggestions at the
conference on approaches that may be useful in addressing infectious syphilis in Ontario.
201a
BEST PRACTICES FOR INCLUDING TRANS PARTICIPANTS IN RESEARCH: TRANS PULSE PROJECT
Greta Bauer 1 ; Rebecca Hammond 2 ; Matthias Kaay 3 ; Kenji Tokawa 3 ; Anjali K 3 ; Michelle Boyce 4
1-Epidemiology and Biostatistics, The University of Western Ontario
3-Trans PULSE Project; 4-TGStation.com
; 2-Community Health and Epidemiology, Dalhousie University;
Plain Language Summary: Researchers are often unclear as to how to best include transgender, transsexual or transitioned (trans) participants in
research. We present guidelines for developing questionnaire items that are inclusive, respectful, and valid.
The Challenge: Increasingly, researchers are making efforts to identify trans participants in their research. However, researchers have varying
levels of knowledge of trans identities and experiences and of community-specific language, and are often unsure as to what types of questions to
ask or how to word items.
Our Approach: Based on our experiences within a trans community-driven research project in Ontario, and our observations of methods used in
existing research, we have identified best practices for inclusion of trans participants and trans issues in research. Specific wording suggestions
apply to English-language Canadian research, but basic principles presented are applicable across languages and settings.
Key Findings: Trans participants in our research have self-identified across a range of more and less conventional identities that are culturally
embedded. How trans participants are included in research depends largely on the nature of the research questions being addressed. We present
a framework for decision-making regarding questionnaire item development that addresses the following: 1) How to identify trans participants in

a research study in a way that is respectful; 2) How to do so without confusing cissexual (non-trans) participants, who may not be familiar with
trans-specific terminology; 3) Which aspects of trans identity or experience to include; 4) How to ensure that items on a broad range of topics are
asked in a way that does not negate the possibility of trans experience; 5) How to adapt sexual behaviour items for trans bodies and experience,
and; 6) Common pitfalls to avoid.
Impact on Policy and Practice: Little research on trans health exists in large part because of the failure to collect such information in health
research. In part as a result, trans people are often reluctant to participate in research. Efforts to remedy this will encourage participation of
community members in research and allow for creation of knowledge that can be used to improve the health of trans communities.
Contact Information: Greta Bauer, Tel: 519-661-2111 x 86262, Email: Greta.Bauer@schulich.uwo.ca
201b
COMMUNITY CONTROL IN COMMUNITY-BASED RESEARCH: TRANS PULSE PROJECT
Robb Travers 1 ; Jake Pyne 2 ; Greta Bauer 3 ; Broden Giambrone 4 ; Rebecca Hammond 5 ; Kyle Scanlon 6 ; Todd Coleman 3
1-Psychology, Wilfrid Laurier University; 2-Trans PULSE Project; 3-Epidemiology and Biostatistics, The University of Western Ontario
; 4-Social and Behavioural Health Sciences, University of Toronto; 5-Community Health and Epidemiology, Dalhousie University; 6-
The 519 Church Street Community Centre
Plain Language Summary: A growing body of literature about community-based research (CBR) shows promising evidence about its practical
application and contribution to solving real world problems. We describe challenges in moving research from a model of community
engagement to one of community control.
The Challenge: Traditional research approaches have been criticized for ignoring community priorities, wasting scarce resources, using
inappropriate methodologies, and asking insensitive questions. CBR differs in that community members are engaged as research partners at
levels of input, process, and outcome. Most writing on CBR appears to assume academic control of projects, revealing the possibility of discord
between goals of CBR and actual practices that unfold.
Our Approach: We present an example of conceptualizing community engagement in CBR, where discourse shifts from community
“engagement” to “control.” We describe the history of the Trans PULSE Project, the development of its innovative community engagement and
capacity-building strategies, and challenges experienced and important lessons learned from attempting to integrate a community development
framework into research.
Key Findings: Trans PULSE is unique—it has been and is driven and controlled by community. Community members interviewed and selected
research partners from academic institutions and agencies and were instrumental in defining project goals, objectives and theoretical frameworks.
A “Terms of Reference” document stipulating a trans majority for major decision-making cements community control. Capacity-building has
focused on positioning the trans community as policy actors, strengthening trans community leadership as a community development goal—in
survey design, qualitative data analysis, hosting of a policy training institute, graduate student training, and knowledge transfer and exchange
strategies. Operationalizing community control raises many challenges, requiring responding to concerns outside of a traditional research team’s
priorities. Academic partners and community members are accountable to different sources, may have different stakes in research, and may
present alternate goals and priorities. To avoid unintentional disempowerment and deliver on the promise of CBR, there is a need to explore the
nature of academic/community partnerships, to ensure that roles of community members are well-conceived and meaningful and to align the size
of project goals with the available resources.
Impact on Policy and Practice: Trans PULSE represents an example of how community can establish control in the CBR process. The Trans
PULSE model involves community members selecting academic research partners; community member majority on the Investigator’s
Committee; and the creation of a community development position and a community engagement team. This model has important implications
for other CBR projects and the potential to truly deliver on the promise of CBR.
Contact Information: Greta Bauer, Tel: 519-661-2111 x 86262, Email: Greta.Bauer@schulich.uwo.ca
201c
LESSONS LEARNED FROM IMPLEMENTING RESPONDENT-DRIVEN SAMPLING: TRANS PULSE PROJECT
Michelle Boyce 1 ; Greta Bauer 2 ; Todd Coleman 2 ; Nooshin Khobzi 2
1-TGStation.com; 2-Epidemiology and Biostatistics, The University of Western Ontario
Plain Language Summary: Respondent-driven sampling (RDS) is a newer method in research, with specific requirements for valid sampling
and analysis. Strategies employed and lessons learned by the Trans PULSE Project are presented.

The Challenge: RDS provides an attractive option for sampling “hidden” populations and calculating valid statistics for networked communities.
As a newer method, it remains difficult to strategize around “seed” numbers for initiating recruitment, secondary incentives, preserving
anonymity, appropriate and feasible data collection modes, and recruitment promotion.
Our Approach: Trans PULSE aims to survey 1000 trans people in Ontario. Modifications to “standard” RDS were implemented to
accommodate this study population. The survey may be completed online, via paper-and-pencil, or by telephone (with language interpreters) and
takes, on average, 90 minutes. Online, the survey is broken into five parts, allowing participants to exit and return. To address anonymity
concerns, a third-party company was contracted to dispense $20 honoraria upon completion. Secondary incentives are not used, both to preserve
anonymity and since high levels of community enthusiasm appeared to negate their necessity in driving recruitment. With no guidelines for
choosing an optimal number of initial participants, the 16-person Community Engagement Team served as seeds.
Key Findings: The third-party honorarium process proved cumbersome for participants and anonymity concerns appeared lower than expected.
While recruitment has progressed at an acceptable pace, secondary incentives and a shorter survey may have allowed faster recruitment.
Eagerness to participate resulted in minor tension with several people wishing to fill out the survey, and concerns over inclusion of
underrepresented groups drove some participants to circumvent the RDS recruitment process. Periodic re-seeding occurred, once we had ensured
that 4-5 waves of participants had been recruited. The multi-mode format of the survey proved a viable option, though online RDS required
original software programming. RDS use in this population involved an ongoing process of adjusting strategy and promotion. In marginalized
communities, the importance of local community leaders’ understanding of the process and promotion is also crucial to success.
Impact on Policy and Practice: RDS remains one of the only methods to obtain valid estimates in hidden populations. Detailed understanding
of the community is required to allow for recruitment to occur properly. Explanations of the nuances of RDS need to be relayed to the broader
community through different modes to allow wider understanding of why limits on recruits are required. A frequently asked questions document
is useful to respond to community concerns.
Contact Information: Greta Bauer, Tel: 519-661-2111 x 86262, Email: Greta.Bauer@schulich.uwo.ca
201d
HIV-RELATED RISK IN ONTARIO’S TRANS COMMUNITIES: TRANS PULSE PROJECT
Todd Coleman 1 ; Greta Bauer 1 ; Nik Redman 2 ; Rebecca Hammond 3 ; Anna Travers 4
1-Epidemiology and Biostatistics, The University of Western Ontario; 2-Trans PULSE Project; 3-Community Health and Epidemiology,
Dalhousie University; 4-Rainbow Health Ontario
Plain Language Summary: Research has rarely attempted to assess rates of HIV and HIV-risk in broader trans populations. Using respondentdriven
sampling, we captured information on HIV-related risk. We present the results from the first 201 participants in Ontario.
The Challenge: Trans-sensitive HIV prevention services are under-developed, often non-existent. Trans sexuality and sexual practices are not
easily captured by cissexual thinking around HIV risk. Broad population-based assessments of HIV-related risk in trans people are few, and little
research has occurred in Canada. Studies have been conducted primarily in U.S. cities with large proportions of street-active participants,
demonstrating that some segments of trans communities are at very high risk for HIV. Disproportionately high HIV prevalence rates have been
measured (from 2% to 86%) – with a meta-analysis calculating an overall prevalence of 27% among trans women.
Our Approach: A multi-mode (online, telephone, paper) survey containing trans-appropriate questionnaire items on sexual experiences and
HIV-related risk was developed. The results represent the first 201 participants.
Key Findings: None of the sample indicated they were HIV positive, and 14% did not know their HIV status. Median lifetime number of sex
partners was 8, ranging from 0 to 900. Roughly 66% had ever had an HIV test and, of these, 28% were tested less than 6 months ago and 29%
were tested 2 or more years ago. Highest rates of self-reported sexually transmitted infections were at 3% with Chlamydia and HPV, genital
warts, or anal warts. 18% of those on the FTM spectrum (n= 98) and 21% of those on the MTF spectrum (n= 101) had ever done sex work or
exchange sex. Of those currently taking hormones, 52% take them by injection. Acquisition of needles for hormone use varied from doctor’s
offices (53%), pharmacies (51%), needle exchanges (19%) and friends (13%). Approximately 4% had injected drugs for non-medical reasons.
None of the sample indicated ever injecting silicone. Many who reported needing services from AIDS service organizations were unable to
access them.
Impact on Policy and Practice: This information will contribute community-appropriate information to the limited research about trans
communities. This study has the potential to influence policy, assist in improving accessibility for trans people to HIV prevention services, and
allow health and service providers to design and deliver efficient programs and services for specific trans communities vulnerable to HIV.
Contact Information: Greta Bauer, Tel: 519-661-2111 x 86262, Email: Greta.Bauer@schulich.uwo.ca

201e
SOCIAL DETERMINANTS OF TRANS HEALTH IN ONTARIO: TRANS PULSE PROJECT
Kyle Scanlon 1 ; Greta Bauer 2 ; Robb Travers 3 ; Matthias Kaay 4 ; Michelle Boyce 5
1-The 519 Church Street Community Centre; 2-Epidemiology and Biostatistics, The University of Western Ontario; 3-Psychology, Wilfrid
Laurier University; 4-Trans PULSE Project; 5-TGStation.com
Plain Language Summary: Social determinants of health impact the health of communities. However, little information on income, education,
housing, employment and other social determinants is available for trans communities. Preliminary results from the Trans PULSE Project’s
Phase II survey are presented.
The Challenge: For trans people, social determinants -- including income, education, employment, housing, food security, social support, and
access to social services and health care -- have a broad range of effects on well-being, and may impact vulnerability to HIV. However, most
research on trans health has not addressed social determinants
Our Approach: Trans PULSE is a large, mixed-methods, community-based research study in Ontario. Phase II consists of a multi-mode
respondent-driven sampling survey that provides for broad inclusion of trans participants, including those not in clinical care or publicly active in
trans communities. Preliminary unweighted statistical results from the first 201 participants are presented.
Key Findings: Participants came from a broad range of backgrounds and were nearly evenly split between female-to-male (FTM) and female-tomale
(FTM) spectrums. Despite 78% of FTMs and 74% of MTFs reporting at least some postsecondary education and half having a
postsecondary degree, 45% earned less than $15,000/year and only 3% of FTMs and 12% of MTFs earned over $80,000/year. Sizeable
proportions reported being unable to use job references, declining a job, being turned down for a job, or being fired or dismissed because they
were trans. 10% of FTMs and 17% of MTFs were currently receiving assistance through ODSP or General Social Assistance; almost 20% had
been homeless. Access to health and social services was problematic, with the majority of those needing the following types of services unable to
access them: housing shelters, sexual assault centres, AIDS service organizations, addictions services, trans-related surgeries and trans-related
speech therapy. Of those who needed emergency room (ER) services, 46% of FTMs and 24% of MTFs reported having avoided the ER. Being
targeted for violence was common. About 80% of participants had seriously considered suicide, and over half of these had attempted it.
Impact on Policy and Practice: While trans Ontarians exist across all socioeconomic classes and a full range of experiences, trans people
overall appear to bear a disproportionate burden with regard to income, employment, health and social service access, housing, violence and
suicide. Bringing these issues to light has the potential to counteract erasure of trans communities and to allow issues to be addressed
proactively.
Contact Information: Greta Bauer, Tel: 519-661-2111 x 86262, Email: Greta.Bauer@schulich.uwo.ca
202
THE MABWANA BLACK MEN’S STUDY
Winston Husbands 1,4 ; Lydia Makoroka 1 ; Robert Remis 2 ; Trevor Gray 3,4 ; Shannon Ryan 5
1-AIDS Committee of Toronto; 2-Dalla Lana School of Public Health, University of Toronto; 3-Prisoners HIV/AIDS Support and Action; 4-
African and Caribbean Council on HIV/AIDS in Ontario; 5-Black CAP
Plain Language Summary: The purpose of the special session is to discuss the MaBwana results and implications, highlight current
epidemiologic trends and HIV prevention efforts with Black gay and bisexual men, and release the MaBwana report "MaBwana: Health,
Community and Vulnerability to HIV among African, Caribbean and Black Gay and Bisexual Men in Toronto" to OHTN conference
attendees.The session will be chaired by Lydia Makoroka, and will feature presentations and discussion on: Current trends in HIV and AIDS
among Black MSM in Ontario (Robert Remis); Engaging Black gay men in HIV prevention efforts (Trevor Gray); MaBwana background,
highlights and implications (Winston Husbands); Current HIV prevention efforts with Black MSM in Toronto (Shannon Ryan).
Objective: The MaBwana Black Men’s Study was implemented in 2006-2009, and is the first Canadian study to examine vulnerability to HIV
among African, Caribbean and Black (ACB) gay and bisexual men. MaBwana study was developed as an initiative of the African and Caribbean
Council on HIV/AIDS in Ontario (ACCHO), within the framework of the strategy on HIV/AIDS for African and Caribbean communities in
Ontario. MaBwana was implemented through one of its member organizations, the AIDS Committee of Toronto.
Methods: MaBwana involved interviews with nine key informants, the MaBwana survey in which 168 men participated, and indepth interviews
with 24 men. The purpose of the key informant interviews was to gather perspectives on effective implementation of the study, and enhance the
research team’s understanding of community interest in the study. The MaBwana survey was designed to examine a range of issues that may
influence vulnerability to HIV. Survey participants were recruited from a variety of spaces and networks populated by Black gay and bisexual
men, The indepth interviews were designed to provide a more detailed understanding of some core issues from the survey (e.g., identity, sexual
relationships and behaviours, HIV testing, community involvement, affiliation with HIV/AIDS issues, etc.). Seventeen of the interviewees had
participated in the survey.

Results: The special session is an opportunity to share the main themes and implications from the research, and discuss current epidemiological
trends and ongoing HIV prevention efforts with Black gay men and MSM in Toronto.
Conclusions: Black gay men are informed and knowledgeable agents who are profoundly interested in the wellbeing of their networks and
communities.
Contact Information: Winston Husbands, Tel: 416-340-8484, ext 454, Email: whusbands@actoronto.org
203a
MAKING THE INVISIBLE, VISIBLE: THE PROMISE OF PHOTOVOICE FOR ENGAGING LGBT YOUTH IN SEXUAL
HEALTH RESEARCH
Holtby Alix 1 ; Katie Cook 1 ; Robb Travers 1,2,3
1-Department of Psychology, Wilfred Laurier University; 2-Dalla Lana School of Public Health, University of Toronto; 3-Centre for Research in
Inner City Health, St. Michael's Hospital, Toronto
Plain Language Summary: LGBTQ youth can experience significant social exclusion including rejection from family and peers, violence,
homelessness, and profound social isolation. Homophobic/transphobic harassment and violence can especially impact the sexual health of
LGBTQ youth and has been linked to health risk behaviours and negative psychosocial outcomes, including higher risk sex and drug and alcohol
problems. These results suggest considerable potential for HIV infection among LGBTQ youth. To contextualize HIV risk in the lives of
LGBTQ youth, we examined social exclusion through the use of photovoice.
Objective: Our challenge was to find innovative means of engaging Waterloo Region LGBTQ youth in sexual health research aimed at better
understanding their experiences of social exclusion (homophobia and transphobia), and the impact on their health and well-being.
Methods: Fifteen youth (aged 16 – 23) from Waterloo Region participated in a series of four Photovoice sessions over a four week period,
where they were asked: “What are your experiences as LGTBQ youth/part of the queer community?” The purpose of the first session was to
provide more information about the study, distribute camera, and provide guidelines for taking pictures. Participants spent four days taking
photos before a first photo discussion session. At this first session, they were asked to fill out a worksheet, answering a number of questions
about their photos, and then to engage in group discussion. This process of photo-taking and discussion was repeated once. Finally, participants
and researchers came together for a fourth time to reflect on the photovoice experience.
Results: The photo discussion groups yielded several key themes related to social exclusion (particularly homophobia and transphobia),
including safety issues, financial dependency on family, invisibility, and isolation. The key finding, however, was the powerful and successful
manner in which youth were engaged by the process of engaging in Photovoice. Youth found the opportunity to share their experiences and
express their voices through photos to be “empowering” and “invigorating”.
Conclusions: The Federal Initiative to Address HIV/AIDS has identified “youth” as a priority population at risk of HIV, and LGBTQ youth as
having greater susceptibility to HIV. Engaging youth in sexual health research can be challenging. Our data suggest that approaches that
combine community development and innovative CBR methods like Photovoice yield rich insights into the challenges that heighten LGBTQ
youth vulnerability to HIV.
Contact Information: Sarah Flicker
203b
HIV/AIDS AND ABORIGINAL YOUTH: AN ARTS-BASED KNOWLEDGE TRANSFER STRATEGY FOR HIV PREVENTION
EDUCATION
Christine Smillie-Adjarkwa 1 ; June Larkin 2 ; Tiffany Nelson 3 ; Sarah Flicker 4 ; Jean-Paul Restoule 5 ; Charlene Avalos 3 ; Tara Goldstein 5 ; Claudia
Mitchell 6 ; The Youth Warriors 3
1-Department of Adult Education & Community Development, Ontario Institute for Studies in Education, University of Toronto; 2-Women and
Gender Studies Institute, University of Toronto; 3-Native Child and Family Services, Toronto; 4-Faculty of Environmental Studies, York
University; 5-Department of Curriculum, Teaching and Learning, Ontario Institute for Studies in Education; 6-Department of Integrated Studies
in Education, McGill University, McGill University
Plain Language Summary: In this presentation we present an innovative knowledge transfer strategy for research on HIV/AIDS and Aboriginal
youth. HIV/AIDS is reaching epidemic proportions in some Aboriginal (First Nations, Metis and Inuit) communities in Canada. As young people
are one of the most vulnerable groups to HIV infection, stopping the spread of HIV among Aboriginal communities must start with youth. While
research can provide valuable information on HIV risk and prevention, this does not always transfer to HIV education. In addition, there is much

evidence that conventional forms of education are not effective with youth. To address these limitations, we worked with youth from Native
Child and Family Services in Toronto to turn the findings from our study with urban and on-reserve Aboriginal youth into creative youth led artsbased
education. We will discuss the process of developing the arts-based education strategy and the value of this approach for HIV prevention
with youth. The presentation will include a video that documents the arts-based knowledge transfer process, featuring samples of the
performances and artistic productions created by the youth.
Objective: Our specific objectives were:
• to involve Aboriginal youth in a creative arts project designed to turn data collected in a study on HIV/AIDS and Aboriginal youth
into HIV/AIDS education materials for both Aboriginal and non-Aboriginal communities
• to document the creative arts process
• to assess the value of the performances and artistic productions for HIV education
Methods: Data for the arts activities were obtained in a previous study on HIV/AIDS in which trained peer facilitators conducted 6 focus groups
in Ontario and Quebec with 61 urban and on-reserve Aboriginal youth. With the assistance of Aboriginal actor, Herbie Barnes, youth from Native
Child and Family Services Toronto turned data from the study into scripts and discussion questions for HIV/AIDS education. The youth also
created photographs and collages to complement their performance pieces.
Results: We developed an innovative strategy for involving youth in the transfer of research data into creative youth friendly educational
materials. The materials have been distributed widely for HIV prevention education and are now being evaluated for their educational value.
Conclusions: Youth can play a key role in knowledge transfer activities for HIV/AIDS data relevant to their specific population. In the process
youth develop the knowledge and skills to take up leadership roles on HIV prevention in their community.
Contact Information: Sarah Flicker
203c
COLLAGING COMPLEXITY: EXPLORING YOUNG WOMEN’S UNDERSTANDINGS OF HIV/AIDS.
Sarah Switzer 1
1-Ontario Institute for Studies in Education, University of Toronto
Plain Language Summary: Using collage as a methodological and conceptual framework for re-conceptualizing knowledge in HIV/AIDS
education, this paper will attend to youth understandings of HIV/AIDS. Through engaging in the process of making collages, what stories do
youth tell about HIV/AIDS? What discourses are produced when collage and narrative are used as methodological tools to address youths
concerns and/or experiences of HIV/AIDS? By responding to their own collage texts, as well as the collage texts of others, how are issues of
representation addressed and interpreted? Using these questions as a frame, this paper will attend to ways in which participants’ narratives and
collages de-centre conventional ways of “knowing” encouraged by current HIV/AIDS education.
Objective: This study uses collage to explore the way in which five young women make sense of HIV/AIDS within the context of their lives.
Participants are undergraduate students, aged 18-24, ethno-racially diverse, heterosexual and non-identified.
Methods: This qualitative study employs collage as a method to gather information on youth understandings of HIV/AIDS. Two focus groups
and individual interviews were facilitated in order to probe partcipants’ understandings of their own collages, as well as the collages of others.
Using Atlas software, I draw upon narrative analysis, feminist, post-structuralist discourse analysis and pyschoanalytic theory to analyze data.
Results: This study yielded the following findings: First, participants understood HIV/AIDS, and ideas of “risk” as constructed at the site of a
racialized, and gendered Other. Second, participants’ understood the connection between HIV/AIDS and their own lives through three factors
impacting one’s ability to engage in safe sex: a concern over the use of alcohol as a factor leading to loss of “self control”, the influence of
Romance and lastly, concerns around trust and monogamy within youth relationships. Underlying each of these “risk” factors were anxieties
around the expression of sexuality. Third, data suggests that participants projected this anxiety around sexuality onto their understanding of
HIV/AIDS, especially in connection to HIV prevalence among young women.
Conclusions: This study provides a window into the way in which five young women understand HIV/AIDS in relation to their own lives. When
compared to existing school-based HIV/AIDS curriculum, these findings reveal disparities between participants’ complex and contradictory
understandings of HIV/AIDS, and the content and form of current curriculum, which presupposes a rational, linear subject who can reduce one’s
risk via conscious acts of knowledge translation. As health promoters and educators, we must not assume a single, unified meaning of HIV/AIDS.
Rather, we must create sex, queer, and youth positive spaces for youth to explore the multiple, and complex meanings youth attribute to
HIV/AIDS.
Contact Information: Sarah Flicker

203d
UNPACKING THE LINKS BETWEEN HIV AND COLONIZATION USING HIP HOP: LESSONS FROM TAKING ACTION WITH
ABORIGINAL YOUTH
Sarah Flicker 1 ; Ali Lakhani 1 ; Ashley Heaslip 2 ; Jessica Yee 3 ; Randy Jackson 4 ; June Larkin 5 ; Melanie Rivers 6 ; Claudia Mitchell 7 ; Jean Paul
Restoule 8
1-Faculty of Environmental Studies, York University; 2-Medical School, McMaster University; 3-Aboriginal Youth Sexual Health Network; 4-
Faculty of Social Work, McMaster University; 5-Women and Gender Studies Institute, University of Toronto; 6-Che Mamuck, BC Centre for
Disease Control; 7-Department of Integrated Studies in Education, McGill University; 8-Department of Adult Education & Community
Development, Ontario Institute for Studies in Education, University of Toronto
Plain Language Summary: Aboriginal people in Canada make up approximately 3% of the population but account for 9% of new HIV
infections; on average, they contract HIV younger. It has been well documented that there are ssignificant gaps in Aboriginal youth HIV
prevention services, capacity and resources and there is a strong need for innovative decolonizing methodologies and approaches for working
with Aboriginal young people to halt the spread of this epidemic. We used hip hop as one way of engaging aboriginal teens in HIV prevention.
We discovered that Aboriginal youth are linking HIV to other issues in their community including alienation, discrimination, isolation and
substance use. Nevertheless, they are hopeful about their futures.
Objective: • To understand how Aboriginal youth link colonization and HIV
• To see how hip-hop helps youth express themselves
• To create and share “by youth for youth” HIV prevention and support materials
Methods: We held two workshops with Aboriginal teens - one urban group of youth (Toronto, n=8) and one reserve group of youth (Kettle Point,
n=27). Youth engaged in fun interactive workshops that covered issues related to sexual health and HIV risk and then paired with artists to create
innovative prevention materials. Over the course of 2 days they each produced original hip hop songs. Follow up individual interviews were
conducted 6 weeks following the workshop. All data (interviews and songs) were coded and analyzed collaboratively by a team of youth and
investigators.
Results: In many contemporary HIV health promotion efforts, the focus in on understanding individual risk and the individual actions that leads
to risk (i.e. safe sex and condom use). In the works created by youth, they are beginning to pull back the lens on health promotion to examine
some of the structural factors that affect their lives and therefore lead to increased risk of HIV. Dominant themes that emerged in the songs
include linking HIV risk to discrimination, violence, isolation, pain, and a desire for escape. Nevertheless, the songs also carry messages of hope,
resistance and resilience.
Conclusions: This approach has broadened the ways in which the youth are speaking about HIV. Hip Hop may be one youth-friendly way of
engaging young people in dialogue around issues that are important to them and helping them to imagine new strategies for prevention.
Contact Information: Sarah Flicker
204a
PERSISTING DISPARITIES OF SOCIAL DETERMINANTS OF HEALTH BETWEEN ABORIGINAL AND CAUCASIAN
PERSONS LIVING WITH HIV: THE POSITIVE SPACES, HEALTHY PLACES STUDY
LaVerne Monette 5 ; Sean Rourke 1,2 ; Ruthann Tucker 1 ; Saara Greene 3,4 ; Michael Sobota 6 ; Jay Koornstra 7 ; Steve Byers 8 ; Steven Hwang 2 ; Jim
Dunn 2 ; Dale Guenter 3 ; Tsegaye Bekele 1 ; Jean Bacon 1 ; Mark Ragan 1 ; The Positive Spaces, Healthy Places Study Team
1-The Ontario HIV Treatment Network; 2-Li Ka Shing Knowledge Institute, St.Michael’s Hospital, University of Toronto; 3-McMaster
University, Hamilton, Ontario; 4-Fife House, Toronto, Ontario; 5-Ontario Aboriginal AIDS Strategy, Toronto, Ontario; 6-AIDS Thunder Bay,
Thunder Bay, Ontario; 7-Bruce House, Ottawa, Ontario; 8-AIDS Niagara, St.Catharines, Ontario
Plain Language Summary: As part of the longitudinal study of PSHP, we re-interviewed 61 of the 80 Aboriginal PHAs (APHAs) and 378 of the
443 Caucasian PHAs (CPHAs) enrolled at baseline. At 12-months follow-up time, a higher proportion of APHAs were living in unstable housing,
experienced homelessness and housing-related discrimination, had a history of incarceration, moved at least once, and use alcohol and substances
in harmful manners than CPHAs. Appropriate intervention programs are required to reduce the persisting disparities of social determinants of
heath between APHAs and CPHAs.
Objective: APHAs face distinct disadvantages of social determinants of health (SDOH) than CPHAs. This study examines the difference in
health outcomes and SDOH between APHAs and CPHAs at 12-months follow-up of the PSHP study.

Methods: We collected 12-months follow-up data from 61 APHAs and 378 CPHAs enrolled in PSHP and examined differences in SDOH
between APHAs and CPHAs.
Results: The 61 APHAs and 378 CPHAs included in this study were different from the 19 APHAs and 65 CPHAs who are excluded with respect
to some SDOH. The 19 APHAs excluded were relatively younger, were living in unstable housing, and had higher level of substance use at
baseline compared to the 61 APHAs included. Similarly, the 65 CPHAs excluded were relatively living in unstable housing, have experienced
homelessness, and had a history of incarceration at baseline compared to the 378 CPHAs included.
Our follow-up data shows that a higher percent of APHAs were women, heterosexual, and have lower level of education than CPHAs. APHAs
experience higher level of unemployment and had lower income than CPHAs. They were more likely to have unstable housing, experience
homelessness and housing-related discrimination, report a history of incarceration, and move than CPHAs. APHAs had higher prevalence of
AIDS and harmful use of substances compared to CPHAs.
Conclusions: The wide disparity of SDOH between APHAs and CPHAs continue to exist. To improve health and quality of life APHAs, active
involvement of Aboriginal communities is needed in developing culturally appropriate programs and services.
Contact Information: Ruthann Tucker, Tel: 416-642-6486, Email: rtucker@ohtn.on.ca
204b
THE NEED FOR STABLE AND AFFORDABLE HOUSING AMONG WOMEN LIVING WITH HIV IN ONTARIO: THE POSITIVE
SPACES, HEALTHY PLACES (PSHP) STUDY
Ruthann Tucker 1 ; Saara Greene 3,4 ; LaVerne Monette 5 ; Sean Rourke 1,2 ; Michael Sobota 6 ; Jay Koornstra 7 ; Steve Byers 8 ; Steven Hwang 2 ; Jim
Dunn 2 ; Dale Guenter 3 ; Tsegaye Bekele 1 ; Jean Bacon 1 ; Mark Ragan 1 ; The Positive Spaces, Healthy Places Study Team
1-The Ontario HIV Treatment Network; 2-Li Ka Shing Knowledge Institute, St.Michael’s Hospital, University of Toronto; 3-McMaster
University, Hamilton, Ontario; 4-Fife House, Toronto, Ontario; 5-Ontario Aboriginal AIDS Strategy, Toronto, Ontario; 6-AIDS Thunder Bay,
Thunder Bay, Ontario; 7-Bruce House, Ottawa, Ontario; 8-AIDS Niagara, St.Catharines, Ontario
Plain Language Summary: Little has been documented as to the specific housing-related needs and barriers of women living with HIV/AIDS in
Canada. As part of the PSHP housing study, we examined the differential housing- and health-related experiences of women and men who are
living with HIV/AIDS. Baseline findings show that compared to men, women living with HIV/AIDS are more likely to be unstably housed and
are faced with unique challenges such as lower income, higher housing costs and living with children.
Objective: Women living with HIV/AIDS have unique needs and face unique challenges surrounding housing and social determinants of health.
This sub-study examines these issues along with the health outcomes of women living with HIV/AIDS.
Methods: As part of the PSHP study, we enrolled 605 people living with HIV from across Ontario. We collected demographic, health, housing,
and health-related quality of life data using a quantitative questionnaire to examine housing and key determinants of health. In this study, we
compare the characteristics of 142 females with that of 456 male participants at baseline and examine key differences.
Results: Of the 142 women, 52% were Caucasian, 30% were African or Caribbean and 16% were Aboriginal. Women participants were on
average 4 years younger and were more likely to identify themselves as African or Caribbean. Women were 3 times more likely to be unstably
housed and twice more likely to have experienced homelessness. They were also more likely to experience housing-related discrimination
because of race, number of people in their household, or source of income. Women had a lower income, higher housing cost, and were less
satisfied with their qualitative aspects of their housing. They were more likely to live with and care for their children and experience difficulty
buying enough food and sufficient clothes. They reported a higher need for health education, food bank services, life skills training, and various
health services. Women were diagnosed with HIV more recently and had a higher CD4 count than men. However, they were more likely to
experience significant depression and they had significantly poorer mental health-related QOL.
Conclusions: Housing solutions for women must address their unique needs. HIV+ women need affordable, supportive, and stable housing that
fosters health and facilitates access to health and social services for themselves and their dependents.
Contact Information: Ruthann Tucker, Tel: 416-642-6486, Email: rtucker@ohtn.on.ca
204d
WORSENING OF SOCIAL DETERMINANTS OF HEALTH AMONG ABORIGINAL PHAS: THE POSITIVE SPACES, HEALTHY
PLACES (PSHP) STUDY
LaVerne Monette 1 ; Sean Rourke 2,3 ; Ruthann Tucker 2 ; Saara Greene 4,5 ; Michael Sobota 6 ; Jay Koornstra 7 ; Steve Byers 8 ; Steven Hwang 3 ; Jim
Dunn 3 ; Dale Guenter 4 ; The Positive Spaces, Healthy Places Study Team

1-Ontario Aboriginal AIDS Strategy, Toronto, Ontario; 2-The Ontario HIV Treatment Network; 3-Li Ka Shing Knowledge Institute, St.
Michael’s Hospital, University of Toronto; 4-McMaster University, Hamilton, Ontario; 5-Fife House, Toronto, Ontario; 6-AIDS Thunder Bay,
Thunder Bay, Ontario; 7-Bruce House, Ottawa, Ontario; 8-AIDS Niagara, St. Catharines, Ontario
Plain Language Summary: As part of the PSHP study, we interviewed 80 Aboriginal persons living with HIV (APHAs) in 2006 and conducted
a follow-up interview with 61of the 80 APHAs 12-months later. A higher number of people were living in unstable housing and experienced
housing-related discrimination at 12-months follow-up than at baseline. Harmful use of alcohol and substances either remained high or decreased
marginally and more people were diagnosed with AIDS.
Objective: Aboriginal Canadians living with HIV face distinct disadvantages of social determinants of health. This study examines the changes
in social determinants of health and health outcomes of APHAs over 12-months period of time.
Methods: As part of the PSHP study, we interviewed 80 APHAs in 2006. We were able to conduct a 12-months follow-up interview with 61 of
the 80 APHAs in 2007. The remaining 19 APHAs were lost to follow-up. We compared the baseline and follow-up data to examine changes
housing, social determinants of health, and health outcomes among the 61 APHAs only.
Results: The 61 APHAs included in this study are different from the 19 who were lost to follow up in some aspects. Those lost to follow up were
younger, had unstable housing and experienced housing-related discrimination, used substances in a harmful manner, and were not receiving
ARV at baseline.
Among the 61 APHAs, level of unemployment remained high, average income increased slightly, percent of people living in unstable housing
increased by three-fold, and percent of people reporting experience of housing-related discrimination increased from 43% to 48% at 12-months
follow-up when compared to baseline. During the same period, the proportion of people diagnosed with AIDS increased from 54% to 59% and
proportion of people receiving ARV treatment increased from 77% to 94%. Harmful use of alcohol and substances declined slightly or remained
the same while prevalence of significant depression increased from 43% to 49%. Compared to baseline, higher percent of APHAs reported
visiting a Family Doctor (71% vs. 94%) and HIV specialist (82% vs. 90%) while the number of people who received Culturally Appropriate
services declined.
Conclusions: The housing problem among APHAs is getting worse impacting their health and health-related quality of life. Appropriate housing
solutions that address the unique needs of APHAs are required.
Contact Information: Ruthann Tucker, Tel: 416-642-6486, Email: rtucker@ohtn.on.ca
205
ENDURING PARTNERSHIPS: FOCUS ON YOUTH IN THE CARIBBEAN
Lynette Deveaux; Bonita Stanton
1-Children's Hospital of Michigan, USA; 2-Focus on Youth, Bahamas
Plain Language Summary: The US-Bahamian research team has published many articles describing specific results of the intervention study.
What we have written less about are the environmental conditions that were critical to the success of this program, both from a process and an
outcomes perspective. Therefore, in this talk we shall describe the context in which the epidemic occurred, events leading up to the collaboration
and the issues, decisions, processes and relationships that we have developed that have allowed it to succeed.
Objective: Beginning in the early 1990’s, an interdisciplinary group including pediatricians, anthropologists, health educators, psychologists and
statisticians, developed and evaluated an HIV prevention intervention targeting early adolescents living in public housing developments in
Baltimore, Maryland. The intervention, "Focus on Kids", was effective in reducing risk behaviors, intentions and perceptions an ultimately was
included in the Center for Disease Control’s portfolio of effective adolescent programs entitled "Programs that Work". Learning about FOK and
concerned about their own growing problem with HIV, professionals from the Ministries of Health and of Education of The Bahamas approached
the researchers about collaborating to develop a program for Bahamian youth.
Methods: A partnership developed which has spanned over a decade and ultimately lead to the development of an intervention program
targeting Bahamian children in Grade six, a 10-session adolescent HIV prevention program entitled "Focus on Youth in the Caribbean"
(CImPACT). Two programs for developed for their parents. Caribbean Informed Parents and Children Together (CImPACT) is a 22-minute
video emphasizing the importance of parent-child communication about sexuality followed by structured role-play and condom practice. "Goal
for It" is a 22 minute video emphasizing the importance of planning ahead and is followed by supervised discussion and answers. The US-
Bahamian team evaluated the these interventions through a randomized, controlled three-celled longitudinal trial (36 months follow-up)
involving 15 elementary schools in The Bahamas.
Results: The programs have been shown to be effective; based on the effectiveness of FOYC through 36 months, the Ministry of Education has
decided to incorporate FOYC+CImPACT into the elementary school curriculum in second semester grade 5 and first semester grade 6 classes
throughout The Bahamas.
Conclusions: This partnership continues as the US and Bahamian team are now conducting an effectiveness trial of an intervention for Bahamian
youth in grade 10 and are preparing to monitor the country-wide implementation of FOYC and CImPACT.

Contact Information: Bonita Stanton, Tel: 313.745.5870, Email: bstanton@med.wayne.edu
206a
DISCLOSURE WORK: TRANS YOUTH NEGOTIATING RELATIONSHIPS, SEXUALITY, AND SAFETY IN A CISNORMATIVE
SOCIAL WORLD
Rebecca Hammond 1,2
1-Department of Community Health, Dalhousie University, Halifax; 2-Hassle Free Clinic, Toronto
Plain Language Summary: What are the challenges trans youth in Ontario face when negotiating relationships and sexual situations? This
presentation draws on data from the Youth-Gender Action Project (Y-GAP) to highlight the idea of 'disclosure work': a set of ongoing activities
trans youth engage in to conceal their trans identity or history or to 'come out' in particular ways at specific times.
The Challenge: There has been little research that has looked at the particular experiences of being young and trans and virtually no research like
this in an Ontario context. In particular, data that examines the experiences of young trans people in various sexual and social situations is almost
altogether absent with the exception of epidemiological studies that provide few insights into the specific experiences and challenges of this
group.
Our Approach: The data was drawn from 21 interviews with trans-identified youth that took place as part of the Y-GAP Project. Y-GAP is a
community-based research project between Dr. Nicola Brown of Central Toronto Youth Services and Rebecca Hammond of Dalhousie
University. These open-ended interviews explore the everyday lives of trans youth and, in particular relation to this presentation, they explore the
strategies, challenges, and fears youth have around managing their identity on an ongoing basis in various social contexts, including intimate
situations.
Key Findings: 'Disclosure Work' is one facet of a broader concept of 'Transition Work'. Transition work describes the interwoven activities trans
youth must necessarily engage in to understand, actualize, and manage their gender identities to the same extent as cis (i.e. non-trans) youth.
Through an illumination of disclosure work, and the other facets of transition work, we are able to get an empirically-grounded understanding of
how the world is organized in ways that are cisnormative: in other words, how they favour, privilege, normalize and expect people to be cis (i.e.
non-trans).
Impact on Policy and Practice: Through illuminating how the institutions and individuals are shaped by the previously unnamed concept of
'cisnormativity', this presentation will be able to help practitioners and policy-makers recognize some of the assumptions and limitations in their
work.
Contact Information: Rebecca Hammond, Tel: 416-854-7386, Email: re.becca@ymail.com
206b
READING DECOLONIZING METHODOLOGIES: TOWARDS AN ABORIGINAL HIV/AIDS RESEARCH APPROACH
Randy Jackson 1,2
1-School of Social Work, McMaster University; 2-Canadian Aboriginal AIDS Network
Plain Language Summary: Decolonizing approaches in a research context has often been described as processes by and for Aboriginal people,
adopts the principles of self-determination, and draws on cultural resources. This presentation focuses on preliminary findings of a graduate level
reading course, bringing together key features of decolonizing research, highlighting several strengths and challenges and maps out a potential
research framework for use in HIV/AIDS Aboriginal research.
The Challenge: An Indigenous approach to research is best defined as by and for Aboriginal people (Denzin & Lincoln, 2008). The development
of knowledge has often been described in the literature as a sacred journey, one that draws on cultural strengths and ways of knowing the world
(e.g., Wilson, 2008) as it asserts principles of self-determination (Smith, 1999). In approaching research in this way, principles of participatory
action are often used (Evans et al, 2009; Cochran et al, 2008), as are innovative methods that potentially lead to interventions that prevent further
exploitation (Wilson, 2008). Consequently it can challenge the dominant research status quo (Prior, 2007; Lincoln & Denzin, 2008).
Our Approach: Using a critical framework, this presentation draws on preliminary findings from a graduate level directed reading course to
present a synthesis of the literature that explores several central questions: (1) What are the methodological features of a decolonizing research
approach? (2) What are this approach’s internal strengths and challenges? (3) Using lessons drawn from the literature, how can future Aboriginal
HIV/AIDS research be developed and implemented? In answering these questions, this presentation draws on thirty select articles and five books.
Key Findings: In synthesizing the literature the key features of a decolonizing research approach are discussed. Critically reflecting on the value
of this approach, several strengths and challenges are highlighted. Important questions are raised, including the existence of a global Indigenous

methodological perspective (Loppie, 2007), challenges to social justice in the context of valuing multiple perspectives, issues of standpoint, and
consequently how such questions might unfold in the context of research practice (Fook, 2003; Lincoln & Denzin, 2008).
Impact on Policy and Practice: Using this reading course as a platform a preliminary and flexible framework for HIV/AIDS research emerges –
one that potentially guides and informs future dissertation work. Other researchers may find value in this framework where it highlights what
decolonizing approaches can do in terms of achieving the goal of social justice.
Contact Information: Randy Jackson, Tel: 647-350-2738, Email: randy.jackson@rogers.com
206c
UNCENSORING STIGMA: RESEARCH AND RESPONSE-ABILITY
Rosemary Jolly 1
1-Queen's University
Plain Language Summary: This paper asks what kinds of innovative qualitative research methodologies might best access information crucial
to effective HIV/AIDS prevention and treatment, yet not easily recovered/understood due to stigma.
Objective: The shame experienced by victims of stigma is most appropriately read as their recognition of their meaninglessness to and within a
community that constructs their suffering as a mark of their non-personhood, or de-subjectification. If we recognize that persons affected/infected
by H/A are the embodiment of that which is considered abject, how does one create a situation in which vulnerability is minimized in order for
the stigmatized person, or the individual who has been de-subjectified, to be recognized, and consider themselves to be recognized, as active
subjects rather than the objects of stigma – an object-hood potentially compounded by being rendered the objects of study. And how can this take
place in a context that recognizes not only individuals, but communities, are stigmatized?
Methods: In conventional qualitative research, even where trust is established, responses and actions that discriminate against participants, and
participants’ mediation of their responses in accordance with survival skills honed in contexts of structural stigma, are not entirely conscious; and
not easily discarded even when they are. Here I propose the use of a set of research gathering techniques that exploit a dramatic sense of the
participants’ ‘self’ in small groups. Exploiting the sense of participants as acting and as actors allows both participants and researcher to access
the information and behaviours that are stigmatized. Acting enables participants to perform behaviour, attitudes and body language without
‘owning’ them. It also enables researchers to see how stigmatized participants perform what they perceive to be societal responses to themselves
as stigmatized subject(s).
Results: Such interactions can constitute research and intervention simultaneously.
Conclusions: While enabling researchers to understand the ways in which structural stigma interacts with interpersonal stigma from the
perspective and implicit knowledge of the participants, participants, for the duration of the intervention, do indeed become subjects with the
agency to narrate their experiences and knowledge of the functions of stigma as subjects with agency, rather than as the quasi- or non- subjects of
a stigmatizing regime that uses shame to entrap.
Contact Information: Rosemary Jolly, Tel: 613-533-6000-77950, Email: jollyr@queensu.ca
207a
PHALEARNING.ORG: A PHA CENTERED TOOL TO ADVANCE COORDINATION AND ACCREDITATION OF COMMUNITY
CAPACITY BUILDING
Alan Li
1,2,7 ; Joan Anderson 1 ; Anna Demetrakopoulos 3 ; Thomas Egdorf 6 ; Mark Fisher 7 ; Devica Hintzen 2,4,5 ; Andre Ceranto 2 ; Maureen
Owino 1,2,5 ; Eric Peters 4 ; Keith Wong 5 ; Henry Luyombya 2,9 ; Emmanuel Ndyanabo 2,5 ; Precious Hove 8
1-Toronto HIV/AIDS Network; 2-Committee for Accessible AIDS Treatment; 3-AIDS Bereavement Project of Ontario; 4-African and Caribbean
Council on HIV/AIDS in Ontario ; 5-Ethno-racial Treatment Support Network; 6-Ontario AIDS Network; 7-Ontario HIV Treatment Network; 8-
Voices of Positive Women; 9-Black Coalition for AIDS Prevention
Plain Language Summary: The lack of overall coordination and streamlined access mechanism amongst the diverse community capacity
building programs for PHAs in Ontario poses a challenge for PHAs to navigate the complex system and creates barriers in advancing sector-wide
recognition for these programs. To promote Greater and Meaningful participation of PHAs by facilitating access to and promoting accreditation
of these training programs, a network of community organizations and PHAs formed the PHA Learning Partnership (PHALP) and developed a
PHA centered web-based portal, phalearning.org, as a single point of access for PHAs to link to training, volunteer and job opportunities.

The Challenge: The community capacity building programs available to PHAs in Ontario provide exciting training opportunities but also pose
challenges in access, coordination and interagency recognition. Research evidence and community planning processes showed that PHAs want a
streamlined mechanism to manage the information and facilitate access to training programs.
Our Approach: Building on the partnership from the PHA Capacity Building Forum ( 2007) organized by the Toronto HIV/AIDS Network
(THN)and Committee for Accessible AIDS Treatment (CAAT), several community organizations with PHA targeted training programs formed
the PHA Learning Partnership (PHALP) to explore mechanisms to facilitate access to and accreditation of these programs. Grounded in the
principle of Greater Involvement of PHAs (GIPA), PHALP involved PHAs and agency partners in extensive planning processes to address
individual and agency needs and concerns, including effective outreach and program promotion, information management and access, social
networking , and most importantly, confidentiality. Initial partners include African & Carribean Council on HIV/AIDS in Ontario , AIDS
Breavement Project of Ontario, CAAT, Ethnoracial Treatment Support Network, Ontario AIDS Network, Ontario HIV/AIDS Treatment
Network, THN, Voices of Positive Women.
Key Findings: Phalearning.org is a web-based portal that provides single point of access for PHAs to self manage information on capacity
building programs, access job postings and volunteer opportunities, with capabilities of social networking. The PHA centered tool enables PHAs
to define and control the extent of their participation. A multi-agency memorandum of agreement was developed to clarify roles, responsibilities,
and accountability mechanisms to ensure PHA leadership, decision-making and ongoing monitoring and evaluation.
Impact on Policy and Practice: PHA managed technical tools can have great benefit to promote access to different educational/practice
opportunities available to PHA to contribute to GIPA. Such tools can also enable agencies to maximize targeted promotion outreach to PHAs.
The collaborative network will foster sector -wide recognition and longer term accreditation objectives of these GIPA training initiatives.
Contact Information: Alan Li, Tel: 416-364-2261, Email: alanli@sympatico.ca
207b
“CAN WE TALK”: A MULTI-SECTORAL COLLABORATIVE INNOVATIVE TRAINING PROGRAM TO FACILITATE
EMPOWERED PHA/HEALTH PROVIDER COMMUNICATION
Alan Li
1,2,4 ; Judy Daniel 3 ; Maureen Owino 1,2 ; Emmanuel Ndyanabo 1,2 ; Keith Wong 2
1-Committee for Accessible AIDS Treatment; 2-Ethno-racial Treatment Support Network; 3-Tibotec, a division of Janssen-Ortho; 4-Ontario HIV
Treatment Network
Plain Language Summary: To address communication challenges between health care providers and PHAs, ETSN and Tibotec piloted a
training module involving case based scenarios, role plays, interdisciplinary discussion, and identification of best practice strategies for
integration into practice. Program is being replicated across communities and has helped advance research agenda on improving client/provider
communication.
The Challenge: Language barrier, power difference between service provider/client, treatment literacy and other social issues all poses
compounding challenges to PHAs in effectively communicating their issues of concerns with their health service providers. This results in
breakdown in dialogue and reduction in their satisfaction with the therapeutic alliance which in turn adversely affects adherence and clinical
outcomes.
Our Approach: Based on an intervention piloted by Tibotec and the Canadian AIDS Society in early 2008, the Ethno-racial Treatment Support
Network (ETSN) developed a full training module that included multiple case based role plays between PHAs and health care providers,
facilitated small group and panel discussions, and group exercise to identify best practice ideas to improve communication. Case scenarios were
then role played again with participants integrating the best practices identified.
The pilot program was attended by 40 PHAs and service providers, with 3 PHA peer treatment counselors from the ETSN worked with a HIV
nurse, 1 HIV primary care physicians and an Infectious Disease specialist role played the case scenarios.
Key Findings: Program evaluation data revealed that participants felt that case based scenarios and role-play methodology were innovative and
very effective in facilitating their participation and cross discipline communication. Best practice ideas on communication that are jointly
developed between PHA’s and health care providers facilitated PHA empowerment as well as improve the provider/client therapeutic alliance.
Service provider participants felt they gained important insight and knowledge beneficial for their practice and supported the need for further
education for service providers on these issues.
Impact on Policy and Practice: Since the pilots, the Canadian AIDS Society has developed a video entitled “Can We Talk” as an educational
tool to facilitate patients and healthcare providers communication and the tool has been used by 20 AIDS Service organizations.
Plans are underway for larger scale replication of the ETSN training module with other PHA populations and for a parallel training program
targeting health care professionals. Experiences from the program also facilitated the development of a large scale national quantitative study on
physician/patient communication by the corporate partner.
Contact Information: Alan Li, Tel: 416-364-2261, Email: alanli@sympatico.ca

207c
COMMUNITY ENGAGEMENT STRATEGY TO INVOLVE ETHNO-RACIAL FAITH-BASED, MEDIA AND SOCIAL JUSTICE
LEADERS TO ADDRESS HIV STIGMA AND DISCRIMINATION
Alan Li 1 ; Josephine Wong 1,2 ; Khalidah Bello 1 ; Fanta Ongoiba 3 ; Amy Casipullai 4 ; Roy Cain 5 ; Jack Kapac 6 ; Firdaus Ali 7 ; Jose Cedano 8 ; Henry
Luyombya 1 ; Kenneth Fung 9 ; Julie Maggi 10 ; Rachel Zhou 5 ; Noulmook Sutdhibhasilp 11 ; Lena Soje 12 ; Avvy Go 13 ; Kwasi Kafele 14 ; James Murray
15 ; Omer Abddulghani 1 ; Cindy Jolly 1 ; Andrew Maio 1 ; Marisol Desbians 1
1-Committee for Accessible AIDS Treatment; 2-Ryerson University; 3-Africans in Partnerships Against AIDS; 4-Ontario Council of Agencies
Serving Immigrants; 5-McMaster University; 6-University of Windsor; 7-Alliance for South Asian AIDS Prevention; 8-Centre for Spanish
Speaking Peoples; 9-University Health Network; 10-St. Michael's Hospital; 11-Asian Community AIDS Services; 12-Black Coalition for AIDS
Prevention; 13-Metro Toronto Chinese and Southeast Asian Legal Clinic; 14-Centre for Addiction and Mental Health; 15-AIDS Bureau, Ontario
Ministry of Health and Long Term Care
Plain Language Summary: The lack of involvement of ethno-racial faith-based, media and social justice sectors in HIV/AIDS work limits the
effectiveness of HIV prevention and support strategies. To address this gap, CAAT develops a community based research with a multi-pronged
stakeholder engagement strategies aimed at mobilizing these ethno-racial leaders to collaborate in developing anti-HIV stigma prevention
interventions.
The Challenge: Immigrants, refugees and non-status people living with HIV/AIDS (IRN-PHAs) face complex barriers in accessing services and
are often marginalized in their ethno-racial communities due to HIV related stigma and discrimination. While faith-based organizations, ethnic
media, and social justice advocates have traditionally contributed to improving qualities of life in newcomer communities, they have had limited
engagement in HIV prevention and support. This negatively impacts the community response to address HIV/AIDS in ethno-racial communities,
perpetuates marginalization of the HIV/AIDS agenda and reinforces stigma and discrimination against people with HIV/AIDS.
Our Approach: The Committee for Accessible AIDS Treatment (CAAT) developed a research grounded in community empowerment principles
to engage leaders from ethno-racial media, faith-based and social justice organizations to develop HIV/AIDS stigma reduction prevention
strategies in 5 ethno-racial communities in the Greater Toronto Area. The first phase involves building a multi-sector project team with strong
community partnership, PHA peer research assistants, and a project advisory committee (PAC) with members from the target sectors to advise
project design, promotion and recruitment strategies. Subsequent phases include qualitative group interviews of the target groups and involving
the whole team in data interpretation and the development of culturally relevant anti-stigma HIV prevention intervention.
Key Findings:
- Effective community engagement requires efforts in building new relationships with non-traditional partners and consolidation of relationship
with existing partners
- An asset-based model that focuses on strength and positive contribution is important in building equitable partnerships amongst sectors without
history of collaboration
- Providing different roles and options for involvement facilitates engagement of cross sector stakeholders in building new partnerships
- Effective engagement of PHAs in their ethno-racial communities needs to be supported with training that addresses disclosure issues and
potential trauma
Impact on Policy and Practice: The multi-sectoral collaboration of target group stakeholders partnership developed for our project will greatly
enhance the outcome of the study to inform policies and programs within and beyond the HIV sector, and contributes to building a more holistic
supportive environment for all PHAs from diverse backgrounds. Program models will have great transferrable and replicable potential for other
marginalized communities affected by HIV/AIDS.
Contact Information: Alan Li, Tel: 416-364-2261, Email: alanli@sympatico.ca
207d
COMING OUT IN RESEARCH: TRAINING TO FACILITATE EFFECTIVE DISCLOSURE OF PHA RESEARCHERS WORKING
WITHIN THEIR OWN ETHNO-RACIAL COMMUNITIES: LESSONS LEARNT FROM THE CAAT MOBILIZING ETHNO-
RACIAL LEADERS STUDY
Josephine Wong 1,2 ; Alan Li 1 ; Roy Cain 3 ; Kenneth Fung 4 ; Kwasi Kefele 5 ; Julie Maggi 6 ; Cindy Jolly 1 ; Andrew Maio 1 ; Omer Abddulghani 1 ;
Marisol Desbians 1 ; Henry Luyombya 1 ; James Murray 7 ; Noulmook Sutdhibhasilp 8 ; Firdaus Ali 9 ; Fanta Ongoiba 10 ; Lena Soje 11 ; Jose Cedano 12 ;
Avvy Go 13 ; Amy Casipullai 14 ; Jack Kapac 15 ; Rachel Zhou 3 ; Khalidah Bello 1
1-Committee for Accessible AIDS Treatment, Toronto; 2-Ryerson University; 3-McMaster University; 4-University Health Network; 5-Centre
for Addiction and Mental Health; 6-St. Michael's Hospital; 7-AIDS Bureau, Ontario Ministry of Health and Long Term Care; 8-Asian
Community AIDS Services; 9-Alliance for South Asian AIDS Prevention; 10-Africans in Partnership Against AIDS; 11-Black Coalition for
AIDS Prevention; 12-Centre for Spanish Speaking Peoples; 13-Metro Toronto Chinese & Southeast Asian Legal Clinic; 14-Ontario Council of
Agencies Serving Immigrants; 15-University of Windsor
Plain Language Summary: Effective engagement of PHAs is critical to the success of ensuring community relevance and meaningful outcome
of the research studies to affected communities. Many PHAs experiences complex challenges in disclosing to members of their own ethno-racial
communities due to stigma and discrimination. To address these challenges, the Committee For Accessible AIDS Treatment (CAAT) developed

specific training for PHA research assistants in its research project to “Mobilize Ethno-racial Leaders against HIV/AIDS Stigma and
Discrimination”. Lessons learnt will inform broader systemic planning for GIPA and community capacity building programs for PHAs.
The Challenge: Immigrants, refugees and non-status people living with HIV/AIDS (IRN-PHAs) face complex barriers in accessing services and
disclosure due to compounding impact of HIV related stigma and discrimination, homophobia, racism, xenophobia and fear of criminalization.
The lack of visible PHA leadership in many ethno-racial communities in turn reinforces denial and silence on HIV/AIDS, undermines HIV
prevention messages, and perpetuates the social exclusion of IRN-PHAs. While there has been growing involvement and support for PHA to
engage in research, disclosure challenge has been an important factor that confines their involvements to within the traditional HIV/AIDS sector
only.
Our Approach: To effectively address disclosure barriers for PHAs in working with their ethno-racial communities, the Committee for
Accessible AIDS Treatment research team works together to develop a culturally relevant training curriculum. Building from lessons learnt from
other marginalized communities such as gay men and mental health consumer advocates, the training curriculum includes modules that deal with
sensitivity and cultural competence in working with diverse sectors, managing potential hostile responses and developing strategies to cope with
trauma, build resiliency and self care.
Key Findings: Key lesson learnt include:
- Disclosure skills training are critical in facilitating meaningful involvement of PHAs in working with diverse communities
- Training must include practical skills in dealing with anti-harassment, anti-oppression strategies as well as positive advocacy skills
- Training needs to prepare team members in responding to different settings (advisory meetings, data collection, consultations, workshops etc.)
with clearly established boundary and role expectations
- Experiences from other marginalized communities are helpful in informing disclosure capacity building
Impact on Policy and Practice: Skill building to address disclosure challenges for PHA in research setting can have profound impact and
benefit to HIV prevention and stigma reduction. Training models and content developed for ethno-racial communities have broad implications
and transferability to other marginalized communities and should be integrated as core curriculum for all PHA researcher training.
Contact Information: Alan Li, Tel: 416-364-2261, Email: alanli@sympatico.ca
208
HIV EPIDEMIC IN UKRAINE - CHALLENGES AND OPPORTUNITIES
Olena Ieshchenko 1 ; Viktor Isakov 2 ; Yuri Kobyshcha 3 ; Carol Major 4 ; Frank McGee 5
1-National AIDS Committee, Ukraine Ministry of Health; 2-International HIV/AIDS Alliance Ukraine; 3-World Health Organization, Ukraine;
4-Ontario HIV Treatment Network; 5-Ontario Ministry of Health and Long-Term Care; -
Plain Language Summary: Ukraine has the most severe HIV epidemic in Europe with an estimated 400,000 people living with HIV, but only
20% diagnosed. Scale-up of accessible prevention, care, treatment and support is urgently needed and to that end a new National AIDS Program
has been developed with ambitious targets in all areas. While strong stakeholder involvement is well established in Ukraine, there remain many
challenges to increase capacity and resources to ensure a strong national response to the HIV epidemic. The OHTN in partnership with the
Canadian Society for International Health, the Ontario Ministry of Health’s AIDS Bureau, the Ukrainian Ministry of Health, HIV/AIDS Alliance
Ukraine, the All Ukrainian Network of PLWHA and others, is assisting in the capacity building process that underpins the scale-up. This session
is open to all and especially to members of the Ukrainian - Canadian community.
Contact Information: Carol Major
210
LESSONS LEARNED FROM DISSEMINATION OF EVIDENCE-BASED INTERVENTIONS FOR HIV PREVENTION
Charles Collins
1-Centers for Disease Control and Prevention
Plain Language Summary: The US Centers for Disease Control and Prevention – Division of HIV/AIDS Prevention began disseminating
evidence-based behavioral interventions to both community-based and clinic-based HIV prevention providers in 2002. Prior to this dissemination,
it was estimated that 70% of all HIV prevention practice was street-outreach condom distribution. HIV prevention in the USA has undergone a
major change as prevention providers were encouraged to adopt evidence-based prevention interventions. Over the last 7 years, 23 unique
evidence-based interventions have been disseminated to over 3388 HIV prevention agencies. The degree to which the field of prevention practice
is willing to adopt evidence-based interventions is dependent on a range of factors including the complexity of the interventions selected for
dissemination, the establishment of a customer centered philosophy that honors prevention agency stakeholder’s ability to select, adopt, adapt,
and implement the interventions; the costs of implementation; and the agency capacity to successfully implement the interventions. There are

multiple lessons learned through this process that may inform other nations considering the use of evidence-based behavioral interventions as
their standard of HIV prevention practice. These lessons include such areas as: determination of the standards for evidence based prevention
practice; planning a national dissemination infrastructure as well as individualized plans for the interventions disseminated through that
infrastructure; development of policy supports to reinforce and regulate evidence-based practice; promote health marketing to adopting agencies
to include support in the selection process of an EBI; consumer focused approaches to intervention materials development and packaging;
designing a training infra-structure that includes train-the-trainer as well as train-the-facilitator options; implementing a capacity building strategy
to strengthen prevention providers ability to implement EBIs with fidelity; development of a quality-control strategy that is sensitive to adaptation
and resource limitations; and, establishing an evaluation structure that is appropriate for agencies that are implementing interventions that have
already been determined to be efficacious. The transfer of scientific research into prevention practice is context dependent because what
constitutes prevention practice is molded and influenced by the social structures and social capital for each capitalistic, industrial, democratic
nation. The lessons learned in the USA may be of benefit when considering strategies to increase the scientific basis for HIV prevention practice
in Canada.
Contact Information: Charles Collins
301
HARM REDUCTION THEATRE TROUPE PROJECT
Silke Haller ; Meskerem Tebeje
1-Voices of Positive Women, Toronto, Canada
Plain Language Summary: VOPW completed a needs assessment across the organization to see if there were any gaps in service. The findings
of this were that HIV positive women who use drugs or have used drugs felt there was a lack of services at VOPW and in the homeless sector
specific to their needs. In 2008 the organization completed a series of focus groups of these women to find out what their programming needs
were. With this information Voices applied for funding for a Harm Reduction Project that includes a harm reduction group and a Theatre Troupe
Project where the women would create a play that to be used as a teaching tool for community organizations.
Objective: To bridge the gap in service delivery for VOPW members who are also substance users. To foster dialogue among substance users
and other VOPW Members. To build skills, fostering self esteem, and give the women a safe space to learn and grow. Providing education to
the public, community organizations and ASO’s about the issues they face on a day to day basis.
Methods: The project coordinator provided outreach to women’s shelters, drop in centre’s and on the street to connect with the women. The
women met on a monthly basis at a Harm Reduction Support Group that provided education about HIV, safer drug use, life skills in self care and
more. Five peers from the harm reduction support group met weekly to create the play. When the play was complete 5 volunteers (VOPW
members) joined the group to be part of the play. can the 5 peers for the theatre troupe who met every week to write create and plan this play.
Results: Women with no prior performance experience are educating ASO Staff and their members on issues that affect them and their
challenges. Project participants have gained confidence in their abilities which promoted better self-care.
Conclusions: Women who are using substances have become members of VOPW and are accessing other services. The Peers have gained skill
in creating performing and planning the play. Community workers are more aware of their issues and are serving these women.
Contact Information: Meskerem W. Tebeje, Tel: (416) 324 8703 x 27, Email: mtebeje@vopw.org
302
PHOTOPOSITIVE: EXPLORING HIV-RELATED STIGMA WITHIN COMMUNITIES OF GAY AND BISEXUAL MEN IN
TORONTO.
Marney McDiarmid 1 ; Gerardo Betancourt 2 ; Miguel Cubillos 3 ; Siva Gunaratnam 4 ; Richard Utama 5 ; David Lewis 6 ; Jimi Lister-Haggerty 7 ; Glen
Brown 8
1-Queen's University, Kingston, ON; 2-Centre for Spanish Speaking People; 3-AIDS Committee of Toronto; 4-Alliance for South Asian AIDS
Prevention; 5-Asian Community AIDS Services; 6-BlackCAP; 7-The Black Eagle; 8-Consultant
Plain Language Summary: The goal of PhotoPositive is to explore how HIV-related stigma is manifesting within gay social networks in
Toronto and to investigate the effects of stigma on HIV positive men.
The Challenge: Currently there is very little research investigating HIV-related stigma as it operates within communities of gay and bisexual
men. Findings from the few studies exploring HIV-related stigma within gay communities indicate that stigma serves to divide the community,
can result in instances of prejudice against HIV positive men and can lead to isolation, rejection, and judgment. (Courtenay-Quirk, et al., 2006;
Diaz, 2006).

Our Approach: In Phase I of our research project a Photovoice methodology was used to explore ten HIV positive men gay men’s experiences
of HIV-related stigma. Photovoice is a CBPR methodology in which participants are given cameras, invited to take photos that reflect their
experiences, and meet to discuss the meaning of their images. Men were recruited primarily through contact with support workers from five
Toronto AIDS Service Organizations (ACAS, ASAP, ACT, Center for Spanish Speaking People, BlackCAP). The study was also advertised
through PLHWA list-serves and flyers distributed at various venues on Church Street. Participants identified as gay or bisexual men, were HIV
positive, and efforts were made to recruit an ethno racially diverse group of men (1 Lebanese, 1 South Asian/Black, 2 Latino, 2 Asian, 4
Caucasian).
Key Findings: Data analysis is currently underway, however, preliminary analysis reveals that for the PhotoPositive participants HIV-related
stigma manifested primarily in sexual contexts. Sexual rejection due to HIV status was a common experience and through their images many
participants conveyed the painful emotional impact of these exchanges. Loneliness, isolation, and a decreased sense of self-worth are emerging
themes. However, the images and narratives of group members also demonstrate an incredible amount of resilience and an ability to rebuild a
sense of self worth and sexuality despite the rejection experienced. Participants noted that HIV-related stigma was far less prevalent in the context
of community engagement such as participation in gay organizations or gay events.
Impact on Policy and Practice: The results of our research help to identify how HIV-related stigma is manifesting within communities of
gay/bisexual men, explore its impact on HIV positive men and better understand their coping strategies. Photos and accompanying narratives will
be distributed through a public exhibit and used inform HIV/AIDS prevention and support programmes.
Contact Information: Marney McDiarmid, Tel: 613.549.6850, Email: marneymcdiarmid@gmail.com
303
PEER INVESTIGATOR EXPERIENCES IN A COMMUNITY BASED RESEARCH STUDY: EXPRESSION THROUGH CREATIVE
PROJECTS.
Peer Investigators 1,2 ; Allison N Scott 3 ; Beth Hayhoe 1 ; Diana Walker 2 ; Ruth Ewert 1 ; Janet Parsons 4 ; Catherine Worthington 5 ; Stephen W
Hwang 3
1-Evergreen Centre for Street Youth, Yonge Street Mission; 2-Youthlink Inner City; 3-Centre for Research on Inner City Health, St. Michael's
Hospital; 4-Li Ka Shing Knowledge Institute, St. Michael's Hospital; 5-Faculty of Social Work, University of Calgary
Plain Language Summary: We have forged a CBR partnership between street-involved young women at risk for HIV, service providers, a
doctoral student and academics. As part of the skills-building and knowledge translation components of the project, peer investigators have
created arts-based projects that express their interests in sexual health or pregnancy and have utilized these projects for knowledge translation and
exchange. In this interactive display peer investigators reveal their creative projects and speak about their experiences in the project.
The Challenge: Five young women who have experienced street life and have an interest in pregnancy or sexual health joined service providers
from Evergreen Centre for Street Youth and Youthlink Inner City, and academics from St. Michael’s Hospital, and the University of Calgary in a
qualitative CBR project on pregnancy and sexual health. As part of the capacity building and knowledge translation phases, peer investigators
completed creative projects that expressed their experiences with pregnancy or that explored their interests in sexual health.
Our Approach: Peer investigators were given one year and a budget to buy supplies and equipment necessary to create a project of their choice.
Outside expertise was brought in when desired by peer investigators, however projects were largely created without assistance.
Key Findings: In this presentation peer investigators reveal their creative projects and discuss their experiences of creating and sharing them.
Each investigator drew upon her skills and interests to create a unique project. Projects are therefore quite diverse and include a quilt, a
cookbook, and mixed-media artwork. Peer investigators’ art explores themes such as concerns regarding sexual education, the emotional impact
of pregnancy, and feelings of love, tenderness and responsibility for their children.
Impact on Policy and Practice: This project represents one model of how the creative process can engage communities at risk for HIV/AIDS in
the CBR process. The creative projects provided both a means for self-expression and a platform for advocacy by individuals within a
community that has often been made invisible.
Contact Information: Allison Scott, Tel: 416-827-3277, Email: scottal@smh.toronto.on.ca
304
REGULATION OF THE IL-7 RECEPTOR ALPHA CHAIN IN PRIMARY HUMAN CYTOTOXIC T-CELLS
Juzer Kakal 1,2 ; Scott Sugden 1,2 ; Paul MacPherson 1,2,3,4
1-University of Ottawa - Department of Biochemistry, Microbiology and Immunology; 2-Ottawa Hospital Research Institute; 3-University of
Ottawa – Faculty of Medicine; 4-The Ottawa Hospital - Division of Infectious Diseases

Plain Language Summary: Interleukin (IL)-7 plays an essential role in CD8 T-cell development, homeostasis and function. Consequently,
expression of the IL-7 receptor alpha-chain (CD127) is tightly regulated throughout the life-span of a CD8 T-cell and transcription of the CD127
gene is responsive to a number of extracellular signals. Here we define the basal CD127 gene promoter in resting CD8 T-cells and show how this
promoter is regulated by dexamethasone and IL-7.
Objective: To identify the core CD127 gene promoter and its response to dexamthasone and IL-7.
Methods: The CD127 gene promoter was cloned from human genomic DNA and core regulatory elements were defined through a mutational
analysis using a luciferase reporter plasmid. Endogenous CD127 transcripts and luciferase expression from the CD127 promoter were measured
in primary CD8 T-cells at rest and in response to dexamethasone or IL-7. Potential signalling pathways were investigated using inhibitors of
Janus Kinases (JAKs), Mitogen-Activated Protein Kinases (MAPK), Phosphoinositide 3-kinases (PI3K), p300, plus inhibitors of transcription,
translation and DNA methylation.
Results: The CD127 gene core promoter was identified within 260bp upstream of the transcriptional start site (TATA box) with additional
partially redundant positive cis-regulatory elements located between -1200 and -1468bp, -1468 and -1760bp, and -1760 and -2406bp. Treatment
with dexamethasone increased CD127 gene expression and we identified a glucocorticoid responsive element between -2269 and -2255bp within
the promoter. Treatment with IL-7 resulted in a 66% decrease in CD127 transcripts. This down regulation of CD127 mRNA by IL-7 was
dependent on JAK-STAT signalling and new protein synthesis as JAK inhibitors and inhibitors of transcription and translation were able to block
IL-7’s effect. Interestingly, IL-7 responsive cis-acting repressor elements were not identified within the first 2900bp upstream of the CD127
TATA box. Treatment with a global methylase inhibitor as well as inhibitors of p300, Pi3K and MAPK signalling had no effect on IL-7
suppression of CD127 mRNA.
Conclusions: The CD127 core promoter in resting CD8 T-cells is located within the first 260bp upstream of the transcriptional start site.
Additional positive cis-regulatory elements are located from -1200 to -2406 relative to the TATA box with a glucocorticoid-responsive element at
-2260bp. Although down regulation of CD127 mRNA by IL-7 is dependent on JAK-STAT signalling and requires de novo protein synthesis, IL-
7 responsive cis-acting repressor elements were not identified within 2900bp upstream of the transcriptional start site.
Contact Information: Juzer Kakal, Tel: (613) 737 8899 ext 79851, Email: jkakal@ohri.ca
305
USING ART TO EDUCATE THE YOUTH AND OPEN-UP A DIALOGUE RE: HIV/AIDS IN THE ETHIOPIAN-CANADIAN
COMMUNITY
Meskerem Tebeje 1 ; Hiwot Teffera 1
1-P2P Canada, Toronto, Canada
Plain Language Summary: Ethiopia is one of the countries listed as HIV endemic on PHAC. In response to the increased need to educate the
community about HIV/AIDS, People to People (P2P) Canada, (a population specific ASO that works with Ethiopian Canadian Community), has
been running a Youth Festival for the past 6 years. Its Youth leadership program targets youth between the ages of 14 and 25 to raise awareness
about HIV/AIDS and relies heavily on art and performance as an education tool.
Objective: The Ethiopian youth experience multiple forms of marginalization including cultural and language barriers that prevents them from
acquiring prevention and care information like other Canadians in the same age group. The youth leadership program’s objective is to facilitate
dialogue about HIV/AIDS, to educate on HIV/AIDS prevention and transmission methods, to build the capacity of the Ethiopian Canadian youth
who are in the most vulnerable age group to contract HIV/AIDS, to facilitate culturally appropriate HIV/AIDS messages using art and
performance, and to promote increased confidence among the youth to practice safer sex.
Methods: 15 youth (14 – 25 years) are recruited annually to attend the P2P youth leadership program. There is a10 week mandatory training on
HIV/AIDS risk, transmission, and prevention issues. Once the training is completed, the youth with the help of a theatre director work on play
themes that carry HIV/AIDS Education messages. Poems, skits, songs, and dances reflect on issues that affect Ethio-Canadian youth including
generation gap, identity Crisis, substance use, teenage pregnancy, and school dropout that increase youth vulnerability to HIV/AIDS. At the end
of the program, the youth would perform at the Youth Festival organized by P2P.
Results: Survey questionnaires and focus groups that were conducted among participating youth and the youth festival attendees by P2P Canada
indicate that the program has been effective in raising awareness about HIV/AIDS and in combating stigma associated with HIV/AIDS.
Conclusions: Art and Performance are found to be very effective tools to promote culturally appropriate messages about HIV/AIDS and to build
the capacity of the Ethiopian Canadian youth. This program has mainly resulted in increased confidence among program participants and
facilitated dialogue about HIV/AIDS, safer sex negotiation, and gender equality in the wider community.
Contact Information: Meskerem W. Tebeje, Tel: (416) 324 8703 x 27, Email: mtebeje@vopw.org

306
REACHING VULNERABLE WOMEN IN PRIORITY AREAS IN THE GREATER TORONTO AREA: VOICES OF POSITIVE
WOMEN’S COMMUNITY CONNECTIONS PROJECT
Meskerem Tebeje 1 ; Hiwot Teffera
1-Voices of Positive Women, Toronto, Canada
Plain Language Summary: In Canada, the greatest increase in HIV infections is among women aged 15-24. African and Caribbean women are
also over-represented. There is a lack of women-specific prevention initiatives for positive and at-risk women who live in the Greater Toronto
Area (GTA) as well as for women who are from endemic countries. Specifically, women from priority neighborhoods are characterized by
poverty, large newcomer populations, marginalized populations (including black women) and limited HIV/AIDS services.
Objective: Voices of Positive Women, an AIDS organization specifically by and for HIV+ women, has established the Community Connections
project in response to the prevention needs of women residing in priority areas in the GTA. In recent years, the project has evolved to include
women who are from endemic countries since geography and related factors are not the sole contributors to women’s HIV vulnerability. The
project aims to increase HIV/AIDS knowledge and self-esteem in women and enhance the quality of life for women at risk of or living with
HIV/AIDS.
Methods: This project recruits female volunteers, from the priority neighborhoods as well as community organizations that serve women from
endemic countries, and trains/supports them to educate women in their neighbourhoods or specific populations on HIV/AIDS.
Results: The project is versatile as it supports women to facilitate workshops in their own communities, promotes women as experts in their lives
and HIV/AIDS, and addresses women’s HIV/AIDS educational needs in a gendered and culturally specific manner.
Conclusions: Barriers include the distance between priority neighborhoods and services in the downtown core and the commitment needed to
create trusting relationships and fully respond to the education needs of each priority area. Culture and language barriers as well as immigration
status are also barriers with respect to providing prevention and care information to women from endemic countries. Also a lack of basic
knowledge about healthy sexuality and HIV/AIDS among workshop participants forced us to do repeat workshops for the same groups of women
which is costly in terms of resources and staff time. We have learned to stay committed to the communities and remain flexible in the content and
framework of the workshops while attempting to tailor woman-specific workshops to address issues including immigration status, poverty,
language barriers, etc.
Contact Information: Meskerem W. Tebeje, Tel: (416) 324 8703 x 27, Email: mtebeje@vopw.org
307
50+ YEARS AS WOMEN LIVING WITH HIV –CASE MANAGERS PROVIDE A ‘WHEALTH’ OF EXPERIENCE
Janet Caswell 1 ; Mary Mwalwanda 1 ; Adriana Carvalhal 2 ; Allyson Ion 2
1-Voices of Positive Women, Toronto; 2-Department of Psychiatry and Behaviour Neurosciences, McMaster University, Hamilton, On., Canada
Plain Language Summary: As Peer Case Managers, we are drawing on 50+ years of personal experience of living with HIV, which enables us
to better understand the challenges faced by other HIV positive women. Through a series of 12 sessions, the strengths, goals and personal
achievements of HIV+ women are identified. Coming from diverse backgrounds ourselves, we are open and sensitive to the diversity of cultures,
traditions and lifestyles. Guided by wHEALTH principles and our familiarity with available resources in the community, we are able to refer
participants to the appropriate services, agencies and people relevant to meet their needs.
Objective: Not as clinicians or mental health professionals but as women living with HIV, we offer client centred case management. Drawing on
our common experience we strive to meet the needs and address the issues of HIV+ women enrolled in wHEALTH. It is our hope that these
women will relate to us as peers and obtain information and support. Our strategy is to build on the client’s strengths rather than focusing on their
challenges and weaknesses.
Methods: It is the expectation that wHEALTH participants and the peer case managers will commit to a series of 12 sessions. Efforts are made
to meet women where they feel comfortable and where confidentiality can be assured. The wHEALTH manual guides the assessment, planning,
implementation, monitoring and evaluation of the intervention delivered to participants. Peer case managers work in collaboration with Voices of
Positive Women and the wHEALTH research team.
Results: 176 HIV+ women from the Greater Toronto and Hamilton areas are expected to enrol in wHEALTH; half of these women will receive
peer case management, the other half will receive support through Voices of Positive Women. To date, 74 women have enrolled (53 in Toronto,
21 in Hamilton). Perspectives of women receiving case management will be shared.

Conclusions: Peer case managers bear witness to the positive impact of peer support and mentorship and we feel fortunate to stand alongside
these women. The value of this project in our own lives is worth noting and we look forward to continuing to impact others through wHEALTH.
There is still a need for the continued support of community agencies and health care providers in order to build more effective partnerships in
providing ongoing, supportive services to HIV + women.
Contact Information: Mary Mwalwanda, Tel: 905 518-3586, Email: msmwalwanda@hotmail.com
308
UNDERSTANDING THE ROLE OF INNATE FACTORS IN MOTHER-TO-CHILD HIV-TRANSMISSION THROUGH BREAST
MILK.
Bethany Henrick 1 ; Kakon Nag 1 ; Anna Drannik 1 ; Kenneth Rosenthal 1
1-Department of Pathology & Molecular Medicine, McMaster University, Hamilton, ON
Plain Language Summary: Studies from Kuhn (2007) convincingly showed that infants who were exclusively breast fed (EBF) by their HIV+
mothers for the first four months postpartum had lower rates of mother-to-child transmission (MTCT) of HIV-1 then non-exclusively breast fed
(nEBF) infants. It remains unclear, however, whether the difference in HIV transmission between these cohorts is related to differences in the
human milk (HM) or differences of infants receiving HM. To better understand this phenomenon, we are investigating differences in innate
factors in HM from EBF or nEBF women.
Objective: We aim to determine if differences in levels of innate factors in HM from EBF and nEBF mothers correlate with vertical HIVtransmission.
Additionally, to determine if the various forms of innate factors found in HM are race-dependent and function differently in vitro.
Methods: : Using BD Flex Sets and an optimized Cytometric Bead Array (CBA) developed in our laboratory enables testing of multiple innate
factors within one HM sample. Western blot and ELISA will be employed to determine different forms and quantify innate factors not included
in our CBA system. HM is self-collected from HIV-uninfected EBF or nEBF women in their homes at one-week, one-month, three-months, sixmonths
and shipped same day to our laboratory where they’re processed. Historic HM samples from EBF and nEBF Zambian women will be
used to establish median and ranges in HIV-infected HM. Outcomes from both HIV-uninfected and infected EBF and nEBF will be compared.
Results: Data from our CBA system show innate factor levels from HIV-uninfected HM similar to those published. IL-8, lactoferrin, sCD14,
RANTES, Elafin/Trappin-2, MIP-1α, and MIP-1β levels were evaluated for 10 HIV-negative HM at one week and three months. Levels vary:
IL-8 mean 4957pg/mL (SD 5460) one week, 1630pg/mL (SD 1264) three months , lactoferrin mean 13824pg/mL (SD 4721) one week,
13346pg/mL (SD 2017) three months, sCD14 significantly decreased post partum: mean 930835pg/mL (SD 33719) one week, 881186pg/mL (SD
33864) three months, RANTES mean 1764pg/mL (SD 2445) one week, 644.4pg/mL (SD 166) three months , Elafin/Trappin-2 mean 7363pg/mL
(SD 4597) one week, 7742pg/mL (SD 9304) three months. Additionally, several sTLR2 forms, stemming from a single multimeric species, were
identified from different women.
Conclusions: : Further testing is required to determine levels of these particular innate factors in HIV-infected women. Testing of women from
different ethnicities is required to determine if differences in sTLR2 forms is race-dependent or specific to the individual. In vitro testing is
required to determine if these forms function differently.
Contact Information: Bethany Henrick, Tel: 905-525-9140-22494, Email: bethanyhenrick@mac.com
310
CORRELATES OF PSYCHOLOGICAL DISTRESS IN HIV POSITIVE (HIV+) WOMEN
Anne Wagner 1 ; Trevor Hart 1,2 ; Saira Mohammed 3 ; Mona Loutfy 3,4
1-Department of Psychology, Ryerson University; 2-Dalla Lana School of Public Health, University of Toronto; 3-Women's College Research
Institute, Women's College Hospital; 4-Department of Medicine, University of Toronto
Plain Language Summary: Ontario has the highest number of HIV+ women in Canada. The proportion of female HIV+ diagnoses
comparatively to the total number of diagnoses skyrocketed from 1.8% in 1985 to 30% in 2006, indicating the changing face of the epidemic in
Canada (Remis, Swantee, Schiedel, & Liu, 2008). HIV+ women have higher rates of psychological distress than HIV- women due to illness,
lower income, often minority status, isolation and grief (Catz, Gore-Felton, & McClure, 2002; Freeman, Nkomo, Kafaar, & Kelly, 2007).
Perceived HIV stigma is associated with increased psychological distress and decreased self-esteem among HIV+ women (Emlet, 2006; Lee et
al., 2002; Rao et al., 2008). Therefore, we hypothesized that perceived HIV stigma would correlate with higher psychological distress among
HIV+ women in Ontario.
The Challenge: The current study investigates the demographic, medical, and experiential variables associated with psychological distress
experienced by HIV+ women in Ontario.

Our Approach: 358 HIV+ women between the ages of 18 and 52 in Ontario completed self-reported measures of demographic variables and
medical variables (e.g., CD4 count and viral load) relating to their HIV status, HIV stigma and psychological distress. Psychological distress was
operationalized by anxiety and depression symptomatology assessed by the Hospital Anxiety and Depression Scale. Women were recruited from
38 participating sites across Ontario including 28 AIDS Service Organizations (ASOs), 8 HIV clinics, and 2 Community Health Centers.
Bivariate associations were examined using t-tests and Pearson’s correlations. Analyses of covariance were conducted with anxiety and
depression as the outcome variables using the significant correlates in bivariate analyses.
Key Findings: At the bivariate level, being in a romantic relationship was associated with lower levels of anxiety [t(356) = 2.97, p = .003] and
depression [t(356) = 3.77, p < .001]. Higher perceived HIV stigma [r(358) = .35, p < .001] was associated with increased levels of anxiety.
Higher perceived HIV stigma [r(358) = .33, p < .001] and lower income [F(7, 350) = 4.08, p < .001] were associated with increased levels of
depression. Perceived HIV stigma was the only significant predictor for both anxiety [F(1,358) = 30.84, p < .001, partial η2 = .088] and
depression [F(1,358) = 28.10, p < 0.001, partial η2 = .080].
Impact on Policy and Practice: Perceived HIV stigma may be a stronger correlate of psychological distress among HIV+ women than either
demographic or HIV-related clinical variables. Interventions that reduce HIV stigma may also serve to reduce psychological distress among
HIV+ women.
Contact Information: Anne Wagner, Tel: 416-660-6170, Email: anne.wagner@psych.ryerson.ca
311
OPTIMIZING PRENATAL HIV TESTING IN ONTARIO
Lynne Leonard 1 ; Lindy Samson 2 ; Stephanie Wolfert 3 ; Sue McWilliam 4 ; Charles Furlotte 5
1-Department of Epidemiology and Community Medicine, University of Ottawa; 2-Divison of Infectious Diseases, The Children's Hospital of
Eastern Ontario; 3-Department of Epidemiology and Community Medicine, University of Ottawa; 4-Department of Epidemiology and
Community Medicine, University of Ottawa; 5-Department of Epidemiology and Community Medicine, University of Ottawa
Plain Language Summary: This qualitative analysis provides first-hand best practice information by exploring experiences of women who
underwent prenatal HIV testing. The women in this study reported variations in HIV testing practices especially regarding HIV related
information provision, test result wait-time, delivery mode of the test, and confidentiality and respect given. Many women found refraining from
breastfeeding was particularly difficult. This study provides information to help guide prenatal HIV testing policy and practices in Ontario.
The Challenge: Women represent an increasing proportion of those living with HIV in Ontario and in Canada. As more women acquire HIV, the
likelihood of women becoming pregnant while being unaware of their positive HIV status also increases. To reduce perinatal HIV transmission,
Ontario requires all pregnant women to be counselled and offered an HIV test. The aim of our study was to document first-hand experiences,
perceptions, and suggestions for best practices surrounding prenatal HIV testing.
Our Approach: We worked with fourteen women, ten of whom learnt of their positive HIV diagnosis through Ontario’s Prenatal HIV Testing
Program and four through the subsequent diagnosis of their new born. A thematic analysis was completed of the qualitative interviews.
Key Findings: While there was consensus that HIV testing during pregnancy is valuable, women reported variations in HIV testing practices
including lack of information regarding HIV testing and perinatal transmission; consent to HIV testing; wait time and delivery mode of HIV-test
results; and the degree of confidentiality and respect received at health care facilities.
Regarding post-HIV-test follow-up, women consistently reported having too little information about HIV treatment for their child and
themselves, and expressed that their child’s health was a primary concern, often negating their own health care needs. Those who received
specialized services shortly after their HIV-positive test result reported gratitude for the opportunity.
Women presented with a caesarean section as an option or as mandatory, were pleased with this method of delivery. Refraining from
breastfeeding was a difficult experience for many women. Women reported guilt, criticism and social pressure about not breastfeeding. In the
absence of counseling, many women encountered difficulty when using various strategies including making up stories and isolating themselves in
order to avoid disclosing their positive HIV status.
Impact on Policy and Practice: This study provides a basis for further development of Ontario’s Prenatal HIV Testing Program in order to
inform helpful, timely and sensitive approaches to prenatal HIV testing in Ontario.
Contact Information: Stephanie Wolfert, Tel: 613-562-5449, Email: swolfert@uottawa.ca
312

HIV-ASSOCIATED NON-ALCOHOLIC FATTY LIVER IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: A
REVIEW
Siavash Piran 1 ; Bianca M Arendt 1 ; Johane P Allard 1
1-Department of Medicine, University Health Network, Toronto, ON, Canada
Plain Language Summary: HIV medications have improved the life expectancy of people living with HIV/AIDS (PHA) but side effects
including changes in body fat distribution (lipodystrophy) and other metabolic abnormalities are common. Many PHA have non-alcoholic fatty
liver disease (NAFLD), and in some cases this leads to inflammation or cirrhosis of the liver. We searched the literature and found that the
mechanisms for the development of NAFLD in PHA are not clearly understood, but those with lipodystrophy seem at risk. Our own studies
showed that PHA with NAFLD weigh less and are more active than HIV-negative NAFLD patients. We also found that changes in fatty acid
profile in the liver and a low intake of antioxidant vitamins might play a role for NAFLD in PHA. Therefore, more studies on nutrition and
dietary intake are needed to develop new strategies to treat and prevent NAFLD in PHA.
Objective: To provide a summary of the existing literature addressing the epidemiology, pathogenesis, and treatment of HIV-associated NAFLD
(HIV-NAFLD).
Methods: We conducted a literature review via a computerized search using Medline and identified all relevant studies published before July
2009.
Results: The prevalence of NAFLD may be up to 30-40% in PHA, and those with lipodystrophy are at risk of NAFLD. HIV-NALFD can result
from the effects of medication and/or HIV-infection on lipid metabolism, but the mechanisms are not clearly understood. In addition, nutrition
and lifestyle may contribute to the pathogenesis. However, HIV-NAFLD may be less associated with obesity and sedentary lifestyle compared
with non-HIV NAFLD patients due to the more predominant role of HIV-drugs. Other factors are hepatic fatty acid composition and oxidative
stress which may play a role in lipid metabolism and peroxidation associated with NAFLD. Indeed, PHA with NAFLD have a higher ratio of
omega-6 to omega-3 polyunsaturated fatty acids (PUFA) in the liver compared with non-HIV controls and this can increase hepatic lipid
accumulation through various mechanisms. In addition, increased lipid peroxidation as a result of altered fatty acid composition and low
antioxidants can contribute to tissue damage and disease progression to cirrhosis. Low PUFA in red blood cells (a marker for dietary intake) and
low dietary intake of vitamin E (an antioxidant) were also documented in HIV-NAFLD. No interventional studies are published on HIV-NAFLD.
Conclusions: Further studies on nutrition and dietary intake in PHA with NAFLD are needed to develop new strategies to treat and prevent HIV-
NAFLD.
Contact Information: Bianca Arendt, Tel: 416-340-4104, Email: barendt@uhnresearch.ca
313
TUBERCULOSIS MORTALITY IN HIV-INFECTED INDIVIDUALS: AN ANALYTICAL ASSESSMENT
Christopher G. Au-Yeung 1 ; Eric Druyts 1 ; Erin Ding 1 ; Aranka Anema 1,2 ; Curtis L. Cooper 3 ; Julio S. G. Montaner 1,2 ; Robert S. Hogg 1,4 ; Edward
J. Mills 1,5
1-British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada; 2-Faculty of Medicine, University of British
Columbia, Vancouver, British Columbia, Canada; 3-The Ottawa Hospital Division of Infectious Diseases, University of Ottawa, Ottawa, Ontario,
Canada; 4-Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; 5-Faculty of Health Sciences, University of
Ottawa, Ottawa, Ontario, Canada
Plain Language Summary: We sought to determine rates of TB mortality in HIV-positive individuals compared to HIV-negative individuals by
World Health Organization (WHO) designated regions, and to assess the effect of healthcare resource and economic variables on reducing
TB/HIV co-infection mortality by using publicly accessible global health data. The highest TB/HIV mortality rates were in Africa. Increasing
health expenditure directed towards collaborative TB/HIV programs may reduce mortality from both diseases.
Objective: Tuberculosis (TB) is a leading cause of death in HIV-positive individuals. We sought to compare mortality rates in TB/HIV coinfected
individuals at a global level and by country/territory, using publicly accessible global health data.
Methods: TB mortality rates for HIV-positive and HIV-negative individuals were calculated for 142 World Health Organization recognized
countries and territories in years 2005-2006 and 154 countries/territories in 2007. Multivariate linear regression determined the impact of
healthcare resource and economic variables on TB deaths in HIV-positive individuals.
Results: The highest rate of HIV-positive TB mortality was in the African Region (AFR) at 2,005 per 100,000 individuals in year 2007. The
Western Pacific Region (WPR), Eastern Mediterranean Region (EMR), and South East-Asia Region (SEAR), had TB/HIV mortality rates of
1,189, 1,332, and 1,350 respectively per 100,000 individuals in the same year. Further, Latin America (LAMR) had a TB/HIV mortality rate 77
times greater than its HIV-negative TB mortality rate. Year 2007 multivariate analyses showed that HIV-positive TB mortality rates were three
times higher in African countries compared to non-African countries (p

Conclusions: Our results indicate that while African countries have the highest TB death rates in HIV-positive individuals, countries in the
SEAR, EMR, and WPR also have high mortality rates. Countries with HIV-positive TB mortality rates that greatly exceed their HIV-negative TB
mortality rates illustrate the challenge of successful co-infection treatment. Increasing health expenditure directed towards collaborative TB/HIV
programs may reduce mortality from both diseases by up to 30%.
Contact Information: Christopher Au-Yeung, Tel: 604-261-0933, Email: cauyeung@cfenet.ubc.ca
314
HIGH RATES OF SMOKING AND DEPRESSION CO-OCCUR AMONG PEOPLE LIVING WITH HIV IN CANADA
Louise Balfour 1,2 ; Kim Corace 1,2 ; Daniella Sandre 1,2 ; Jessica Steinmoeller 2 ; Paul MacPherson 1,2 ; George Tasca 1,2
1-The Ottawa Hospital - General Campus, Ottawa, Canada; 2-The University of Ottawa
Plain Language Summary: This study examined the rates of cigarette smoking, marijuana smoking and depressed mood in people living with
HIV/AIDS (PHAs). Very little research currently exists on marijuana smoking among PHA's. This study found very high rates of both marijuana
and cigarette smoking at an HIV outpatient clinic in Ottawa, Ontario. It also found that people with high levels of depression tended to have
higher rates of smoking than people with low levels of depression. This study has important implications for improving the quality of life and
treatment care of people living with HIV/AIDS.
Objective: This study aimed to examine the prevalence and interrelationship between cigarette smoking, marijuana smoking, and depression in
an HIV outpatient sample.
Methods: This is a cross-sectional study of 101 men and women attending an HIV outpatient clinic in Ottawa, Canada. During regular HIV
outpatient visits, participants consented to complete questionnaire package that included validated measures of depression and smoking
behaviors.
Results: Canadian HIV patients reported very high rates of both cigarette smoking (46%) and marijuana smoking (40%). As well, 57% of HIV
patients scored above clinical cut-off scores for depression. Compared to HIV patients with low depressive symptoms, those with high depressive
symptoms reported more cigarette smoking (p < .01) and greater marijuana use (p < .01).
Conclusions: These results highlight the need to regularly assess and address smoking behavior and depression among HIV patients. The
significant relationship between cigarette and marijuana smoking and depression suggests potential overlapping biochemical causal pathways.
Important clinical implications for optimizing HIV treatment care and quality of life will be discussed. This population has unique needs and
requires a tailored intervention to promote smoking cessation and avoid cardio-vascular and pulmonary disorders.
Contact Information: Louise Balfour, Tel: (613) 737-8037, Email: lbalfour@ottawahospital.on.ca
315
THE EFFECT OF HSV-2 INFECTION ON HIV REPLICATION IN THE FEMALE GENITAL TRACT
Victor Ferreira 1 ; Aisha Nazli 1 ; Charu Kaushic 1
1-Center For Gene Therapeutics, Department of Pathology and Molecular Medicine, McMaster University, Michael G. DeGroote Center for
Learning and Discovery, Hamilton, Ontario, Canada L8N 3Z5.
Plain Language Summary: There is increasing evidence that HSV-2 is facilitating the perseverance of the global HIV-1 epidemic. HSV-2
prevalence is as high as 90% in HIV-positive populations and increased HIV levels are found in the genital tract and blood of co-infected
individuals. Whether specific components of HSV-2 contribute directly or indirectly to HIV replication is currently not well understood. To
address this, we are using HSV-2 mutants that lack specific viral components to determine which part of HSV-2 could induce HIV replication. To
examine the indirect effects of HSV-2 on HIV-replication, the role of inflammatory and antiviral mediators produced in the genital tract
following HSV-2 infection will be examined.
The Challenge: To determine the direct and indirect effects of HSV-2 infection on HIV-1 replication in the female genital tract.
Our Approach: 1G5 cells expressing the luciferase gene under the control of the HIV-LTR promoter were infected with wild type (WT) HSV-2,
UV-inactivated HSV-2 and HSV-2 mutants, such as vhs- and TK-. LTR induction was determined by measurement of luciferase activity.
Cultures of primary genital epithelial cells (GECs) were infected with different types of HSV-2. Proinflammatory cytokines (TNF-α, IL-6, IL-
1α), chemokines (IL-8, RANTES, MIP-1α, MIP-1β, MCP-1), interferon-β, nitric oxide and intracellular signaling pathways were analyzed.
Key Findings: To determine the direct effect of HSV-2 on HIV replication, 1G5 cells were exposed to HSV-2. LTR induction was measured by
luciferase activity. WT and vhs- HSV-2 induced HIV replication significantly (p

may be essential for HSV-2-mediated induction of HIV replication. To determine whether HSV-2 infection could indirectly influence HIV-1
replication, primary GEC responses to WT, UV-inactivated and HSV-2 mutants were measured. Cytokine production (IL-6, IL-8, TNF-α, MIP-
1β, MCP-1) by GECs was increased 12-24 hours following infection with UV-inactivated and mutant HSV-2. Fewer cytokines (TNF-α, IL-8)
were upregulated following infection with WT HSV-2. Type-I interferon was also induced in GECs 24 hours following infection with UVinactivated
virus (p

Ontario, Ottawa; 6-St. Michael's Hospital, Toronto, Canada; 7-University of Toronto, Toronto, Canada; 8-The Ontario HIV Treatment Network,
Toronto, Canada; 9-Ottawa General Hospital, Ottawa, Canada
Plain Language Summary: Informed prenatal HIV testing, which includes adequate pre & post test counseling, provides an important
opportunity for women to learn of their HIV status, get to know more about HIV and prevent mother-to-child-transmission (MTCT). Although it
is known that Islam shapes the values and practices of Muslims in Ontario, its influence on the perspectives and practices of Muslim women
regarding prenatal HIV testing is not well known. Within the spectrum of Muslim identities, even less is known about African/Caribbean & Black
Muslim women. To better understand the prenatal HIV testing experiences of these women, data from participants of the Optimizing Prenatal
HIV Testing In Ontario (OPHTIO) Study was analyzed. Findings show that none of the Muslim women in the study were offered HIV testing
with informed consent. Also, for various reasons, these women did not ask for an HIV test. More effort should be directed towards ensuring
culturally appropriate HIV counseling and testing is made consistently available to pregnant African/Caribbean & Black Muslim women in
Ontario.
Objective: To highlight the unique experiences of African/Caribbean & Black Muslim women with the Ontario Prenatal HIV Testing program.
Methods: In-depth interviews were conducted in Toronto and Ottawa with women who self-identified as African/Caribbean Black and Muslim.
To be eligible, women had to speak either English or French, have received prenatal care in Ontario since 1999 and not have known their HIV
status before accessing prenatal care. Interviews were transcribed and analyzed thematically using appropriate theoretical frameworks.
Results: Of the total interviewed for the OPHTIO study (n= 60), 7 women self-identified as African/Caribbean Black and Muslim. Altogether,
these participants had 22 children and 2 were pregnant at the time of the interview. Thus they had numerous encounters with the prenatal care
system. All were Canadian citizens but countries of birth differed; Canada (n=1, 14%), Ethiopia (n=1, 14%), Ghana (n=1, 14%), Somalia (n=3,
44%) and US (n = 1, 14%). Marital status varied; married (n=4, 57%), divorced (n=2, 29%), common-law (n = 1, 14%). All either stated that they
were ‘very religious’ or attended religious services ‘once a week or more’ or both.
(i) None of the participants were offered HIV testing with informed consent in any of their pregnancies. (ii) None received pre or post test
counseling. (iii) While (n=4, 57%) know they were tested for HIV during their last pregnancy, they were not given 'offered' HIV testing. Of the
women who knew they were being tested during their last pregnancy, most(n=3, 75%) were told they would be tested by their prenatal care
provider and (n=1, 25%) realised through reading the lab requisition form. (iv) None asked to be tested for HIV, mainly because most (n=6, 83%)
thought HIV testing was mandatory and assumed their prenatal care provider was already testing them for HIV. (v) All recommended more
counseling and more HIV information to be shared during prenatal care.
Conclusions: Findings suggest the need for greater adherence to prenatal HIV testing guidelines by those who provide prenatal care to
African/Caribbean & Black Muslim women. Also, innovative strategies need to be developed to inform African/Caribbean Muslim women about
prenatal HIV testing and encourage them to seek HIV testing and information.
Contact Information: Uitsile Ndlovu, Tel: 416-593-7655 ext. 4918, Email: uitsile@gmail.com
318
DETECTION OF HUMAN PAPILLOMA VIRUS IN SELF COLLECTED VAGINAL AND ANAL SAMPLES FROM AFRO-
CARIBBEAN WOMEN RESIDING IN TORONTO
Anu Rebbapragada 1,2 ; Stephen Perusini 1 ; Alessandro DiPrima 1 ; Sanja Huibner 3 ; Lisungu Chieza 6 ; Wangari Tharao 6 ; Mona Loutfy 3 ; Scott
Boerner 3,5 ; Robert Remis 4 ; Rupert Kaul 3
1-Ontario Agency for Health Protection and Promotion; 2-Department of Laboratory Medicine and Pathobiology, University of Toronto; 3-
Department of Medicine, University of Toronto; 4-Department of Public Health Sciences, University of Toronto; 5-Cytopathology, Toronto
General Hospital, University Health Network; 6-Women's Health in Women's Hands Community Health Centre
Plain Language Summary: HIV prevalence among persons in Ontario from HIV-endemic countries has dramatically increased in the past five
years. Since co-infections that may influence HIV transmission may also be more common in persons from HIV-endemic countries, it is critical
to understand the prevalence and risk factors for these co-infections within this community, and to decipher the mechanisms driving local HIV
transmission. Human Papilloma virus (HPV) is the most common sexually transmitted infection and persistent infection with High Risk HPV
(HR HPV) genotypes leads to cancer of the cervix and anus. The incidence of anal cancer is increasing among people with HIV/AIDS. While
several studies have examined the prevalence of anal HPV infection in men, very little is known about the natural history, biology or risk factors
underlying anal HPV infection in women, either with or without HIV. The goal of this investigation was to examine the associations between HR
HPV, HIV and other sexually transmitted infections in Afro-Caribbean women recruited at Women's Health in Women's Hands (WHIWH)
community health clinic in Toronto.
Objective: This report presents the preliminary findings from a cross-sectional epidemiology study that aims to examine the associations between
HIV, HPV and other sexually transmitted infections in Afro-Caribbean women residing in Toronto. The full study aims to recruit N=600 women
(N=300 HIV uninfected and N=300 HIV infected). The associations between HIV status and infection with HPV genotypes (high risk, HR and
low risk, LR) in the vagina and anal tract was examined in N=87 women.
Methods: This ongoing cross-sectional epidemiological study commenced in March 2009 and is nested at the WHIWH clinic in Toronto.
Consent was obtained from eligible Afro-Caribbean women and sampling procedures consisted of: a) computer based self administered
questionnaire to collect demographic information, ethnic/racial background, education, sexual behavior, history of STIs and other medical

conditions; b) 2 tubes of blood for HIV, Hepatitis, CMV and Herpes serology; c) self-collected vaginal swabs for detection of vaginal HPV DNA
and bacterial vaginosis and d) self-collected anal swab for detection of HPV DNA and anal intraepithelial lesions by Pap cytology. HPV DNA
genotypes (HR and LR) were detected by the Roche Linear Array assay.
Results: The associations between HIV and HPV infection was examined in 87 women (N=47 HIV infected, N=28 HIV uninfected and N=12
with unknown/pending status). Overall HR HPV infection was detected in 45% (N=39/87) of vaginal samples and 30% (N=26/87) of anal
samples with 9 cases of anal intraepithelial lesions (5 low grade, 4 high grade). Among HIV infected women, 70% (N=33/47) had HR HPV
vaginal infection and 49% (N=23/47) had HR HPV anal infection. All HIV infected women with anal HR HPV also had vaginal HPV infection.
Among HIV uninfected women, HR HPV was detected in 11% (N=3/28) of vaginal and 4% (N=1/28) of anal samples tested.
Conclusions: HR HPV is detected more frequently in HIV infected women than uninfected women. In women, anogenital HPV infection is
likely to be multicentric and transmission between reservoirs within the vaginal, cervical and anal compartments may be possible. These data will
help elucidate the natural history, biology and risk factors underlying anogenital HPV infection and will aid the design of anal cancer prevention
strategies tailored for women at risk.
Contact Information: Anu Rebbapragada, Tel: 416 235 5930, Email: anu.rebbapragada@oahpp.ca
319
CHANGES IN THE INCIDENCE AND OUTCOMES OF HEMATOLOGIC MALIGNANCIES IN INDIVIDUALS WITH HIV IN THE
CART ERA
Linda Taggart 1 ; Pierre Isogai 2 ; Nancy Risebrough 2 ; Nicole Mittmann 2 ; Anita Rachlis 3 ; Kevin Imrie 1 ; Matthew Cheung 1
1-Department of Hematology/Oncology, Sunnybrook Health Sciences Centre; 2-Health Outcomes and Pharmacoeconomics Unit, Sunnybrook
Health Sciences Centre; 3-Department of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario
Plain Language Summary: We studied changes in immune system cancers in individuals with HIV before and after combinations of
antiretroviral medications were commonly used, estimated as January 1, 1997. Data was obtained from the Ontario HIV Treatment Network
Cohort Study, which collects information on HIV-infected adults throughout Ontario. Characteristics that predicted who would develop non-
Hodgkin’s lymphoma, a type of immune system cancer, and who was at greater risk of dying after this diagnosis, were determined. There was no
significant difference in the number of people developing immune system cancers before and after 1997. Low CD4 count, high viral load and
living before 1997 were risk factors for developing NHL. Once diagnosed with NHL, those with low CD4 count, previous AIDS-defining illness
and longer duration of HIV had shorter survival.
Objective: To study trends in the incidence and outcomes of hematologic malignancies (HMs) in the pre and post combination antiretroviral
therapy (cART) eras.
Methods: A retrospective analysis was performed using the Ontario HIV Treatment Network Cohort Study (OCS), an ongoing prospective study
of HIV-infected adults throughout Ontario. Incidence rates of HMs were calculated for the pre- (

1-Department of Epidemiology and Biostatistics, The University of Western Ontario ; 2-AIDS Committee of London ; 3-The African and
Caribbean Council on HIV/AIDS in Ontario; 4-Department of Women’s Studies and Feminist Research, The University of Western Ontario; 5-
London Cross Cultural Learner Centre
Plain Language Summary: The BLACCH Study is a community-based, mixed-methods, interdisciplinary study looking at health and HIV in
London-Middlesex, Ontario’s Black communities. The purpose of this study is to improve health promotion and HIV prevention programming in
these communities.
The Challenge: The most extensive heath studies involving African, Caribbean and Black (ACB) persons have focused on HIV, and these often
do not fully acknowledge the ethnic, religious and socioeconomic diversity within communities. Furthermore, these studies rarely examine how
the interactions between racism, gender, HIV-related stigma and multiple forms of oppression affect HIV vulnerability and prevention efforts,
and they typically do not take place outside of major urban centres. This lack of information negatively impacts HIV prevention efforts for ACB
communities.
Our Approach: The BLACCH Study uses a community-based approach to collect extensive information about the health of ACB communities
in Middlesex County, Ontario. Community partners include the London Cross Cultural Learner Centre, the AIDS Committee of London, and the
African and Caribbean Council on HIV/AIDS in Ontario. The first stage of the project consists of semi-structured interviews to collect
information about the breadth of health-related experiences in Middlesex County’s ACB communities. A purposive sample of 30 persons will be
interviewed—seven (7) persons providing health or support services to the local ACB communities and twenty-three (23) ACB community
members. ACB persons involved in the interviews are from diverse backgrounds and represent a cross-section of these communities. The
interview topics include: religion; nationality; language; migration; HIV-related beliefs, behaviours, knowledge, experiences, stigma and services;
social network characteristics; gender; socio-economic status and housing. The interviews are being analyzed using a modified grounded theory
approach to identify emergent themes based on lived experiences.
Key Findings: Data collection is underway, and preliminary analysis of the interview data will be presented.
Impact on Policy and Practice: This phase of the BLACCH Study will provide information useful for designing culturally appropriate research
methods and content for a population-based survey that will reach larger samples of ACB communities. Additionally, information gathered from
the interviews will help inform the design of a comprehensive knowledge translation strategy. Findings will be shared with ACB communities
and organizations serving these communities using a combination of media. The BLACCH Study’s overall purpose is to provide evidence to
guide the creation and implementation of culturally-appropriate health promotion and HIV prevention and care programs for ACB communities,
especially those outside of more well-resourced urban centres.
Contact Information: Shamara Baidoobonso, Tel: (519) 520-5433, Email: sbaidoob@uwo.ca
321
OVERCOMING EMPLOYMENT BARRIERS: HEALTH AND FINANCIAL WORRIES AMONG A COHORT OF HIV-POSITIVE
INDIVIDUALS ON HAART.
Eirikka Brandson 1 ; Keith Chan 1 ; Surita Parashar 1,3 ; Alexandra Borwein 1,3 ; Eric Druyts 1 ; Alexis Palmer 1 ; Julio Montaner 1,2 ; Robert Hogg 1,3
1-British Columbia Centre for Excellence in HIV/AIDS, Vancouver BC; 2-Faculty of Medicine, University of British Columbia, Vancouver BC;
3-Faculty of Health Sciences, Simon Fraser University, Burnaby BC
Plain Language Summary: Highly active antiretroviral therapy (HAART) has made employment more of an option for people living with HIV.
In addition to financial gain, employment is a valuable component in quality of life. The results of this analysis show illness as the primary barrier
to employment. Unemployed individuals who report illness as their main reason for unemployment report lower quality of life than those who are
unemployed for other reasons, specifically greater health and financial worries.
Objective: To identify the factors associated with illness as the main barrier to working among those who are unemployed.
Methods: The Longitudinal Investigations into Supportive and Ancillary health services (LISA) cohort is a prospective study of HIV-positive
persons on HAART. Participants must be ≥19 years of age and antiretroviral-naïve prior to initiating HAART. An interviewer-administered
survey collects explanatory information. Clinical variables are obtained through a linkage with the Drug Treatment Program at the BC Centre for
Excellence in HIV/AIDS. Quality of life was assessed using the HAT-QoL scale which covers nine domains: overall function, sexual function,
disclosure worries, health worries, financial worries, HIV mastery, life satisfaction, medication concerns, and provider trust. Categorical variables
were compared using the Fisher’s Exact Test and continuous variables were assessed using the Wilcoxon Rank-Sum Test. A multivariate logistic
regression model was used to examine variables associated with unemployment as a result of illness.
Results: As of July 2008, the LISA cohort consisted of 457 participants, 351 (77%) of whom reported being unemployed. Of those who were
unemployed, 162 (46%) were permanently unable to work and 127 (36%) identified illness as a barrier to employment. Those who identified
illness as an employment barrier were more likely to be food insecure (p=0.004), experience stigma (p=0.009), have lower CD4 counts
(p=0.030), and report lower quality of life in five of the nine domains than those who identified any other reason for unemployment. In the

multivariate model, having more health worries (AOR=1.23, 95% CI: 1.11-1.37) and greater financial worries (AOR=1.16, 95% CI: 1.05-1.28)
were associated with reporting illness as an employment barrier.
Conclusions: There is a high prevalence of unemployment within this cohort. Among those reporting illness as a barrier to employment we find
they have more health and greater financial worriers than others unemployed. Further efforts are needed to increase support for those unemployed
living with HIV in order to lessen the psychological impact associated with the illness.
Contact Information: Eirikka Brandson, Tel: 604-682-2344 ext. 66067, Email: ebrandson@cfenet.ubc.ca
322
THE BROADER DETERMINANTS OF HEALTH IN AN ABORIGINAL CONTEXT
Marlene Larocque 1 ; Rosemary Forbes 1
1-Interagency Coalition on AIDS and Development (ICAD)
Plain Language Summary: HIV/AIDS in Aboriginal communities in Canada present a growing concern for individuals, families, service
providers, the health care system, public policy makers, and communities in general. Whilst a social determinants of health approach is an
appropriate and effective lens from which to understand disparities in the health status of individuals and communities, it does not explain all the
conditions that leave Aboriginal peoples susceptible to high rates of HIV/AIDS. This oral presentation will demonstrate how broader
determinants of health (such as colonization, migration, cultural continuity, self-determination etc.) adds a distinct layer of consideration that are
specific to Aboriginal Canadians and how including these in a holistic analysis can generate new framework for analysis and understanding.
The Challenge: Epidemiological monitoring and surveillance regarding the prevalence and incidence of HIV acquisition within the First Nations,
Inuit and Métis populations in Canada reveal a growing trend in the scope of HIV infection in this segment of the population. The Aboriginal
population in Canada represents approximately 4% of the population in Canada, yet accounts for up to 7.5% of current HIV cases, making the
HIV epidemic 2.8 times higher within this populace. While it is difficult to obtain a precise accounting of all HIV cases in the Aboriginal
population due to problems related to the accuracy and availability of ethnicity data, under-reporting and testing trends, it is clear that young
Aboriginals and Aboriginal women are especially vulnerable to contracting HIV and represent the majority of HIV cases in the Aboriginal
population in Canada.
Our Approach: In Canada, the social determinants of health serve as an appropriate and effective lens from which to understand the origins of
disparities in the health status of individuals and populations. The broader determinants of health add a distinct layer of considerations that are
specific to Aboriginal Canadians and may help to explain the barriers they face in achieving and maintaining a health status comparable to the
rest of the Canadian population.
Key Findings: Including the broader determinants of health in an Aboriginal context will provide us with a more holistic approach that can
generate a new frameworks for analysis and understanding.
Impact on Policy and Practice: The broader determinants of health are a relatively new lens for examining the current health profile of
Aboriginal Canadians. With regard to HIV acquisition, more concentrated research on how these determinants facilitate a higher rate of HIV
acquisition within this population is required to fully establish the relationship.
Contact Information: Rosemary Forbes, Tel: 613 233-7440 ext. 14, Email: rforbes@icad-cisd.com
323
THE EFFECT OF MEDICATION SUPPORT SERVICES ON THE ASSOCIATION BETWEEN HOUSING AND ADHERENCE
AMONG A COHORT OF UNSTABLY HOUSED
PEOPLE LIVING WITH HIV/AIDS ACCESSING HAART.
Surita Parashar 1,3 ; Keith Chan 1 ; Suzy Coulter 4 ; Alexis K. Palmer 1 ; Nadia O'Brien 1 ; Eirikka K. Brandson 1 ; Julio S. Montaner 1,2 ; Robert S. Hogg
1,3
1-BC Centre for Excellence in HIV/AIDS, Vancouver BC; 2-Department of Medicine, University of British Columbia, Vancouver BC; 3-Faculty
of Health Sciences, Simon Fraser University, Burnaby BC; 4-Maximally Assisted Therapy clinic, Vancouver Coastal Health Authority,
Vancouver BC
Plain Language Summary: Stable housing is a known determinant of health behavior, including adherence to HIV therapy. However, factors
associated with adherence amongst unstably housed people living with HIV/AIDS (PLWHA) remain relatively understudied. We investigated
predictors of adherence amongst unstably housed PLWHA in the Longitudinal Investigations into Supportive and Ancillary health services
(LISA) cohort, a subset of the Drug Treatment Program (DTP) at the BC Centre for Excellence in HIV/AIDS. The findings suggest that
medication support services, such as daily ARV dispensation and comprehensive adherence assistance, are effective in improving adherence for
unstably housed PLWHA.

The Challenge: Unstable housing is associated with poor health behavior and outcomes. Corroborating previous studies on the housing-health
nexus, we found that stable housing is a significant predictor of HIV therapy adherence within the LISA cohort (29% vs. 35%, p=0.009).
Alongside advocating for secure and affordable shelter for all, what can be done in the interim to improve adherence for unstably housed
PLWHA? What programs and services are successful in removing access barriers and improving adherence for this population?
Our Approach: The LISA cohort is a prospective study of people living with HIV on HAART in BC. Interviewer-administered surveys collect
information regarding housing, income, medication support and other clinically relevant socio-demographic factors. Clinical variables, such as
CD4 count and viral load, are obtained through linkages with the DTP. In order to determine the relationship between use of medication support
and adherence for unstably housed LISA study participants (n=132, 34%), logistic regression was used with adherence (≥95% vs.

ENHANCING LABOUR FORCE PARTICIPATION FOR PEOPLE LIVING WITH HIV IN CANADA: SCOPING REVIEW
RESULTS
Catherine Worthington 1 ; Kelly O'Brien 2,3 ; Elisse Zack 4 ; Eileen McKee 4 ; Brent Oliver 1
1-Faculty of Social Work, University of Calgary; 2-Department of Physical Therapy, University of Toronto; 3-School of Rehabilitation Science,
McMaster University; 4-Canadian Working Group on HIV and Rehabilitation, Canada
Plain Language Summary: The overall purpose of the study is to develop a framework of labour force participation for people living with HIV
in Canada. In this abstract we describe the first research phase, where we conducted a scoping review of literature in the area of labour force
participation and income support for people living with HIV/AIDS (PHAs). This review determines what is known from the literature about
labour force participation for PHAs; identifies key factors related to labour force participation for PHAs and distinguishes gaps in the existing
research evidence.
The Challenge: To conduct a scoping review to inform the development of a conceptual framework to promote the enhancement of labour force
participation for PHAs in Canada.
Our Approach: The research process was guided by a community advisory committee that included PHAs, employers, service providers,
insurers, and policy makers. We conducted a scoping review of published and grey literature on labour force participation for PHAs from 1980 to
end of February 2008. A search of databases including ABI, PsycINFO, MEDLINE, EMBASE, and CINAHL identified 11,165 potentially
relevant abstracts. 243 articles met the inclusion criteria (restricted to English or French articles primarily from developed countries). A
corresponding review of grey literature gathered through key informants and web searches identified 42 additional relevant articles. Data were
extracted onto a standardized charting form and summarized to formulate a preliminary framework. The framework was reviewed and augmented
by members of the advisory committee during a day-long consultation.
Key Findings: The preliminary conceptual framework incorporates key themes related to labour force participation for PHAs, including the
meaning of work; the range of vulnerable populations affected; work characteristics; barriers and facilitators to work (the episodic nature of HIV
and issues related to health, employment, community, and public policy); strategies and supports for entering, returning to and/or sustaining
employment; and potential outcomes of labour force participation (risks/benefits for individuals, and costs/benefits for employers, governments,
and insurers).
Impact on Policy and Practice: Changing workplace and income support policies and developing programs to assist PHAs to participate in the
labour force is a challenge in need of attention. This preliminary framework will be further developed through a consultative process to inform
programs and policies that can assist PHAs to return to and sustain paid employment. This framework should be of use to a wide range of policy
makers, program planners and researchers interested in promoting labour force participation of PHAs, as well as PHAs, employers, insurance
companies and health care providers.
Contact Information: Kelly O'Brien, Tel: 416-978-0565, Email: kelly.obrien@utoronto.ca
327
“GOT A ROOM FOR ME?” HOUSING EXPERIENCES OF ELEVEN OLDER ADULTS LIVING WITH HIV/AIDS IN OTTAWA
Charles Furlotte 1 ; Karen Schwartz 2
1-HIV and HCV Prevention Research Team, Epidemiology and Community Medicine, University of Ottawa; 2-School of Social Work, Carleton
University
Plain Language Summary: Little is currently known about the housing experiences of older adults living with HIV/AIDS in Ottawa. While
there has been ample research into housing for older adults or people living with HIV, no study to date has focused specifically on Canadians
living with HIV-disease and who are aging. This project provides a preliminary analysis interview data concerning housing experiences of eleven
older people living with HIV/AIDS in the national capital.
Objective: The primary objective of this study was to conduct an exploratory thematic analysis of the housing experiences of eleven older adults
living with HIV in Ottawa. This small study will help to inform the development of future research into housing and aging PHAs.
Methods: This study was component of a larger thesis project carried out by Furlotte (2009). Participants were recruited through posters placed
strategically at an ASO in Ottawa, and referral referred by the case manager at a local ASO. Participants were asked to provide informed consent,
and complete a demographics/ descriptive information questionnaire. Following this, participants participated in an audio-recorded interview in
which they were asked to talk openly about their experiences with health and social services, including housing assistance.
Results: The mean age of the participants (n=11) interviewed was 60 years; the youngest participant was 52, the oldest participants were 67. The
group consisted of two females (18%), and nine (81%) males, and no one identified as transgendered or inter-sex. The participants were mostly
white, European, English-speaking, well-educated people of varying sexual orientation, relationship status and income. Three participants
indicated that they lived in subsidized housing units, 4 participants indicated that they owned of were currently paying a mortgage on their own
home, and 2 identified as living with family members. Two of the participants in the present study reported being homeless. These participants

eported accessing shelter services as well as living on the street. Also, several participants reported being near homelessness and other nonhomeless
participants expressed empathy and concern for homelessness among PHAs. None of the participants reported long term residential
care; however one participant did refer to at one time requiring the in-home services of a personal care assistant. Several rich themes emerged
concerning sustainable housing: participants reported experiencing homelessness, characterized by unhealthy spaces. Some participants reported
lacking access to both general PHA-focused subsidized housing services, long term residential care and financial security. Stories revealed some
participants feel lack of recognition and confusion in their housing prospects.
Conclusion: Together, these examples tie into previous literature which identifies housing as a major social determinant of health. Preliminary
findings from exploratory interviews suggest the need for further investigation into the intersection of HIV and aging in relation to housing in
Ontario. The author suggests an age-focused exploration of several large Ontario-based datasets. Participants’ experiences point to positive and
negative aspects of programming and policy planning for this population.
Notes: This thesis project was carried out with the assistance of a grant from the OAN/OHTN.
Contact Information: Charles Furlotte, Tel: 613 608 2429, Email: cfurlott@uottawa.ca
329
RISK BEHAVIOUR AMONG EAST (EAST AFRICAN HEALTH STUDY IN TORONTO) PARTICIPANTS WITH MULTIPLE AND
CONCURRENT SEXUAL PARTNERS
Kimberly Gray 1 ; Liviana Calzavara 1 ; Wangari Tharao 2 ; Ashley Johns 1 ; Ann Burchell 3 ; Ted Myers 1 ; Robert S. Remis 4 ; Carol Swantee 5 ;
Catherine Chalin 4
1-HIV Social, Behavioural and Epidemiological Studies Unit, Dalla Lana School of Public Health, University of Toronto; 2-Women's Health in
Women's Hands, Toronto; 3-Division of Cancer Epidemiology, McGill University, Montreal; 4-Dalla Lana School of Public Health, University
of Toronto; 5-Ontario Ministry of Health and Long Term Care, HIV Laboratory, Toronto
Plain Language Summary: The East African Health Study in Toronto (EAST) was the first large-scale Canadian survey of HIV among people
from African countries. Multiple and concurrent sexual relationships (having two sexual partners during the same time period) have been shown
to substantially increase the risk for HIV infection. We found that some EAST participants reported multiple and concurrent sexual partnerships
and inconsistent and/or imperfect condom use, which may put them at high risk for HIV infection and transmission.
Objective: To examine risky sexual behaviour of East Africans reporting two or more sexual partners in the previous year.
Methods: From 2004-2006, 456 men and women were interviewed from Toronto’s Ethiopian, Kenyan, Somali, Tanzanian, and Ugandan
communities. Univariate and bivariate analyses were used to characterize sexual behaviour (previous 12 months) and compare those reporting
two or more sexual partners to those with one.
Results: Of participants who reported ever having sex, 22% (76/352) had two or more sexual partners in the previous year. Of these, the
distribution of the number of partners was as follows: two - 50%, three - 33%, and four or more - 12%. 81% (61/75) reported sex with at least one
person born in Africa. 7% (5/72) reported no condom use in the previous year and 69% (50/72) inconsistent or imperfect use. 43% (32/75)
reported sex with concurrent partners and 27% (18/66) reported their partner had concurrent sex partners; 14% (9/66) reported both they and their
partner had concurrent sex partners. More men than women reported two or more partners in the previous year (28% vs. 11%, p

Plain Language Summary: The purpose of this study was to examine sexual risk behaviours and expectations to engage in sexual risk
behaviours during Reading Week (RW) vacation in a sample of Canadian undergraduate students. Results indicated that students did not perceive
themselves to be at risk for contracting sexually transmitted infections (STIs) or HIV, even though they engaged in unprotected sex while away
on vacation.
Objective: Previous research has reported that students going away during Reading Week (RW) or Spring Break vacations, are likely to engage
in high alcohol consumption, and are more open to casual sex (Mewhinney, Herold, & Maticka-Tyndale, 1995). The present pilot study expanded
on these findings to examine sexual risk behaviours, and substance use among a sample of university students going away on vacation in
February 2006 and 2007.
Methods: Sixty-one university students (10 males, 51 females) were recruited from York University in Toronto, ON. The mean age of
participants was 20.45 (SD = 1.96). Participants completed a questionnaire 1-2 weeks before RW vacation, and 1-2 weeks after returning from
RW vacation. Questions assessed students’ expectations to engage in behaviours that may predispose them to engage in unprotected sex prior to
departure for RW, and behaviours during RW upon their return. Unprotected sex was defined as unprotected vaginal intercourse (UVI) and
unprotected anal intercourse (UAI) in the past 6 months.
Results: Findings suggest a possible increase in the frequency of UVI (M = 13.24 prior to departure and M = 19.27 upon return from RW),
although results were not statistically significant. Analyses revealed significant associations between expected risk behaviours (e.g., getting
drunk) before RW and behaviours that were performed during RW (ps ≤ .039). Despite having engaged in UVI and UAI (48% and 6% of
participants, respectively), most of the students who engaged in unprotected intercourse were not concerned about contracting STIs or HIV
during RW (72%). A large proportion of students (43%) reported getting drunk and 23% used marijuana while on RW vacation.
Conclusions: Although the results of the present study indicate an increase in engagement of high-risk sexual activity during RW, our results are
limited by the size of the sample. The current findings suggest that it may be beneficial for university health education programs to design and
target sexual health awareness initiatives prior to RW.
Contact Information: Bojana Petrovic, Tel: 416-979-5000 x2179, Email: bpetrovic@ryerson.ca
331
GAY POZ SEX: A COMMUNITY BASED COUNSELLING INTERVENTION FOR HIV-POSITIVE MEN
Trevor Hart 1,2 ; Barry Adam 3,4 ; John Maxwell 5 ; Robert MacKay 5 ; David Hoe 5 ; Robert Leahy 5 ; Herbert Co 5 ; Eleanor Maticka-Tyndale 6 ; James
Murray 7
1-Department of Psychology, Ryerson University; 2-Dalla Lana School of Public Health, University of Toronto; 3-Department of Sociology,
Anthropology and Criminology, University of Windsor; 4-Ontario HIV Treatment Network; 5-Poz Prevention Working Group; 6-Department of
Sociology, Anthropology and Criminology, University of Windsor; 7-AIDS Bureau, Ontario Ministry of Health and Long Term Care
Plain Language Summary: The Gay Positive Sex (GPS) study utilizes motivational enhancement to promote sexual health practices and reduce
risk behaviour among HIV-positive gay and bisexual men.
The Challenge: Despite the Greater Involvement of People Living with HIV/AIDS (GIPA) principle (UNAIDS, 2007), partnerships with people
living with HIV/AIDS (PLHAs) in HIV socio-behavioural research is lacking. The lack of involvement with PLHAs in HIV prevention research
is especially problematic considering that HIV prevention must include PLHAs to be effective at a population level (Janssen, 2001).
Our Approach: GPS, a Community-based Participatory Research counselling intervention, uses motivational enhancement counselling in a
small-group format to facilitate sexual health promotion and sexual risk reduction among HIV-positive gay and bisexual men. The research team
includes partners from universities, AIDS service organizations (ASO), government, and HIV-positive gay and bisexual men from the
community. The Information-Motivation-Behavioural Skills (IMB) model (Kalichman et al., 2008), serves as the theoretical model guiding the
GPS program. The IMB model specifies that HIV/STI prevention information and motivation increase HIV/STI preventive behaviour
independently and by increasing behavioural skills (e.g., effective condom negotiation) that in turn increase HIV/STI preventive behaviour.
Efforts have been made to maintain the sustainability of partnerships, knowledge, and funding of the intervention beyond the current study has
been a key focus of the GPS program.
Key Findings: The GPS program is currently being piloted at the AIDS Committee of Toronto. Implementing the intervention at this community
setting also serves to increase the generalizability of findings, as the intervention, if found to be effective, will also be delivered at ASOs across
Canada. GPS’s goal is to improve the sexual health of HIV-positive gay and bisexual men and reduce sexual risk behaviours. This program is a
good example of how research can be used as a vehicle for testing new sexual health and HIV/STI prevention programs at AIDS service
organizations. GPS is also a good example of how PHAs may be the most valuable resource for sexual health promotion and HIV/STI prevention
for fellow PHAs.
Impact on Policy and Practice: An effective HIV/STI prevention intervention for HIV-positive gay and bisexual men can impact
epidemiological trends, given the high HIV prevalence rate among gay and bisexual men in Canada and increasing HIV incidence. An effective
intervention also may have wider health benefits for HIV-positive men by reducing exposure to co-infection with hepatitis, syphilis, and other
sexually transmitted infections, and with alternative strains of HIV (Gordon, Stall, & Cheever, 2004).

Contact Information: Trevor Hart, Tel: 416-979-5000 ext. 6192, Email: trevor.hart@psych.ryerson.ca
332
COST-EFFECTIVENESS OF ANAL CANCER SCREENING IN HIV-POSITIVE MEN
Jonathan Lam 4 ; Jeffrey Hoch 1 ; Jill Tinmouth 2,3,4 ; Marie Sano 3 ; Janet Raboud 3,4 ; Irving Salit 3,4
1-St. Michael’s Hospital, Toronto, ON, Canada; 2-Sunnybrook Medical Centre, Toronto, Canada; 3-University Health Network, Toronto General
Hospital, Toronto, Canada; 4-University of Toronto, Toronto, Canada
Plain Language Summary: Anal cancer occurs at high rates in HIV-positive men who have sex with men (MSM). Pre-cancerous changes can
be found by using anal Pap smears, HPV detection or by specialized anoscopy exam (HRA).We studied which method found the most cases at
the lowest cost. Going right to HRA for screening is the most cost-effective strategy.
Objective: Anal cancer occurs at high rates in HIV-positive men who have sex with men (MSM). Anal cytology (Pap tests) and oncogenic HPV
detection in addition to HRA are two potential screening tests for anal neoplasia but the cost-effectiveness of these screening tests are unknown.
The objective was to assess the cost-effectiveness of HRA, anal cytology and/or anal HPV detection in screening for high grade anal dysplasia
(AIN 2/3) in HIV positive MSM.
Methods: The subjects were 401 HIV+ males who were screened for anal cancer in the Toronto Research for Anal Cancer Evaluation (TRACE)
study. Compared with usual care (i.e., no screening), a decision analytical model was used to determine the cost-effectiveness of three anal
cancer screening strategies: 1) the direct use of HRA, 2) abnormal cytology followed by HRA and 3) oncogenic HPV detection followed by
HRA. The model included different definitions of abnormal cytology (i.e., HSIL, LSIL and ASCUS) and the combined use of cytology and HPV
testing. The outcome was the number of AIN 2/3 cases detected. Costs were estimated from institutional data and sensitivity/specificity of
cytology and HPV tests were obtained from the TRACE study.
Results: The costs (Canadian $) per procedure for HRA, cytology and HPV testing were $270, $126 and $134, respectively. The direct use of
HRA was the most cost-effective strategy. It detected 98 cases of AIN 2/3 and cost $1,727/case. Probabilistic sensitivity analysis found that
three other strategies that could be just as cost-effective as the direct use of HRA.
Conclusions: In HIV-infected MSM, the direct use of HRA is the most cost-effective strategy for detecting AIN 2/3. The higher cost per use for
HRA was offset by the high sensitivity and low specificity of HPV and cytology testing.
Contact Information: Irv Salit, Tel: 416 340 3697, Email: isalit@rogers.com
333
DEVELOPING A NEW HIV DISABILITY QUESTIONNAIRE: A COMMUNITY-INTEGRATED APPROACH
Kelly O'Brien 1 ; Rob Alexander 2 ; Ken King 3 ; James Murray 4 ; Meskerem Tebeje 5 ; Ahmed Bayoumi 6 ; Tarik Bereket 1,6 ; Marilyn Swinton 1 ;
Geoff Norman 1 ; Patty Solomon 1
1-McMaster University; 2-Prisoner’s with HIV/AIDS Support Action Network; 3-Canadian Working Group on HIV and Rehabilitation; 4-
Ontario Ministry of Health and Long Term Care; 5-Voices of Positive Women; 6-St. Michael's Hospital
Plain Language Summary: A group of researchers and community members developed a draft HIV Disability Questionnaire for adults living
with HIV. Community members were involved in all stages of the questionnaire development. This is one way to approach the development of a
new measurement tool in HIV so that it may be broadly used in clinic and ASO settings to describe HIV-related disability.
The Challenge: To develop a draft HIV disability questionnaire using a community-integrated approach.
Our Approach: A group of researchers and community members developed a draft HIV Disability Questionnaire (HDQ) for adults living with
HIV. We pooled items from existing instruments based on dimensions of disability in the Episodic Disability Framework. This framework was
developed in an earlier phase of research from the perspective of adults living with HIV. Community members met on two occasions to provide
input on the HDQ development in the following areas: 1) questionnaire content (including generating new items where needed), 2) refinement of
items, response sets and questionnaire instructions, 3) timeframe of the questionnaire, 4) how to capture the episodic nature of disability, and 5)
how the HDQ can be used by people living with HIV, clinicians, AIDS service organizations (ASOs) and policy makers.
Key Findings: The draft HDQ consisted of 69 items that describe the presence, severity and episodic nature of disability in four domains:
symptoms/impairments (35 items), uncertainty (15 items), difficulties with day-to-day activities (8 items), and challenges to social inclusion (11
items). Currently we are administering the draft HDQ with 20 adults living with HIV and 5 HIV clinicians and conducting interviews to assess
the sensibility of the questionnaire (face and content validity and ease of usage). Community members helped to ensure we piloted the HDQ with
a diverse sample of participants and will help to interpret the sensibility findings and revise the HDQ for broader administration. We believe this
community-integrated approach will enhance the content validity, feasibility, and applicability of the HDQ for use in clinic and ASO settings.

Impact on Policy and Practice: An HIV disability questionnaire may be used by health providers and ASOs to describe the types of disability
adults living with HIV experience. A community-integrated approach to the HDQ development will maximize its applicability to the HIV
community. Policy makers may be interested in knowing the prevalence of HIV-disability and the types of disability that may be episodic in
nature. Future work will include sharing the HDQ with clinicians, ASOs, and policy makers interested in measuring HIV-related disability.
Contact Information: Kelly O'Brien, Tel: 416-978-0565, Email: kelly.obrien@utoronto.ca
334
FROM STIGMA TO DISABILITY: THE ROLE OF DEPRESSION AMONG PHAS
Kimberly Corace 1 ; Louise Balfour 1 ; Christine Cabrera 1 ; Rebecca Wallace 1 ; Daniella Sandre 1 ; Giorgio Tasca 1 ; Jonathan Angel 1 ; Gary Garber
1 ; Curtis Cooper 1 ; Paul MacPherson 1 ; D. William Cameron 1
1-The University of Ottawa at The Ottawa Hospital, Ottawa, Canada
Plain Language Summary: Stigma is defined as a complex, multidimensional social and psychological phenomenon that discredits, disqualifies,
and denies an individual’s acceptance as a whole person. Stigmatized people lose social status, as they are not viewed as full members of society;
they are rejected and marginalized. People living with HIV/AIDS (PHAs) are often stigmatized, and for these individuals such stigma is
associated with psychological distress, anger, shame, social isolation, fear of accessing health care services, and reduced mental and physical
functioning. The present study examined the relationship between HIV-related stigma, depression, and disability among 73 men and women
living with HIV. Results indicated that a higher level of perceived HIV-related stigma was significantly associated with higher levels of
depression and greater disability (e.g., impairments in social, occupational, and daily functioning). Furthermore, results suggested that depression
is a possible mechanism through which stigma influences disability among PHAs.
Objective: This study examined (1) the relationships among HIV-related stigma, depression, and disability among PHAs, and (2) the mediating
role of depression to explain the relationship between HIV-related stigma and disability.
Methods: PHAs (N = 73) were recruited during regular HIV clinic visits at The Ottawa Hospital. As part of a larger study, participants
completed a questionnaire package that contained sociodemographic information, a depression scale (Radloff et al., 1977), an HIV stigma scale
(Wright et al., 2007), and a measure of disability (adapted from Tait et al., 2007).
Results: Correlational analyses indicated that HIV-related stigma was significantly positively correlated with depression and disability.
Depression was also significantly positively correlated with disability. In order to determine whether the direct relationship between HIV-related
stigma and disability was mediated by depression, regression analyses were conducted in the manner suggested by Baron and Kenny (1986).
Analyses revealed that depression partially mediated the relationship between HIV-related stigma and disability. That is, PHAs suffering from
higher levels of HIV-related stigma, experienced higher levels of depression, which in turn, increased their perceived disability.
Conclusions: Depression may account for the relationship between HIV-related stigma and disability, such that higher levels of depression will
result in greater vulnerability to disability among stigmatized PHAs. Thus, targeting and treating depressive symptoms among PHAs may buffer
the negative impact that stigma has on disability, thereby improving the social, occupational, and daily functioning of PHAs. The role of
depression in the relationship between stigma and disability among PHAs demands further attention.
Contact Information: Kim Corace, Tel: 613-737-8866, Email: kcorace@ottawahospital.on.ca
335
INTERPROFESSIONAL MENTORSHIP AS A MEANS TO BUILD CAPACITY AMONG REHABILITATION PROFESSIONALS
AND PEOPLE LIVING WITH HIV IN ONTARIO.
Julie Hard 1 ; Patricia Solomon 2 ; Kelly O'Brien 2,3 ; Catherine Worthington 4 ; Elisse Zack 1
1-Canadian Working Group on HIV and Rehabilitation; 2-School of Rehabilitation Sciences, McMaster University, Hamilton ; 3-Department of
Physical Therapy, University of Toronto, Toronto; 4-Department of Social Work, University of Calgary, Calgary, Canada
Plain Language Summary: We describe an interprofessional mentorship programme to advance HIV rehabilitation care and practice for people
living with HIV (PHAs) in Ontario. Three rehabilitation professionals (physiotherapist, occupational therapist speech-language pathologist) and
3 PHAs formed a panel of mentors for rehabilitation clinicians interested in HIV care and practice.
The Challenge: PHAs experience a high prevalence of impairments, activity limitations and participation restrictions. Rehabilitation
professionals have a role in addressing disablement issues for PHAs; however, only 19% of respondents to a national survey agreed they
possessed adequate knowledge to provide services for PHAs. Hence, there is a need to build capacity among rehabilitation professionals to better
address the needs of PHAs.

Our Approach: With OHTN support, we developed, implemented and evaluated a 6 month pilot mentorship programme as a model to increase
capacity of rehabilitation professionals to better address the needs of PHAs in Ontario. Aims included; 1) describing changes in knowledge,
attitudes and practices of rehabilitation professional participants, 2) identifying strengths and challenges associated with the programme, 3)
identifying key elements of HIV mentorship that promotes knowledge translation, and 4) determining participant satisfaction with the
mentorship process.
A panel of 6 mentors (3 rehabilitation professionals and 3 PHAs with expertise in HIV and rehabilitation) facilitated learning among 5
rehabilitation professionals from across central south-western Ontario. An in-person introductory workshop providing inter-professional HIV
education was followed by five consecutive monthly meetings. Participants were encouraged to connect with mentors throughout the
programme. Participants explored issues identified from cases in clinical practice. Changes in knowledge, attitudes and practices were evaluated
through pre-post mentorship surveys, interviews and focus groups.
Key Findings: Interprofessional mentorship promoted positive changes in knowledge and attitudes. Clinical practices remained unchanged for
mentees reporting not having PHAs on their current caseload; however mentees expressed feeling confident in their ability to address issues
facing PHAs . Mentorship is useful for clinicians new to HIV care. Mentees benefit from the shared expertise of colleagues and PHAs. Face-toface
interactions are preferred for engaging learners compared to teleconferencing but clinical schedules and case loads made teleconferencing
more accessible to participants. All participants reported valuable learning when interacting with an experienced interprofessional panel of
mentors.
Impact on Policy and Practice: The interprofessional rehabilitation mentorship programme facilitated learning to increase capacity of
rehabilitation professionals in HIV care. Lessons learned from this project form the basis for an expansion mentorship programme currently being
implemented to enhance rehabilitation care for PHAs across Ontario.
Contact Information: Julie Hard, Tel: 416-513-0440 x 224, Email: jhard@hivandrehab.ca
336
EXPLORING RELATIONSHIPS BETWEEN DIMENSIONS AND CONTEXTUAL FACTORS OF DISABILITY: DEVELOPMENT
OF A MEASUREMENT MODEL
Kelly O'Brien 1 ; Ahmed Bayoumi 2,6 ; Curtis Cooper 3 ; Sandra Gardner 4 ; Trevor Hart 5 ; Peggy Millson 6 ; Geoff Norman 1 ; Sean Rourke 4 ;
Sergio Rueda 4 ; Patty Solomon 1
1-McMaster University; 2-Centre for Research on Inner City Health, St. Michael's Hospital; 3-University of Ottawa; 4-Ontario HIV Treatment
Network; 5-Ryerson University; 6-University of Toronto
Plain Language Summary: A first step in understanding the components of disability experienced by adults living with HIV is to understand
which questions best capture this information. We developed a model that identified the questions in the OHTN Cohort Study (OCS) Extended
Questionnaire that might best characterize HIV-related disability. Our results will be useful for future work that will develop a measure of
disability for use in research studies.
The Challenge: We previously developed a conceptual framework of disability which describes the experiences of people living with HIV. In
this study, we assessed how items measured in the OHTN Cohort Study (OCS) could be used to describe these experiences.
Our Approach: The Episodic Disability Framework defined dimensions of disability and contextual factors of disability. Our objective was to
lay the foundation for Structural Equation Modeling, a method that explores complex relationships between constructs. This approach uses latent
variables, which are not measured directly but rather estimated from measured variables. We developed a model to describe the relationship
between latent variables in the Episodic Disability Framework and instruments measured as part of the OCS.
Key Findings: We developed a model consisting of 7 latent variables. Three variables related to dimensions of disability. 1) Mental and
physical health symptoms and impairments will be represented by relevant items in the following scales / domains: symptom distress, SF-36 (role
emotional, mental health, pain and vitality), MOS-HIV cognitive function, EQ5D (anxiety / depression and pain), CES-D, and HUI (emotional,
cognition, sensation, dexterity and pain). 2) Difficulties with day-to-day activities will be represented by scores on the SF-36 (physical function
and role physical), EQ5D (mobility, self-care, usual activities), and HUI (getting around, self-care). 3) Challenges to social inclusion will be
represented by employment status, occupation, income, education, housing status, and SF-36 (social function). Four variables related to
contextual factors, 4) social support (represented by services in the household and MOS-Social Support scale); 5) stigma (represented by the HIV
Stigma Scale); 6) living strategies (represented by the Brief Cope scale, Mastery scale, alcohol, cigarette, cannabis and non-medical drug use);
and 7) personal attributes (represented by gender, age, race and ethnicity). Our next steps are to conduct a confirmatory factor analysis testing the
hypotheses that OCS measures represent the latent variables of disability.
Impact on Policy and Practice: These results will help increase our understanding about how items in the OCS represent the construct of HIVspecific
disability and lay the foundation for developing useful measures for clinical and health services research.
Contact Information: Kelly O'Brien, Tel: 416-978-0565, Email: kelly.obrien@utoronto.ca
337

IMPLEMENTATION OF A STUDENT-INITIATED PRECLERKSHIP HIV ELECTIVE
Nisha Andany 1 ; Christe Henshaw 1 ; Meghan Ho 1 ; Julie Thorne 1 ; Nikki Hoffman 1 ; Derek Chew 1 ; Denise Jaworsky 1 ; Sean Rourke 1,2 ; Mark
Fisher 2 ; Anita Rachlis 1,3
1-Faculty of Medicine, University of Toronto; 2-Ontario HIV Treatment Network; 3-Department of Infectious Diseases, Sunnybrook Health
Sciences Centre, Toronto, Ontario, Canada
Plain Language Summary: The literature indicates North American medical students require more comprehensive HIV training. To address
these needs, eight University of Toronto (UofT) medical students developed a Preclerkship HIV Elective (PHE). The goals of this extracurricular
program were to increase medical students’ HIV knowledge and better prepare them to serve affected populations in the future.
Objective: To implement and evaluate a student-initiated Preclerkship HIV Elective (PHE) aimed at increasing medical students’ knowledge of
HIV and related issues.
Methods: PHE was developed in partnership with the Ontario HIV Treatment Network (OHTN), and through consultations with several AIDS
service organizations and professors within the Faculty of Medicine. The goals were to to address important issues in HIV care and supplement
medical curriculum content. The elective consisted of lectures, small group sessions, clinical observerships, community placements, independent
reading assignments, and a counseling/testing workshop. The lectures were made available to all health profession students. Eighteen secondyear
medical students participated in the inaugural year of PHE. Following completion of HIV content in the preclerkship medical curriculum
and prior to the start of PHE, second-year medical students were recruited to complete a self-evaluation of HIV knowledge, interest and
preparedness level. Students who did not participate in the PHE functioned as the control group. PHE participants completed this questionnaire
again upon completion of the elective to facilitate program evaluation. Feedback on participant satisfaction was also collected.
Results: 73 second-year medical students completed the initial HIV knowledge, interest, and level of preparedness questionnaire. 69.1% (n=55)
were interested in HIV medicine, and 65.1% of respondents (n=63) felt they had inadequate HIV training. An interim process evaluation was
conducted after five lectures and seven small group sessions. Lectures had a mean attendance of 70 (σ=12), mainly first- and second- year
medical students. This represents 16% of UofT Preclerkship medical students. The mean satisfaction for these lectures was 96.3% (σ=3.1%).
Small group sessions had a mean attendance of 15 (σ=4); mean satisfaction for these sessions was 92.6% (σ=10.9%).
Conclusions: Preliminary results demonstrate significant student enthusiasm for additional HIV learning opportunities. Student-run initiatives
can supplement medical curriculum content and program feedback may be used to advocate for changes in medical curricula. Factors for success
include student leadership and interest, community support, and faculty mentorship. The OHTN will use pilot data from this initiative to explore
how to expand PHE programs and build capacity in interdisciplinary healthcare and support across Ontario.
Contact Information: Nisha Andany, Tel: (416) 452-0924, Email: nisha.andany@utoronto.ca
338
CONDOMS AND COMMUNITY: ENHANCING COMMUNITY ENGAGEMENT TO INFORM PUBLIC HEALTH PRACTICE AND
CONDOM DISTRIBUTION
Domenico Calla 1 ; Nicole Greenspan 1,2 ; Barbara Macpherson 1
1-Planning & Policy, Toronto Public Health; 2-Department of Health Policy, Management and Evaluation, University of Toronto
Plain Language Summary: Meeting community needs and maximizing safer sex supplies (like condoms and lubricant) builds a community’s
ability to prevent HIV infections. The Toronto Public Health (TPH) Condom Distribution Program (CDP) developed a stakeholder engagement
plan to assess community needs. Through stakeholder consultations and an Advisory Committee the CDP uses community expertise to improve
condom distribution in Toronto.
The Challenge: Since 1986 the CDP has supplied free condoms to various programs and agencies throughout Toronto. The program reduces
structural barriers (i.e. cost, availability) which limit condom use. However, the acquisition of free condoms does not necessarily lead to actual
use. To increase the likelihood that condom distribution furthers condom use, the CDP must ensure that program activities are better informed by
community needs and expertise.
Our Approach: Morgan and Lifshay's (2006) conceptual framework of community participation was utilized to develop a multi-phase
stakeholder engagement plan to maximize the use of community expertise in CDP design, delivery, and evaluation. These phases were designed
to facilitate a more comprehensive and sustained community participation strategy. The initial two phases of the plan completed to date involved
discussion with groups of TPH stakeholders involved in the CDP. Qualitative data was gathered. Four more phases (including consultations with
CDP stakeholders external to TPH, meetings with CDP suppliers, and activities to maintain community engagement) are planned. This
presentation summarizes findings from the initial phases of the stakeholder engagement plan.

Key Findings: Eleven consultation sessions were conducted with internal stakeholders between March and June 2009. Five salient themes
emerged: 1) CDP staff and stakeholder roles are unclear; 2) the process for filling community condom requests is often confusing; 3) assessment
of program/agency needs requires improvement; 4) program transparency is needed; and 5) condom wastage should be better prevented.
Stakeholder sessions helped recruit seven TPH staff into a new CDP Advisory Committee. Consultation with the committee found that a ‘one
size fits all’ approach to condom distribution is inaccurate. Continuing to purchase a variety of condom styles, brands, and sizes ensures that
diverse safer sex needs are met.
Impact on Policy and Practice: By establishing a forum for the mutual exchange of information and ideas, the CDP continues to incorporate
stakeholder expertise into program planning and delivery. In 2009, stakeholder engagement activities influenced program purchasing and helped
make the program more ‘user-friendly.’ Through community engagement the CDP strengthens stakeholder relations to better achieve its health
promotion mandate.
Contact Information: Domenico Calla, Tel: 416-338-7942, Email: dcalla@toronto.ca
339
INCREASING COMMUNITY KNOWLEDGE OF HIV AND LEGAL DISCLOSURE IN AN ERA OF CRIMINALIZATION.
Diana Cooper 1 ; Laurel Challacombe 1 ; Darien Taylor 1 ; Laurie Edmiston 1
1-CATIE (Canadian AIDS Treatment Information Exchange)
Plain Language Summary: In 1998, the Supreme Court of Canada (Cuerrier decision) established a precedent requiring disclosure of HIVpositive
status prior to engaging in sex deemed to pose a “significant risk” of transmission. People with HIV/AIDS (PHAs) who have not
disclosed their status have since been charged and sentenced for various criminal offences. In 2008, CATIE conducted a national needs
assessment in which almost 70% of front-line staff of AIDS service organizations expressed a high level of need for information on legal issues.
In response, CATIE delivered a national HIV Disclosure & the Law (HDL) project to increase community knowledge of the legal and ethical
issues on HDL. Participant evaluations were very favorable and suggested an increase in community knowledge.
The Challenge: To investigate the impact of CATIE’s HDL community forums and service provider trainings on participating PHAs and service
providers.
Our Approach: CATIE held 7 community forums (282 attendees) and 8 service provider workshops (164 attendees) across Canada between
January and March, 2009. A legal expert developed and presented the information to participants. The community forums were aimed at PHAs,
service providers, public health practitioners and other community members. The staff training workshops were aimed at staff, board members,
community partners and service providers. Attendees evaluated the events; simple frequency descriptives were compiled to determine impact and
a paired t-test was performed to investigate self-reported change in knowledge.
Key Findings: Over 95% of community forum and service provider workshop participants felt that participation increased their knowledge of the
law regarding HIV disclosure. Roughly 95% of community forum and service provider workshop participants reported that they will apply the
knowledge gained when making decisions about HIV disclosure or when assisting others in making such decisions. On average, community
forum participants rated their knowledge of HDL before the event at 5.7 (on a 10 point scale) – this increased significantly to 7.9 after the forum
(P

Plain Language Summary: Cardiovascular disease (CVD) is now a leading cause of morbidity and mortality among people living with
HIV/AIDS (PHAs). After controlling for pre-existing disease, cigarette smoking is the most significant predictor of CVD among PHAs (Furber
et al., 2008). In view of the alarmingly high rate of smoking (40%-70%) among PHAs (e.g. Stein et al. 2008) as compared to the national average
(19% in Canada, Health Canada, 2007), quitting smoking is likely to be the single most effective intervention to reduce mortality due to CVD
among PHAs. Unfortunately, smoking cessation programs are rarely delivered in routine HIV clinical care. As well, standard smoking cessation
interventions are not tailored to address the unique needs of HIV positive smokers who also have higher rates of depression (40-60%) as
compared to the general population. Depression is a significant barrier to successful smoking cessation and as such, HIV quit smoking
interventions need to assess and address symptoms of depression throughout the smoking cessation process.
Objective: The main objective of this project is to develop an innovative “HIV quit smoking program” and to evaluate the psychological and
biological outcomes of such a program. More specifically, we will examine whether the “Ottawa Model for Smoking Cessation” (from the Ottawa
Heart Institute), can be effectively adapted for HIV patients who wish to quit smoking.
Methods: PHAs interested in quitting smoking are being recruited during regular HIV clinic visits at The Ottawa Hospital. Questionnaire
packages including validated measures of depression and smoking behaviours will be completed at study baseline. Participants will receive free
nicotine replacement therapy (NRT), telephone and in-person smoking-cessation counselling, as well as relapse prevention and targeted
interventions to reduce depressive symptoms in participants identified as depressed. Smoking status, psychological functioning, immunological
measures (e.g. CD4 count), metabolic parameters (e.g. lipid levels), and body mass index (BMI) will also be assessed from baseline through 6
month follow-up.
Results: Results from preliminary pilot data on the uptake and response to our “HIV Quit Smoking Program” will be presented including: the
impact of smoking cessation on psychological (depression, quality of life), immunologic (CD4 count), and metabolic parameters (lipid levels and
BMI).
Conclusions: We expect a smoking cessation success rate of 30-40%, which in turn, may assist in influencing health care policy by providing
evidence for the benefits of incorporating HIV quit smoking programs into routine HIV clinical care across Canada.
Contact Information: Daniella Sandre, Tel: 613-737-8036, Email: dasandre@ottawahospital.on.ca
341
BUILDING A COLLECTION OF “EVIDENCE”-BASED HIV FRONT-LINE PRACTICES: THE PROGRAMMING CONNECTION –
SHARED EXPERIENCE. STRONGER PROGRAMS.
Christine Johnston 1 ; Ed Jackson 1 ; Laurel Challacombe 1 ; Laurie Edmiston 1
1-CATIE (Canadian AIDS Treatment Information Exchange)
Plain Language Summary: In response to needs identified through a national consultation conducted by CATIE, a bi-lingual online toolkit of
program development & delivery information (“The Programming Connection: Shared experience, stronger programs”) is under development.
Overtime, this initiative will: provide case study descriptions of programming in HIV and HCV prevention, care, treatment and support; provide
supportive programming tools and; encourage networking between service providers. This living collection will offer resources to facilitate the
sharing and revitalization of current and development of new programs.
The Challenge: In 2008, CATIE conducted national consultations with stakeholders to identify and develop an action plan to address the
knowledge needs of front-line agencies. Informants recommended that CATIE seek and identify Canadian “best practices”, and synthesize these
practices into a database. By responding to these recommendations, CATIE could facilitate the systematic exchange of knowledge related to
service delivery and support front-line capacity building.
Identifying a program as “best” or “promising” based on dominant approaches to “evidence” is a challenge in the Canadian context given the
national landscape of HIV front-line program evaluation.
Our Approach: The field of programming in HIV and HCV is moving increasingly toward “evidence-based practice” and many groups have
constructed definitions and frameworks for developing a “best practice”. While large-scale interventions often rely on systematic evaluation to
determine efficaciousness, the practices evaluated may not be easily adopted by or appropriate for resource-limited CBOs. In Canada, a major
challenge in identifying programs labeled as “best” is the lack of appropriate evaluation of community-driven small-scale programs, and thus
evidence of “effectiveness”. The Programming Connection will support the development of new models for evidence-informed program
development and delivery that recognizes that practice-based evidence is critical to the development of the best possible programs.
Key Findings: Development of a “best” practices collection required a new definition of “evidence”. “Evidence” is based on practice-wisdom and
informed by research. The Programming Connection will use practice-based evidence to identify diverse examples of success and responsiveness

in front-line work, and support the uptake of these practices through the development and dissemination of knowledge tools in program planning
and evaluation.
Impact on Policy and Practice: The Programming Connection will stimulate the implementation of new front-line practices and raise practice
standards by providing CBOs and PHUs with easy access to information on lessons learned from practice, research and theory. It will also
facilitate national dialogue and partnership building, and support the identification of gaps in knowledge to support the development of new
research questions and front line programs.
Contact Information: Christine Johnston, Tel: 416 203-7122 ext 226, Email: cjohnston@catie.ca
342
MOBILIZING EVIDENCE AT THE FRONT LINES: IMPROVING HIV/AIDS POLICY AND CARE IN CANADA
Michael Wilson 1,2 ; Sean Rourke 2,3,4 ; John Lavis 5,6,7 ; Jean Bacon 2 ; Jacqueline Arthur 8
1-Health Research Methodology Program, McMaster University; 2-Ontario HIV Treatment Network; 3-Department of Psychiatry, University of
Toronto; 4-Centre for Research on Inner City Health, St. Michael's Hospital; 5-McMaster Health Forum; 6-Centre for Health Economics and
Policy Analysis, McMaster University; 7-Department of Clinical Epidemiology and Biostatistics, McMaster University; 8-Public Health Agency
of Canada
Plain Language Summary: Through a survey of community-based AIDS service organizations and public health units across Canada, we
sought to develop a better understanding of how to support the use of evidence by front-line HIV/AIDS organizations. Findings from 104
participants indicated that they would like to increase their use of evidence but their current capacity to acquire, assess, adapt and apply it is
inconsistent. We recommend two types of initiatives: 1) broad-based capacity-building designed to help front-line organizations find and use
evidence, and 2) knowledge support systems that allow organizations to efficiently find relevant and user-friendly evidence.
The Challenge: It is important to support front-line organizations’ capacity to find and use relevant and high quality evidence as doing so will
help ensure that services, programs and advocacy are informed by the best available evidence. We sought to develop a better understanding of
how to support the use of evidence by HIV/AIDS front-line organizations.
Our Approach: We selected a purposive sample of community-based AIDS service organizations (n=95) and all public health units (n=131)
from all regions in Canada and invited senior managers from each to participate in a structured telephone survey. The survey asked questions
about organizational characteristics, the types of evidence and mechanisms for finding evidence that organizations currently use and would prefer
to use, and their organizational capacity to acquire, assess, adapt and apply evidence.
Key Findings: Findings from 104 participants indicated that they would prefer to increase their use of all types of evidence compared to their
current use. Specific types of preferred evidence include research evidence, as well as epidemiological data, consultations with people living
with HIV/AIDS, guidelines and best-practice documents, and plain language materials that synthesize and adapt evidence for use by front-line
agencies. Preferred mechanisms for receiving (or supporting the use of) evidence include workshops/skills-building sessions, websites that
provide categorized research with user-friendly summaries, and targeted email updates of new evidence. However, on average, participants
indicated that their organization inconsistently acquires, assesses, adapts and applies evidence, especially with respect to having enough time to
find and obtain evidence and to adapt it for their specific context.
Impact on Policy and Practice: Given that participants indicated they would like to increase their use of evidence but reported limited capacity
to acquire, assess, adapt and apply it, we recommend two types of initiatives: 1) broad-based capacity-building designed to help front-line
organizations find and use evidence, and 2) knowledge support systems that allow organizations to efficiently find relevant and user-friendly
evidence.
Contact Information: Michael Wilson, Tel: 416-642-6486 ext 2223, Email: mwilson@ohtn.on.ca
343
REGULATION OF PROGRAMMED CELL DEATH IN MONOCYTES FROM HIV+ PATIENTS BY INTERFERON-Γ AND
INTERLEUKIN-10
Abdulkarim Alhetheel 1,3 ; Musa Elsageyer 1 ; Ashok Kumar 1,2,3 ; Marko Kryworuchko 1,2,3
1-Infectious Disease and Vaccine Research Centre, Children’s Hospital of Eastern Ontario (CHEO)- Research Institute; 2-Department of
Pathology and Laboratory Medicine, University of Ottawa; 3-Department of Biochemistry, Microbiology and Immunology, University of Ottawa
Plain Language Summary: Monocytes/Macrophages (M/M) are cells of the immune system critical for pathogen clearance, and their functions
are largely controlled by soluble host proteins called cytokines. For instance, the cytokine interferon (IFN)-γ potentiates M/M killing of
intracellular bacteria, while interleukin (IL)-10 suppresses this process. Studies have revealed that M/M are also targets for HIV infection and that

many of their functions are compromised through the course of chronic HIV infection. These cytokines also regulate M/M activities by
influencing the susceptibility of these cells to undergo programmed cell death (PCD) which was the focus of our studies.
Objective: PCD is regulated by a complex interplay between apoptosis ''self-killing'' and autophagy ''self-eating'' pathways. Our objectives were
to investigate how cytokines control monocyte PCD through these pathways and study the molecular mechanisms involved.
Methods: Monocyte PCD was measured by flow cytometry. TRAIL, Caspase 8, LC3-II, STAT, and AKT expression was evaluated by ELISA,
flow cytometry and western blotting, respectively. Pharmaceutical inhibitors and siRNAs were used to block signaling pathways, caspases, and
autophagy.
Results: We found that spontaneous and IFN-γ-induced monocyte PCD was elevated in HIV+ patients compared to HIV- controls. However,
pre-treatment with IL-10 rescued monocytes from this fate. IFN-γ upregulated spontaneous TRAIL secretion and caspase 8 activation, while IL-
10 inhibited these effects. Interestingly, spontaneous and IFN-γ-induced monocyte PCD appeared to be independent of caspase activation but
rather depended on the induction of autophagy. LC3-II expression, an autophagy marker, was upregulated spontaneously, enhanced further by
IFN-γ but unexpectedly, was also upregulated with IL-10 stimulation. At the level of the molecular mechanism, blocking the Signal Transducer
and Activator of Transcription (STAT) or phosphatidylinositol-3-kinase (PI3K)/AKT signaling pathways inhibited PCD and LC3II expression in
response to IFN-γ. However, blocking STAT or PI3K activation also diminished LC3-II expression and the cytoprotective effects of IL-10.
Conclusions: Spontaneous and IFN-γ-induced monocyte PCD and the cytoprotective effects of IL-10 appeared to both depend on induction of
autophagy and required STAT and PI3K signaling. Further investigations on how autophagy pathways can either lead to cell death or survival,
depending on the stimulus, are warranted and may have important implications concerning the elimination of this important cellular reservoir for
HIV.
Contact Information: Abdulkarim Alhetheel, Tel: 613-7377600 ext 3911, Email: aalhe047@uottawa.ca
344
CYTOKINE MEDIATED REGULATION OF THE TRANSCRIPTIONAL REPRESSOR, GROWTH FACTOR INDEPENDENT – 1
AND INTERLEUKIN-7RA IN HUMAN CD8 T CELLS.
Anita Benoit 1,3 ; Ashok Kumar 1,2,3 ; Marko Kryworuchko 1,2,3
1-Infectious Disease and Vaccine Research Centre, Children’s Hospital of Eastern Ontario (CHEO) - Research Institute; 2-Department of
Pathology and Laboratory Medicine, University of Ottawa; 3-Department of Biochemistry, Microbiology and Immunology, University of Ottawa
Plain Language Summary: CD8 T lymphocytes are critical cells of the immune system whose role is to kill virus-infected cells. However, they
become impaired in HIV-infected individuals, exhibit altered expression of surface and signaling proteins and are unable to eliminate the virus
from the body. Our work is focused on understanding why this may occur at the molecular level.
Objective: An increased proportion of Interleukin-7 receptor alpha low-expressing (IL-7Ralow) effector-like CD8 T cells with altered
functionality have been described, particularly in viremic HIV+ individuals. We have demonstrated increased expression of Growth Factor
Independent-1 (GFI1), a transcriptional repressor, in IL-7Ralow CD8 T cells from HIV+ patients. Increased GFI1 expression has also been
associated with enhanced cell survival and proliferation, and IL-7Ra downregulation in murine studies. Therefore, the following study
objectives were elaborated:
1) Identify the cytokines that may regulate IL-7Ra in human CD8 T lymphocytes via GFI1.
2) Investigate the signaling pathways responsible for the regulation of GFI1 and IL-7Ra expression in CD8 T cells.
Methods: Cytokine-induced signaling in human primary CD8 T cells was investigated by flow cytometry and quantitative real time PCR was
used to measure IL-7Ra and GFI1 expression levels. Small-interfering RNA and Pharmaceutical inhibitors targeting cytokine-induced Mitogen-
Activated Protein Kinase (MAPK), the Janus kinase (Jak) / Signal Transducers and Activators of Transcription (STAT) and PI3-kinase (PI3K) /
Akt signaling pathways were used and their effects established by immunoblotting.
Results: Amongst the cytokines tested (IL-2, IL-4, IL-7, IL-15) that were capable of downregulating IL-7Ra expression only IL-4 concomitantly
increased Gfi1 expression. Experiments investigating the role of the signaling pathways involved suggested that basal IL-7Ra expression levels
may be sustained by the MAPK signaling pathway whereas IL-4-induced suppression of IL-7Ra may be under the control of the Jak/STAT and
PI3-kinase (PI3K) / Akt signaling pathways.
Conclusions: Further studies are required to confirm the mechanisms involved in the regulation and functional role of GFI1 in human CD8 T
cells, and constitutive versus IL-4-mediated regulation of IL-7Ra expression levels. Such studies may provide insight into the mechanism(s)
responsible for the accumulation of IL-7Ralow CD8 T cells in HIV infection.
Contact Information: Anita Benoit, Tel: 613 737 7600 ext.3911, Email: abeno026@uottawa.ca

345
REGULATION OF IL-23 IN HUMAN MONOCYTES FOLLOWING HIV INFECTION
Maria Blahoianu 1,2 ; Ali Rahim Rahimi 1,2 ; Nirangala Gajanayaka 2 ; Ashok Kumar 1,2
1-University of Ottawa; 2-Children's Hospital of Eastern Ontario
Plain Language Summary: Cytokines are a group of small proteins that serve as signaling compounds, allowing cells to communicate with one
another. My project focuses on two cytokines, IL-23 and IL-27 that have important roles in regulating cell-mediated immune responses. My
research will ultimately focus on the signaling pathways that HIV-infection employs to target cellular mechanisms, and start the progression of
the disease. These results will help elucidate the molecular mechanisms by which HIV changes the expression of IL-23 and IL-27 cytokines. As a
result, further understanding of the effects that HIV has on cytokine expression will be provided and novel strategies may be developed,
enhancing the host immune response against HIV infection.
Objective: My experimental objectives are as follows:(1) To determine the signaling pathways involved in IFN-γ-induced IL-23 and IL-27
expression in human monocytes, (2) To characterize IL-23 and IL-27 expression in HIV-infected individuals and following in vitro infection with
HIV of monocytes and (3) To determine the mechanisms by which HIV regulatory proteins modulate the signaling proteins implicated in IFN-γinduced
IL-23 and IL-27 expression in human monocytes.
Methods: Human primary monocytes are obtained from peripheral blood mononuclear cells (PBMCs) of healthy donors. Monocytes are isolated
and cultured in IMDM supplemented with 10% FBS , 100 units/ml penicillin, 100μg/ml gentamicin, 10mM HEPES, and 2mM glutamine. In
order to study the regulation of IL-23 and IL-27, specific signaling pathways are studied. By using a series of small protein inhibitors I am able to
investigate the MAPK signaling pathways using SP600125, SB203580 and PD98059, which are JNK, p38 and ERK inhibitors respectively. PI3K
signaling pathway is examined using the LY294002 inhibitor. Once I have determined the signaling pathways induced by IFN-γ stimulation, the
effect of HIV regulatory proteins on IL-23 and IL-27 expression will be established.
Results: The results show that IFN-g and IFN-g/LPS-induced IL-23 expression is negatively regulated by the JAK/STAT, PI3K and the JNK
MAPKs signalling pathways. In contrast, exposure of monocytes to the p38 inhibitor SB202190 also showed significantly decreased IL-23 and
IL-12/23p40 protein production in either IFN-g or IFN-g/LPS-stimulated monocytes. However, treatment of cells with the p38 inhibitor resulted
in increased IL-23p19 mRNA expression following stimulation with IFN-g alone whereas cells treated with IFN-g/LPS showed no change in IL-
23p19 mRNA expression.
Conclusions: The purpose of my project is to provide further insight into the effect that HIV and its regulatory proteins have in the modulation of
Th1 cytokines. By understanding the mechanisms that HIV uses to minimize a Th1 response, novel therapeutic approaches can be used to
attenuate the HIV-associated immune deficiency. This is the first report showing the differential regulation of IFN--induced IL-23 expression
in primary human monocytes. IFN-g and IFN-g/LPS-induced IL-12p40 and IL-23 induction was negatively regulated by the JAK/STAT, PI3K
and the JNK pathway and positively regulated by the p38 MAPKs.
Contact Information: Maria Blahoianu, Tel: (613)-852-1062, Email: mblah011@uottawa.ca
346
REGULATION OF IL-23 INDUCED SIGNALING AND RECEPTOR EXPRESSION IN HUMAN CD4 T CELLS ISOLATED FROM
HIV POSITIVE PATIENTS
Nor Fazila Che Mat 1 ; Christina Guzzo 1 ; Xiubo Zhang 1 ; Wendy Wobeser 2 ; Katrina Gee 1
1-Department of Microbiology and Immunology, Queen’s University, Kingston, ON, Canada; 2-Clinical Immunology Outpatient Clinic,
Kingston General Hospital, Kingston, ON, Canada.
Plain Language Summary: Cytokines are involved early in pathogenesis of HIV infection and disease progression as determinants controlling
virus infection and also as a component of immunologic dysregulation and immunodeficiency. The IL-12 family of cytokines which include a
novel cytokine, IL-23, are key cytokines that regulate the CD4 T cell response. HIV infection has been shown to modulate IL-12, however the
effects of infection have not been described for the other members of this family. In particular, IL-23 plays a vital role in the induction of the
memory T cell response and this cytokine mediates cellular function by binding to a specific IL-23 receptor chain (IL-23R), which pairs with IL-
12Rβ1. How HIV infection affects IL-23 signaling components is not understood at this time and is the focus of this project. IL-23 signal
transduction is activated through the JAK-STAT intracellular signaling pathway. The components involved in this pathway include: Janus Kinase
2, Tyk2, signal transducer and activator of transcription 1 (STAT1), STAT3 and STAT4
Objective: The aim of this study is to examine the effect of HIV infection on IL-23-induced signaling and function and also IL-23 expression in
human T cells.

Methods: Primary CD4 T cells from healthy controls and HIV-infected patients were isolated by negative selection using Rosettsep magnetic
beads (Stem Cell Technologies) using protocols approved by the Queen’s University Research Ethics Board. Cells were treated with recombinant
human IL-23 (5μg/ml) and untreated cells were used as a control. Total protein was isolated from cells pellets and total RNA was prepared by
using TriReagent. All samples were evaluated for the activation of the Jak/STAT pathway and the IL-23 receptor expression genes by Western
analysis and reverse quantitative polymerase chain reaction (q-PCR) respectively. The amounts of IL-23 in the plasma were determined by doing
Enzyme-Linked Immunosorbent Assays (ELISA).
Results: Our results show that IL-23 can strongly induce the phosphorylation of STAT-1, STAT-3, STAT-4, JAK-2, and TYK-2 and the
expression of Socs3 in SUPT-1 cells in human CD4 T cells. We also show that IL-23 was able to induce the expression of both IL-23 receptor
subunits in SUPT-1 and primary CD4 T cells. In a primary HIV isolates, these affects of IL-23 are lost. Our results demonstrate the CD4 T cells
from HIV infected patients constitutively express activated signaling proteins and expression of both IL-23 receptor subunits are upregulated in
HIV-infected patients compared to healthy controls
Conclusions: Our results indicate that IL-23-induced functions can be inhibited during HIV infection. HIV might have a significant effect on IL-
23 function and having a better understanding of how IL-23 expression and function is modulated during HIV infection may lead to the
identification of novel therapeutic targets.
Contact Information: Nor Fazila Che Mat, Tel: 613-583 6654, Email: 7mnfc@queensu.ca
347
EFFECTS OF HIV-1 ON THE MATURATION AND ANTIGEN PRESENTATION OF MONOCYTE DERIVED DENDRITIC
CELLS.
Peter Fairman 1,2 ; Jonathan Angel 1,2,3
1-Dept. Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, Ontario.; 2-Ottawa Hospital Research Institute, Ottawa,
Ontario. ; 3-Division of Infectious Disease, Ottawa Hospital-General Campus, Ottawa, Ontario.
Plain Language Summary: Dendritic cells (DC) are mediators of the adaptive immune response responsible for the presentation of antigen to
naïve T-cells in secondary lymph organs. The effects of HIV-1 on DC maturation are not well established and conflicting results have been
reported.
Objective: The objective of this study is to evaluate the effects of HIV-1 on the maturation of monocyte derived dendritic cells (MDDC) in vitro.
Surface molecule expression and phagocytic activities over the course of DC maturation were measured.
Methods: Monocytes isolated from peripheral blood mononuclear cells were differentiated into immature MDDC (iMDDC) according to the
established methods. Cells were first incubated with HIV-1(CS204) for 2, 12 and 24 hours and then cultured for 48h in the presence or absence of
a maturation inducing inflammatory cytokine cocktail (IL-1β, IL-6 and PGE2), along with appropriate controls and then examined by flow
cytometry for expression of CD14, DC-SIGN, CD80, CD86, CD40, CCR7, MHC I and MHC II. To measure endocytosis, iMDDC were
incubated with HIV(CS204) for 2, 12 and 24 hours followed by a 1 hour incubation with FITC-conjugated dextran and then examined by flow
cytometry.
Results: Incubation with HIV-1(CS204) for 2, 12 or 24 hours resulted in a significant decrease in CD14 expression as well as increases in
CD40, CD80, CD86, and MHC II expression consistent with the induction of dendritic cell maturation and similar to that seen following
stimulation with the inflammatory cytokine cocktail. Pretreatment with HIV-1(CS204) did not alter the induction of maturation by the cytokine
cocktail. After incubation of iMDDC with HIV-1(CS204) for 2, 12 or 24 hours endocytosis of FITC-dextran was observed to be decreased
consistent with a more mature state of DC . The presence of HIV-1(CS204) gag mRNA within DC was confirmed by RT-PCR.
Conclusions: In vitro HIV-1(CS204) appears to alter maturation and endocytotic activity of MDDC. Understanding the mechanisms of dendritic
cell dysfunction in HIV infection will provide further insight into HIV immune pathogenesis.
Contact Information: Peter Fairman, Tel: 613-737-8160, Email: pjfairma@hotmail.com
348
DEVELOPMENT OF A QUANTITATIVE BEAD CAPTURE ASSAY FOR SOLUBLE IL-7 RECEPTOR ALPHA IN HUMAN
PLASMA
Syvie Faucher 1 ; Angela M Crawley 2,3 ; Wendy Decker 1 ; Alice Sherring 1 ; Dragica Bogdanovic 1 ; Tao Ding 1 ; Michele Bergeron 1 ; Jonathan B
Angel 2,3,4 ; Paul Sandstrom 1
1-National HIV and Retrovirology Laboratories, Public Health Agency of Canada, Ottawa; 2-Ottawa Hospital Research Institute; 3-Department
of Biochemistry, Microbiology and Immunology, University of Ottawa; 4-Division of Infectious Diseases, Ottawa Hospital-General Campus

Plain Language Summary: IL-7 is an essential cytokine in T-cell development and homeostasis. It binds to the IL-7R receptor, a complex of the
IL-7R α (CD127) and common γ CD132) chains. There is significant interest in evaluating the expression of CD127 on human T-cells as it often
decreased in medical conditions leading to lymphopenia. Previous reports showed the usefulness of CD127 as a prognostic marker in viral
infections such as HIV, CMV, EBV and HCV. A soluble CD127 (sCD127) is released in plasma and may contribute to disease pathogenesis
through its control on IL-7 activities. Measuring sCD127 is important to define its role and may complement existing markers used in
lymphopenic disease management.
Objective: To develop of a quantitative capture immunoassay for the measurement of the sCD127 chain and assess its concentration and stability
in the plasma of healthy individuals.
Methods: We developed a quantitative bead-based sCD127 capture assay. Polyclonal CD127-specific antibodies were chosen for capture and a
biotinylated monoclonal anti-CD127 antibody was selected for detection. The assay can detect native sCD127 and recombinant sCD127 which
served as the calibrator. The analytical performance of the assay was characterized and the concentration and stability of plasma sCD127 in
healthy adults was determined.
Results: The assay’s range was 3.2-1000 ng/mL. The concentration of plasma sCD127 was 164±104 ng/mL with over a log variation between
subjects. Individual sCD127 concentrations remained stable when measured serially during a period of up to one year.
Conclusions: This is the first report on the quantification of plasma sCD127 in a population of healthy adults. Soluble CD127 plasma
concentrations remained stable over time in a given individual and sCD127 immunoreactivity was resistant to repeated freeze-thaw cycles. This
quantitative sCD127 assay is a valuable tool for defining the potential role of sCD127 in lymphopenic diseases.
Contact Information: Sylvie Faucher, Tel: 613-957-0174, Email: sylvie_faucher@phac-aspc.gc.ca
349
EFFECTS OF INTERLEUKIN-7 ON NOTCH-1 EXPRESSION IN CD8 T-CELLS
Feras Ghazawi 1,2 ; Elliott Faller 1,2 ; Paul MacPherson 1,2,3
1-Ottawa Health Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada; 2-Department Biochemistry, Microbiology and Immunology,
University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada; 3-Division of Infectious Diseases, Ottawa Hospital General Campus, 501
Smyth Road, Ottawa, Ontario, Canada
Plain Language Summary: Interleukin (IL)-7 plays an essential role in T-cell development, homeostasis, and activation. Throughout the lifespan
of a T-cell, the IL-7 receptor alpha-chain (CD127) is tightly regulated and provides important signals influencing cell survival, proliferation,
and differentiation. Interleukin-7 down regulates expression of its own receptor (CD127) at both the level of transcription and surface protein
expression. It has been recently shown that activation of Notch-1, an important signaling pathway which involves gene regulation mechanisms
that control multiple cell differentiation processes during embryonic and adult life, is crucial for CD127 gene expression in thymocytes. It is not
known whether Notch-1 plays a role in CD127 expression in mature CD8 T-cells and whether IL-7 alters CD127 gene transcription by affecting
Notch-1 expression.
In this study, we measured the effects of IL-7 on Notch-1 mRNA transcript levels by quantitative Real-Time PCR and on Notch-1
protein expression by flow cytometry in CD8 T-cells.
Objective: To determine if IL-7 down regulates CD127 gene transcription by suppressing Notch-1 expression in CD8 T-cells.
Methods: CD8-T cells from healthy HIV-negative adult volunteers were treated with 10 ng/ml of IL-7 for 3, 12 and 24 hours and Notch-1
mRNA transcript levels were compared to untreated controls using the BioRad iCycler iQ Real Time PCR system. Notch-1 protein expression
was examined in IL-7 treated and untreated CD8 T-cells by flow cytometry using a Coulter Epics ALTRA flow cytometer.
Results: IL-7 induces a time-dependent upregulation of Notch-1 mRNA transcripts in mature CD8 T-cells. After 24 hours of treatment there is
about 2 fold increase of Notch-1 mRNA transcripts as compared to untreated controls. Additionally, there are no significant changes in Notch-1
protein expression between IL-7 treated and untreated CD8 T-cells.
Conclusions: IL-7 appears to up regulate expression of Notch-1 in mature CD8 T-cells, at least at the mRNA transcripts level, suggesting CD127
is not down regulated by suppressing Notch-1. What role if any Notch-1 plays in CD127 expression in mature CD8 T-cells requires further
investigation.
Contact Information: Feras Ghazawi, Tel: 613-293-0678, Email: dr.feras@gmail.com
350
THE EFFECT OF HIV INFECTION ON EXPRESSION LEVELS OF THE INTERLEUKIN-27 HETERODIMERIC CYTOKINE AND
RECEPTOR.

Christina Guzzo 1 ; Nor Fazila Che Mat 1 ; Wendy Wobeser 2 ; Katrina Gee 1
1-Department of Microbiology and Immunology, Queen’s University, Kingston, ON, Canada. ; 2-Clinical Immunology Outpatient Clinic, Hotel
Dieu Hospital, Kingston, ON, Canada.
Plain Language Summary: Interleukins, cytokines secreted by leukocytes, are predominant messengers that modulate immune responses. There
are over 30 different types of human cytokines called interleukins (IL) that have been identified. During HIV infection, cytokine expression and
function become deregulated. Of particular note is IL-12, a cytokine which has suppressed production in the setting of HIV infection.
Interestingly, administration of IL-12 has been investigated as a potential therapy for HIV infection. IL-12 shares receptor components as well as
downstream functions with a newly described cytokine, IL-27. IL-27 exhibits pro- and anti-inflammatory properties and can be regarded as an
immunomodulator. Although IL-27 has recently been shown to act as a novel anti-HIV cytokine, the effect of HIV infection on IL-27 expression
and function has not been characterized. The overall objective of this project is to understand how HIV affects expression levels of the IL-27
cytokine, receptor subunits, and regulation of IL-27-induced signalling pathways.
Objective: We sought to identify the effect of HIV infection and HAART treatment on expression levels of the IL-27 heterodimeric cytokine in
plasma and IL-27 receptor expression levels in resting monocytic cells.
Methods: In accordance with Queen’s University Research Ethics Board approval, informed consent was obtained from HIV patients willing to
donate blood for this study. Primary human monocytes were isolated from peripheral blood mononuclear cells using a CD14 positive magnetic
negative selection kit from Stem Cell Technologies. Primary monocytes were isolated from healthy, uninfected volunteers, and HIV positive
patients naive to therapy as well as those receiving therapy. Cell pellets were processed for real time PCR analysis to examine expression levels
of the IL-27 receptor chains gp130 and WSX-1. Plasma was also collected from all samples to examine expression levels of heterodimeric IL-27
by ELISA.
Results: Preliminary results show HIV viral load and HAART may affect IL-27 expression.
Conclusions: How HIV affects IL-27 expression and function is not well characterized. This study is a critical first step to discover how this
cytokine may helpful towards the identification of novel treatment modalities or potential prognostic indicators. This work is supported by a
studentship from the OHTN.
Contact Information: Christina Guzzo, Tel: 613.766.2644, Email: 3cg8@queensu.ca
351
HIV INDUCES A UNIQUE CYTOKINE PROFILE WITH DELAYED INTERFERON ALPHA PRODUCTION IN PLASMACYTOID
DENDRITIC CELLS
Calvin Lo 1 ; Dylan Johnson 1 ; Monica Yu 1 ; Martin Hyrcza 1 ; Wendy Dobson-Belaire 2 ; Mario Ostrowski 1
1-Department of Immunology, University of Toronto; 2-Department of Molecular Genetics, University of Toronto, Toronto ON Canada
Plain Language Summary: Plasmacytoid dendritic cells (pDCs) are rare cells that can be found in the blood. Normally, when there is a viral
infection, these cells are activated and produce large amounts of a highly effective anti-viral molecule, known as interferon alpha (IFN-alpha).
Experiments using tissue culture have shown that IFN-alpha can stop HIV from infecting T cells. However, in humans pDCs are not able to stop
HIV infection from taking hold. We show that when pDCs are activated by HIV, they do not produce IFN-alpha as early as when they are
activated by other viruses like influenza or herpes. This delay may allow HIV to establish itself before IFN-alpha can take effect. In addition, HIV
seems to activate pDCs to produce molecules that attract T cells. This means that HIV may be using pDCs to bring in more target cells that can
then be infected. By learning more about these cells, new avenues in the development of preventative treatments can be explored.
Objective: Determine differences in the level and kinetics of cytokine production by pDCs in response to HIV and other viral stimuli.
Methods: Isolated pDCs were exposed to influenza virus, sendai virus, herpes simplex virus and HIV in vitro. Supernatant was harvested at
various time-points and levels of IP-10, IFN-alpha, TNF, IL-10, IL-12, IL-6, IL-8 and MIP1-beta were quantified by cytometric bead array
analysis. Activation of signaling pathways critical for IFN-alpha production (AKT, IRF7) were studied by intracellular staining and flow
cytometry.
Results: PDCs produced robust levels of IFN-alpha in reponse to sendai, influenza and herpes simplex within 4 hours of stimulation. In contrast,
HIV induced early production of IP-10 and IL-8, but did not elicit comparable levels of IFN-alpha until 12 hours post exposure. Flu virus induced
early AKT phosphorylation, as well subsequent IRF7 phosphorylation. In contrast, HIV induced dephosphorylation of IRF7, and delayed AKT
phosphorylation.
Conclusions: Here we provide evidence suggesting that the pDC cytokine response to HIV differs significantly from other viruses, the most
striking aspect being a delayed IFN-alpha response. Preliminary evidence suggests that regulation of this process may occur at the level of the
AKT-IRF7 axis. Physiologically, this difference may help provide an explanation for the ability of HIV to overcome the IFN-alpha response
during initial exposure at the mucosa. In addition, HIV induced production of chemoattractive cytokines may implicate pDCs as key players in
the recruitment of target cells during early infection.

Contact Information: Calvin Lo, Tel: 416-471-1718, Email: calvin.lo@utoronto.ca
352
INDUCTION OF TIM-3 EXPRESSION BY THE COMMON GAMMA-CHAIN CYTOKINES IL-2, IL-7, IL-15 AND IL-21
Brad R. Jones 1 ; Shariq Mujib 1 ; Calvin Lo 1 ; Diana Hunter 1 ; Mario Ostrowski 1,2
1-Department of Immunology, University of Toronto; 2-Li Ka Shing Institute of Knowledge, St. Michael’s Hospital, Toronto ON Canada
Plain Language Summary: Cytotoxic T cells (CTLs) are important in immune responses against viruses, because they kill virus-infected cells.
Research has shown that during chronic viral infections, CTLs lose the ability to kill and divide effectively; these cells are deemed ‘exhausted.’
Exhausted cells have been shown to display higher levels of certain receptors on their surface, one of which is a marker known as Tim-3.
Blocking the Tim-3 receptor in a laboratory setting has been shown to revive CTL activity. In HIV infected individuals, over 70% of CTLs
express Tim-3. However the mechanism leading to these elevated levels is currently unknown. This study aims to examine the induction of Tim-
3 on T cells by different immune modulating molecules called cytokines.
Objective: Examine the effects of common gamma-chain cytokines on Tim-3 expression levels on T cells
Methods: Isolated CD4+ T cells were infected with HIV-1 in vitro. Whole PBMC, and isolated CD4+ or CD8+ T cells were treated with stimuli
including LPS, and cytokines. Tim-3 expression was analyzed at various time-points by flow cytometry, in conjunction with a number of
phenotypic markers and CFSE. Upon removal of cytokine, apoptosis (annexin-V) was analyzed along with Tim-3 expression.
Results: In vitro HIV-1-infection had no effect on the Tim-3 expression levels of CD4+ T cells. The common gamma-chain cytokines induced
high levels of Tim-3 expression with the following hierarchy of potency: IL-15>IL-2>IL-21>IL-7, while LPS and IL-4 had no effect. The
gamma-chain cytokines induced distinct profiles of Tim-3/PD-1 co-expression with some driving a dual-positive population, and other
preferentially upregulating either Tim-3 or PD-1. Tim-3 expression was primarily limited to cells that had undergone proliferation in response to
cytokine, and these cells preferentially underwent apoptosis upon cytokine removal.
Conclusions: Here we provide evidence against the direct exposure of T cells to virus, or exposure to LPS as etiologies for global Tim-3
upregulation in HIV-1 infected individuals. Potent upregulation of Tim-3 is however driven by exposure of T cells to common-gamma chain
cytokines. Physiologically, this upregulation likely serves to balance the survival signals provided by these cytokines, and to drive the elimination
of these activated cells upon removal of cytokine (resolution of infection).
Contact Information: Shariq Mujib, Tel: 416-946-0277, Email: shariq.mujib@utoronto.ca
353
EXPRESSION OF THE INTERLEUKIN-7 RECEPTOR IS DOWN REGULATED ON CD4 T-CELLS BY THE HIV TAT PROTEIN
Denny McLaughlin 1 ; Paul MacPherson 1
1-Department of Microbiology and Immunology, University of Ottawa
Plain Language Summary: HIV infection elicits defects in CD4 T-cell homeostasis in both a quantitative and qualitative manner. Interleukin-7
(IL-7) is essential to T-cell homeostasis and several groups have shown reduced levels of the IL-7 receptor alpha-chain (CD127) on both CD4
and CD8 T-cells in viremic HIV+ patients. Our lab has demonstrated that soluble HIV Tat protein specifically down regulates cell surface
expression of CD127 on human CD8 T-cells in a paracrine fashion. Once taken up by CD8 T-cells, Tat enters the cytoplasm and interacts directly
with the cytosolic tail of CD127 inducing receptor capping, endocytosis and degradation. The effects of Tat on CD127 expression in CD4 T-cells
has yet to be described.
Objective: The purpose of this study is to determine if, similar to CD8 T-cells, HIV Tat down regulates surface CD127 expression on CD4 T-
cells.
Methods: Primary CD4 T-cells isolated from healthy HIV-negative volunteers were incubated in media alone or with Tat protein (10 ug/ml) for
up to 48 hours and then analyzed by flow cytometry for CD127 expression and other cell surface markers.
Results: Similar to CD8 T-cells, soluble HIV Tat protein induces a 27.5% +/- 4.6% decrease in surface CD127 expression on CD4 T-cells
relative to cells cultured in media alone at 48 hours (n=2). This down regulation was not associated with cell activation as cells treated with Tat
demonstrated no change in CD25, CD28, or CD56. Indeed, there was no change in overall phenotype including CD45RA, CD3, and CD4.
Further, expression of CD132, the common gamma-chain which associates with CD127 to form the IL-7 receptor, was unaffected by Tat.
Conclusions: The accessory HIV protein Tat significantly down regulates surface expression of the IL-7 receptor alpha-chain (CD127) on both
CD4 and CD8 T-cells. In view of the important role IL-7 plays in lymphocyte proliferation, homeostasis and survival, this down regulation of

CD127 by Tat likely plays a central role in immune dysregulation and CD4 T-cell decline. Understanding this effect could lead to new
therapeutic approaches to reverse the CD4 T-cell loss evident in HIV infection.
Contact Information: Denny McLaughlin, Tel: 613 737-8899 (x79851), Email: dennythanh@yahoo.com
354
TLR-9 AGONIST PROTECTS HUMAN MONOCYTIC CELLS AGAINST HIV-VPR-INDUCED APOPTOSIS: A CRITICAL ROLE
FOR CALMODULIN-DEPENDENT PROTEIN KINASE-II AND AN ANTI-APOPTOTIC CIAP-2 GENE
Mansi Saxena 1,2 ; Aurelia Busca 1,2 ; Ashok Kumar 1,2
1-Department of Biochemistry, Immunology and Microbiology, Faculty of Medicine, University of Ottawa, Ontario, Canada, K1H8M5.; 2-
Virology Research, Research Institute I, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, Ontario, K1H 8L1
Plain Language Summary: HIV/AIDS progression is characterized by rapid depletion of immune cells like CD4 positive T cells. However,
monocytic cells survive HIV's cytopathic effects and develop into viral reservoirs. Our objective is to elucidate what factors may be responsible
for making human monocytic cells resistant to HIV induced cell death and what signaling pathways and anti apoptotic genes are involved in this
resistance. To this effect we have shown that pretreatment with TLR-9 agonist CpG protects against HIV-Vpr induced apoptosis and down
regulation of TLR signaling proteins.
Objective: To elucidate mechanisms by which TLR 9 agonist CpG induces protection against HIV-Vpr induced apoptosis in THP-1 cells and
primary human monocytes.
Methods: Synthetic HIV-Vpr (56-92) peptide is used as a model apoptosis inducing agent in primary human monocytes, isolated from blood
donated by healthy volunteers, and in THP-1 cell line. Flowcytometry is used to assay cell viability and Western blotting is used to analyze
protein expression in response to CpG with or without pretreatment with various signaling inhibitors.
Results: We demonstrate that CpG, induces resistance to HIV-1-Vpr (52-96)-induced apoptosis human monocytic cells. Futhermore, studies
using calcium signaling inhibitors strongly suggest that this resistance is mediated by activation of calcium signaling, in particular CaMKII
phosphorylation. Vpr(52-96) treatment induced rapid downregulation of TLR signaling proteins and pretreatment CpG significantly prevented
this down regulation. cIAP2 (cellular Inhibitor of Anti-apoptotic protein 2) is so far the only anti-apoptotic gene found to be significantly up
regulated in response to CpG. Moreover calcium signaling inhibitors which abrogated CpG induced protection also prevent CpG induced up
regulation of cIAP2 in human monocytic cells.
Conclusions: This is the first study that demonstrates 1) induction of resistance to HIV accessory protein, Vpr induced apoptosis following
stimulation with distinct TLR-9 agonist by activating a calcium/CaMK-II activated pathway and 2) prevention of Vpr induced rapid down
regulation of TLR signaling molecules by pretreatment with CpG in human monocytic cells. Our observations suggest that TLR9 agonist CpG is
one of the factors involved in endowing resistance against apoptosis in human monocytic cells and maybe an important element in establishing of
HIV persistence and disease progression.
Acknowledgements: This work was supported by grants from the Canadian Institute of Health Research to AK. MS was supported by OGS
program. AK is a recipient of the Career Scientist Award from the OHTN.
Contact Information: Mansi Saxena, Tel: 613-882-0502, Email: 84mansi@gmail.com
355
THE EFFECT OF MIXED CAROTENOIDS SUPPLEMENTATION ON CD4 T LYMPHOCYTE COUNT IN HIV/AIDS
Neera Singhal 1,2 ; Yinghua Su 1 ; Joel Singer 3 ; William Cameron 1,2
1-Clinical Epidemiology Program / Ottawa Health Research Institute; 2-Division of Infectious Diseases, University of Ottawa at The Ottawa
Hospital, Ottawa; 3-Canadian HIV Trials Network at University of British Columbia / St. Paul’s Hospital, Vancouver
Plain Language Summary: We analysed data from the Carotenoids Trial (CTN 091) for effect of carotenoids supplementation on the number of
immune cells in the blood (CD4 T lymphocyte count) in patients with advanced HIV infection. 331 AIDS patients received natural mixed
carotenoids plus multivitamins or the multivitamins alone daily, with three-monthly follow up. We found that carotenoids treatment and increase
in serum carotene is associated with increase in CD4 T lymphocytes, in advanced HIV infection.
Objective: We aimed to assess the effect of carotenoids supplementation and change in serum carotene on CD4 T lymphocyte count in AIDS.
Methods: The Carotenoids Trial (CTN 091) was a randomised double blind control clinical trial of carotenoids supplementation in treated AIDS
patients. Study participants received natural mixed carotenoids (initially equivalent to 72 mg beta-carotene) plus multivitamins (n=165) or the
multivitamins alone (n=166) daily and were followed up quarterly. We performed a stratified analysis of changes from baseline in CD4+ cell

count in quartiles of serum carotene change from baseline. We also performed longitudinal analysis using the Generalized Estimating Equations
(GEE) with identical link function.
Results: Baseline median (IQR) CD4+ cell count was 60 (28, 100) and 76 (30, 114) cells/µL, and serum carotene was 1.8 (1.2, 2.6) and 1.8 (1.2,
2.9) µmol/L in treatment and control groups, respectively. In stratified analysis at nine months overall, the highest quartile change in serum
carotene from baseline (mean +3.4 µmol/L) had a mean change of +67 CD4+ cells/µL, while the lowest quartile of serum carotene change (mean
-1.2 µmol/L) had a +23 CD4+ cells/µL change, which was statistically significant (p=0.04) across quartiles overall, and also in the treatment
group (p=0.04). An increase of 1.0 µmol/L in serum carotene was associated with an average 5 cells/µL increase in CD4 T lymphocytes
(p

Methods: Primary cultures of human fetal astrocytes (HFAs) were treated with gp120 (1.0nM), for 6 and 24 hours in the presence or absence of
SN50 (1μM; NF-κB inhibitor), CXCR4 and CCR5 neutralizing antibodies (1mg/ml). TNF-α, IL-1β and IL-6 secretion in response to gp120 were
measured using ELISA analysis. Astrocytes were also treated with 0.5ng/ml and 10 ng/ml concentrations of TNF-α or IL-6 for the desired time
(6h, 12h and 24h). In addition, IL-6 treatments were also performed in the presence of SN50. Immunoblot analysis was subsequently used to
determine the protein expression of CXCR4, CCR5 and P-gp. Functional assay with [3H]digoxin was performed to determine P-gp activity in
gp120 treated cells.
Results: Immunoblot analysis confirmed the presence of CXCR4 and CCR5 receptors in HFAs. However, pretreatment of the cells with only
CCR5 neutralizing antibody attenuated the TNF-α, IL-1β and IL-6 secretion. Treatment with gp120 reduced P-gp expression and increased
cellular accumulation of [3H]digoxin. IL-6 treatment decreased P-gp expression whereas TNF-α treatment increased its protein expression.
However, P-gp expression was not altered when cultured cells were exposed to gp120 or IL-6 in the presence of SN50, an inhibitor of NF-κB.
Conclusions: Our data suggest that the interaction of gp120 with CXCR4 and CCR5 receptors are necessary for cytokine secretion and also
demonstrate that the regulation of P-gp by gp120 and cytokines are NF-κB pathway dependent in human astrocytes.
Supported by the Canadian Institute of Health Research (CIHR) and the Ontario HIV Treatment Network (OHTN)
Contact Information: Tamima Ashraf, Tel: 647-994-1281, Email: tamima.ashraf@utoronto.ca
358
MONOCYTES TO MACROPHAGES DIFFERENTIATION CONFERS RESISTANCE TO HIV-VPR INDUCED APOPTOSIS: ROLE
OF ANTI-APOPTOTIC BCL2 AND INHIBITORS OF APOPTOSIS (IAP) PROTEINS
Aurelia Busca 1,2 ; Ashok Kumar 1,2,3
1-Department of Biochemistry, Microbiology, and Immunology, University of Ottawa K1H 8M5, Ottawa, Ontario, Canada.; 2-Infectious Disease
and Vaccine Research Centre, Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, Ontario K1H 8L1, Canada; 3-Department of
Pathology and Laboratory Medicine, University of Ottawa K1H 8M5, Ottawa, Ontario, Canada.
Plain Language Summary: Macrophages are resistant to HIV cytopathic effects and serve as crucial viral reservoirs during HIV infection. HIVinfected
macrophages can not be eliminated by current therapeutic approaches. The main aim of this research is to understand why HIV-infected
macrophages are resistant to cell death, with the ultimate goal of finding therapeutic strategies for their elimination. As a study model for the
mechanisms of cell death we have used Vpr (viral protein R), an HIV protein known for its ability to kill various cell types. Our results suggest
that macrophages are more resistant to Vpr-induced cell death compared to their originating cells, by disrupting the balance of genes that control
apoptosis. Inactivating antiapoptotic molecules, a strategy currently evaluated for cancer treatment, may also be beneficial for elimination of
HIV-infected macrophages.
Objective: To determine the roles of the main families of anti-apoptotic proteins, IAPs and Bcl-2, in controlling macrophage viability, either
spontaneous or in response to HIV protein, Vpr.
Methods: Macrophages were differentiated from the promonocytic cell line THP1 in the presence of PMA for 2 days. THP1 macrophages were
stimulated with Vpr peptide for 24h, in the presence or absence of pre-treatment with inhibitors for MAPKs, PI3K and NFkB. Apoptosis was
measured by intracellular propidium iodide staining and the expression level of various antiapoptotic proteins was evaluated by Western blot.
Results: PMA differentiated THP-1 macrophages exhibit significantly lower level of apoptosis to HIV-Vpr compared to THP-1 cells, suggesting
that monocyte to macrophage differentiation impacts on susceptibility to HIV-Vpr induced apoptosis. Our results show that although HIV-Vpr
activated MAPKs and PI3K/Akt pathways, Vpr induced apoptosis was mediated by JNK and ERK kinases. The level of antiapoptotic cIAP1,
cIAP2, Mcl-1 and Bcl-xL proteins increased and proapoptotic Bax decreased throughout differentiation, consistent with their resistant phenotype.
Vpr efficiently down-regulated cIAP1 and Bcl2 in sensitive THP-1 cells but not in THP1 macrophages. Furthermore, blocking of NFkB
transcription factor increased both spontaneous as well as Vpr-induced apoptosis.
Conclusions: Our results suggest that monocytes are sensitive to Vpr but develop resistance following differentiation into macrophages.
Moreover, resistance to Vpr induced apoptosis may be mediated by anti-apoptotic Bcl2 and IAP proteins through activation of NFkB. Modulation
of the apoptotic pathway during differentiation provides insight into the possible mechanism for viral reservoirs persistence and potential
therapeutic approaches to target upstream signaling molecules and antiapoptotic genes.
Contact Information: Aurelia Busca, Tel: 613.737-7600 ext 3919, Email: aureliabusca@yahoo.com
359
IDENTIFICATION OF THE OLIGOMERIZATION INTERFACE IN THE TRANSMEMBRANE DOMAIN OF HIV-1 VPU

David Davidson 1,2 ; Isabel Leung 1,2 ; Shuang Wang 1,2 ; Simon Sharpe 1,2
1-Molecular Structure and Function, The Hospital for Sick Children, Toronto, ON, Canada; 2-Department of Biochemistry, University of
Toronto, Toronto, Canada
Plain Language Summary: The integral membrane protein Vpu is encoded by HIV-1 and expressed in infected cells. There it exhibits ion
channel activity and also plays an important role in the release of newly formed virus particles from infected cells. Experimental evidence has
shown that these activities require only the transmembrane domain of Vpu, although the mechanisms for channel assembly and Vpu function are
not well understood. Here we identify a conserved motif of small amino acids responsible for assembly of Vpu into a functional channel or pore.
Combined with previous structural data, this allows us to model the channel structure, moving towards an understanding of the molecular basis
for Vpu function in the HIV-1 lifecycle. Furthermore, we are screening sites within the channel for interactions with known Vpu inhibitors. While
these compounds are not clinically useful, understanding their mechanism of action will inform future efforts to develop new inhibitors of Vpu
function.
Objective: The primary goal of this study is to define the residues required for cation channel/pore formation and thus the functional activity of
the HIV-1 accessory protein Vpu. In addition, we are using solid state nuclear magnetic resonance (NMR) to determine the sites of smallmolecule
interaction with the Vpu channel, in order to define the primary sites for drug-binding and the mechanism for Vpu inactivation.
Methods: We have cloned, expressed, and purified a full length construct of Vpu for ongoing structural and biochemical studies. Ala to Val
mutations were made at highly conserved sites within the transmembrane domain. Oligomerization was monitored by SDS-PAGE, while channel
activity was assessed using a liposome dye-release assay. Additional characterization of the mutants was carried out using circular dichroism and
fluorescence spectroscopy. NMR spectroscopy of 13C, 15N labeled Vpu was carried out in the presence and absence of the inhibitor HMA.
Results: Sequence analysis and mutagenesis, combined with SDS-PAGE and biophysical analysis have revealed a set of highly conserved
residues which are important for assembly and function of Vpu. NMR results show an interaction of HMA with selected sites within the channel,
providing the first experimental information regarding the molecular basis for small molecule inhibition of Vpu.
Conclusions: Biophysical analysis of the Vpu channel structure and its interactions with small molecule inhibitors is providing an improved
understanding of its molecular structure, and insights into the sequence requirements for Vpu function. Ongoing experiments seek to determine
the high-resolution structure of the Vpu oligomer, and to fully define drug-binding sites.
Contact Information: Simon Sharpe, Tel: 416-813-7852, Email: ssharpe@sickkids.ca
360
DETECTING NOVEL SAM68ΔC-ASSOCIATED PROTEINS INVOLVED IN DISRUPTING HIV-1 REPLICATION
Simon Duffy 1 ; Kiera Clayton 1 ; Alan Cochrane 1
1-Department of Molecular Genetics, University of Toronto, Toronto, Canada.
Plain Language Summary: The protein Sam68 was first described as a protein that stimulated HIV-1 replication. However, removal of a large
segment at the end of the Sam68 gene, resulted in a protein called Sam68∆C that inhibits HIV-1 infection even when the normal protein is
present. HIV-1 must infect a cell and transport its genetic code into the nucleus, where the DNA resides. However, to make new infectious virus
and to spread to other cells, its genome has to escape the nucleus and be assembled into a virus particle. The mutant Sam68∆C blocks its exit
from the nucleus and thereby prevents the generation of new virus. Our goal is to determine how Sam68∆C blocks viral exit and replication by
isolating the protein while it's still bound to other cellular proteins and to identify these proteins involved in disrupting HIV-1. Our hope is that
this will lead to the discovery of new targets to fight HIV-1 infection.
Objective: Sam68∆C is a C-terminal deletion mutant of the RNA-binding protein Sam68 that has a dominant negative effect on Rev-dependent
nuclear export of HIV-1 incompletely spliced RNAs. Previous work in our lab demonstrated that changes in the composition of HIV-1 mRNPs,
specifically disruption of PABP1 binding, inhibits translation of these mRNPs. We hypothesize that other RNP components are disrupted by
association with Sam68∆C. Our challenge was to identify Sam68∆C-associated factors and, by specifically disrupting them, determining which
factors may exert a significant influence on HIV-1 replication.
Methods: We expressed HIV-1 Env and Sam68∆C in 293T cells and performed tandem affinity purification (TAP) to precipitate Sam68∆C as
well as any associated protein complexes. These associated proteins were identified by MALDI-TOF mass spectroscopy. Intereference RNA
(RNAi) was used to specifically disrupt expression of some of the relavent factors and their effect on HIV-1 replication was determined. For
those, factors that independently disrupted HIV-1 replication, specific experiments were devised to examine the nature and specificity of this
disruption.
Results: While the majority of Sam68∆C-associated proteins were unchanged upon expression of HIV env RNA, some distinctions were
observed. This study will summarize some Sam68∆C-associated factors relevant to HIV-1 infection and examine the effects of disrupting the
expression of these factors.
Conclusions: Sam68∆C-mediated disruption of HIV-1 replication involves it association with other host factors. These factors are, themselves,
important in the life cycle of HIV-1 and represent potential gene targets for future therapies.

Contact Information: Simon Duffy, Tel: 416-977-2500, Email: simon.p.duffy@gmail.com
361
EXPRESSION OF ABC DRUG EFFLUX TRANSPORTERS IN A HIV-1 TRANSGENIC RAT MODEL
Kevin Robillard 1 ; Reina Bendayan 1
1-Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto
Plain Language Summary: ATP-binding cassette (ABC) membrane-associated drug efflux transporters, P-glycoprotein (P-gp) and multidrug
resistance associated protein 1 (MRP1), can significantly restrict the permeability of antiretrovirals into target tissues leading to sub-therapeutic
drug concentrations and the formation of viral reservoirs such as the brain and testes. Our previous studies demonstrated that HIV-1 viral
envelope glycoprotein-120 (gp120) can trigger an inflammatory and oxidative stress response which can alter the expression of these transporters
in primary cultures of rat astrocytes.
Objective: The main objective of this study are to investigate, in vivo, the effect of HIV-1 viral proteins on the functional expression of P-gp and
Mrp1 in a non-infectious HIV-1 transgenic rat model
Methods: We used a non-infectious HIV-1 Sprague-Dawley rat model (HIV-rat) containing a gag/pol-deleted provirus which express 7/9 HIV-1
genes. Tissues and serum were isolated from two month old male HIV-rat or age-matched wild-type control rats (WT-rat). Tissues were analyzed
for P-gp and Mrp1 mRNA expression using real-time quantitative PCR (qPCR). ABC protein expression in tissue lysates was determined using
antibody specific-immunoblots. Serum levels of pro-inflammatory cytokines (i.e., TNF-α and IL-6) were analyzed using a specific enzymelinked
absorbent assays (ELISA).
Results: Although serum levels of TNF-α were modestly increased (2-fold) in the HIV-rat group (30 pg/ml) compared to the WT-rat group (

esult, the level of unspliced HIV-RNA is decreased by hnRNPD p37 and p40, and increased by hnRNPD p42 and p45.Additional studies also
indicate a requirement for hnRNP D in the cytoplasmic accumulation of HIV RNAs suggesting a role in either transport or stability.
Conclusions: Different hnRNP D isoforms have different effects on HIV-1 expression, which require further studies to fully characterize.Current
work will investigate if the impact of hnRNPD isoforms on viral mRNA levels is due to direct or indirect interaction with viral RNA as well as if
it involves stabilizing or destabilizing the viral mRNA. Together, the data will provide important insights into the role of this host factor in
regulating HIV-1 replication and potential new strategies to control virus replication.
Contact Information: Alan Cochrane, Tel: 416 978-2500, Email: alan.cochrane@utoronto.ca
363
HIV-1 INCREASES NON-LTR ASSOCIATED LONG INTERSPERSED ELEMENT 1 EXPRESSION BY RETROTRANSPOSITION
Haihan Song 1 ; Bradley Jones 1 ; Yang Xu 1 ; Mario Ostrowski 1
1-Clinical Sciences Division, Faculty of Medicine, University of Toronto
Plain Language Summary: Globally, Human Immunodeficiency virus (HIV-1) has killed more than 25 million of the 60 million people it has
infected so far. Effective preventive and therapeutic vaccines are urgently needed to control the continuing spread of HIV. The usual strategy for
an HIV vaccine is targeting the virus protein on HIV infected cells, and then eliminating the infected cells. However, this strategy often fails
because HIV mutates too rapidly to be targeted consistently. The ultimate goal of this study is to develop a novel HIV vaccine using non-LTR
associated long interspersed element 1 (LINE-1). LINE-1 exists in normal human bodies. We found that HIV increases LINE-1 expression in
HIV infected cells, thus a vaccine targeting these increased LINE-1 expressing cells could therefore specifically eliminate HIV infected cells.
This study shows the mechanism of the up-regulation of LINE-1 in HIV-1 infected cells.
Objective: HIV increases LINE-1 expression in HIV infected cells. We hypothesize that the increase of LINE-1 is through up-regulation of
LINE-1 retrotransposition. Since APOBEC3 A, B and F and G have been shown to inhibit LINE-1 expression, and since HIV-1 Vif degrades
APOBEC3 F and G, it is possible that HIV-1 allows LINE-1 expression through Vifs action on APOBEC3F/G. It is also possible that other HIV-
1 proteins affect LINE-1 control. The effects of HIV-1-Vpr on a cell, which include the generation of double-strand breaks and enhanced
homologous recombination, are super-imposable with the effects of LINE-1 retrotransposition.
Methods: We use an in vitro retrotransposition assay. Jurkat cells were transfected with a plasmid containing the retrotransposition-competent
human LINE-1 element, then infected with HIV-1 or HIV-1 mutant viruses. EGFP and HIV-1-Gag expression were analyzed.
Results: We consistently observed that the percentage of eGFP+ cells increased progressively in Gag+HIV-1-NL4-3-infected cells, peaking at 4
days after infection. Substantially lower frequencies of eGFP+ cells were observed in HIV-1 NL4-3 Vif deficient virus and HIV-1 NL4-3 Vpr
deficient virus.
Conclusions: These data indicate that the increase of LINE-1 in HIV-1 infected cells is through up-regulation of LINE-1 retrotransposition and is
controlled by HIV Vif and Vpr action and thus contributing a novel mechanism for HIV-1 pathology.
Contact Information: Haihan Song, Tel: 416 946 0120, Email: jerrysong@ymail.com
364
A SELF-BOOSTING CYTOMEGALOVIRUS (CMV) VECTOR IN THE DEVELOPMENT OF A PROTECTIVE HUMAN
IMMUNODEFICIENCY VIRUS (HIV) VACCINE
Aruna Ambagala 1 ; David Willer 1 ; Jacqueline Chan 1 ; Angie Marsh 1 ; Paul Sandstrom 2 ; Rick Pilon 2 ; Jocelyn Fournier 3 ; Kelly S. MacDonald 1
1-Mount. Sinai Hospital/University of Toronto, Toronto, Canada; 2-National HIV and Retrovirology Laboratories, Health Canada, Ottawa,
Canada; 3-Health Products and Food Branch, Health Canada, Ottawa, Canada
Plain Language Summary: Human cytomegalovirus (HCMV) is a ubiquitous herpesvirus responsible for asymptomatic, dormant, lifelong
infection in healthy individuals. The ability of HCMV to: 1) induce a strong, mucosally-oriented immune response, 2) frequently reactivate and
self-boost the immune response, and 3) re-infect immune individuals’, are key advantages over other vaccine vectors tested to date.
Cytomegaloviruses are highly species-specific viruses and generally restricted in ability to infect even closely related hosts. Therefore, to test our
hypothesis, we propose to use rhesus cytomegalovirus (RhCMV), a non-human primate cytomegalovirus, as a vaccine vector for use in the
development of vaccines designed to induce protective immunity to simian immunodeficiency virus (SIV).
Objective: To explore the use RhCMV as a vaccine vector for development of an HIV/SIV vaccine using cynomolgus macaques by
characterizing the primary and secondary immune responses against endogenous CMV followed by the super-infecting RhCMV vaccine strain.
Methods: Phase 1: To determine if CMV sero-positive cynomolgus macaques can be infected with RhCMV and to evaluate immunogenicity of
the vector. Phase 2: Construction of RhCMV expressing codon-optimized SIV antigens gag, pol, env and Nef-Tat-Rev fusion protein, and assess

the levels and pattern of SIV antigen expression and growth in vitro. Phase 3: Compare the in vivo growth and immunogenicity of these vectors
and their ability to confer protection following a multi-low dose mucosal challenge with pathogenic SIVmac239 in cynomolgus macaques.
Results: Phase 1: To differentiate RhCMV from endogenous cynomolgus CMV, a recombinant RhCMV expressing green fluorescent protein
(RhCMV-EGFP) has been constructed. Six CMV seropositive adult cynomolgus macaques were subcutaneously inoculated with live RhCMV-
EGFP and two animals were inoculated with UV-inactivated RhCMV-EGFP. Four animals served as control animals. Currently we are in the
process of evaluation of clinical and immunological responses to the vaccine vector (RhCMV) as well as to EGFP.
Conclusions: This CMV-based SIV vaccine study will address key issues of the immunogenicity, protective efficacy and self boosting-capacity
of this herpesvirus vector.
Contact Information: Aruna Ambagala, Tel: 416-946-3732, Email: aruna.ambagala@utoronto.ca
365
THE IMPACT OF AIDS VACCINE RESEARCH ON HEALTH SYSTEMS STRENGTHENING
Shayna Buhler 1
1-Interagency Coalition on AIDS and Development
Plain Language Summary: Through a summary of research on the mid-term impacts of AIDS vaccine research, there is evidence that although
this research may not result in a safe and effective vaccine for some time, in the meantime it is having positive impacts on health systems
strengthening in the countries and communities where research is taking place.
The Challenge: According to the Canadian HIV Vaccine Initiative, “A safe, effective, affordable and globally accessible preventive HIV vaccine
offers the greatest promise for reducing global rates of HIV infection and reversing the devastating social and economic costs and development
inequalities that have been exacerbated by HIV/AIDS.” Sustained and sufficient investment in AIDS vaccine research is a crucial component of
comprehensive HIV prevention. However, it may take long time for a safe and effective vaccine to be developed and there has been some
discouragement related to recent setbacks in AIDS vaccine research, and sustaining support for the research process is a challenge.
Our Approach: In light of the length of time AIDS vaccine research may take, and the reliance on continued support of donors, researchers, and
the individuals and communities that participate in vaccine trials, we have examined the mid-term impact that AIDS vaccine research is having
on the countries and communities where it is taking place. Through summarizing research, primarily that conducted by the International AIDS
Vaccine Initiative (IAVI), we have examined the impact that AIDS vaccine research is having on health systems in the countries where research
is being conducted.
Key Findings: Although the development of a safe and effective HIV vaccine may be a long way off, there is increasing evidence that in the
meantime AIDS vaccine research is having an impact on health systems strengthening in five key areas: the training and retention of human
resources, infrastructure development, improved regulatory processes, improved health services and enhanced HIV services.
Impact on Policy and Practice: Understanding the mid-term gains produced by AIDS vaccine research can help build support, including among
policy makers and researchers, for the long term challenge of vaccine research. This understanding is also critical in promoting continued efforts
among all those involved in AIDS vaccine research to contribute to ensure that the communities that make research possible will benefit from the
process, and are equipped to benefit from a vaccine when one is developed.
Contact Information: Shayna Buhler, Tel: (613) 233-7440 ext. 12, Email: sbuhler@icad-cisd.com
366
PROBING THE PROMISCUITY DISPLAYED BY THE BROADLY NEUTRALIZING ANTI-HIV-1 ANTIBODY 2F5 IN
RECOGNIZING A VARIETY OF GP41 MPER-RELATED PEPTIDES: A BASIS FOR THE DESIGN OF SMALL MOLECULE
VACCINES.
Jean-Philippe Julien 1 ; Steve Bryson 1 ; Rosemary Hynes 1 ; Emil Pai 1,2,3
1-Department of Biochemistry, University of Toronto; 2-Department of Medical Biophysics and Molecular Genetics, University of Toronto; 3-
Ontario Cancer Institute/Princess Margaret Hospital, Division of Cancer Genomics & Proteomics
Plain Language Summary: The antibody under study here, named 2F5, was first isolated from an asymptomatic patient and is one of the very
few isolated antibodies that have the ability to prevent new HIV-1 infections from viruses of different genetic background. Here, we report on the
HIV-1 genetic diversity of the area recognized by 2F5 on the surface of the virus. Subsequently, we analyze at the atomic level the ability of this
antibody to adapt and interact with a diverse panel of HIV-1 sequences. From these results, we propose the design of a small molecule vaccine
looking at eliciting antibodies possessing 2F5 properties.

The Challenge: The quest to create an HIV-1 vaccine capable of eliciting broadly neutralizing antibodies (bnAbs) against Env has been
challenging. Amongst others, one difficulty in creating a potent immunogen resides in the substantial overall sequence variability of the HIV
envelope protein.
Our Approach: The membrane-proximal region (MPER) of gp41 is a particularly conserved tryptophan-rich region spanning residues 659 to
683, which is recognized by three bnAbs (2F5, Z13 and 4E10). In this study, we first describe the variability of residues in the gp41 MPER and
report on the invariant nature of 15 out of 25 amino acids comprising this region. Subsequently, we evaluate the ability of the bnAb 2F5 to
recognize 31 varying sequences of the gp41 MPER at a molecular level.
Key Findings: In 19 cases, resulting crystal structures show the various MPER peptides bound to the 2F5 Fab’. A variety of amino acid
substitutions outside the 664DKW666 core epitope are tolerated. However, changes at the 664DKW666 motif itself are restricted to those
residues that preserve the aspartate’s negative charge, the hydrophobic alkyl-pi stacking arrangement between the beta-turn lysine and tryptophan,
and the positive charge of the former. We also characterize a possible molecular mechanism of 2F5 escape by sequence variability at position
667, which is often observed in HIV-1 clade C isolates.
Impact on Policy and Practice: Based on our results, we propose a somewhat more flexible molecular model of epitope recognition by bnAb
2F5, which could guide future attempts at designing small molecule MPER-like vaccines capable of eliciting 2F5-like bnAbs.
Contact Information: Jean-Philippe Julien, Tel: 416-978-6457, Email: jeanphilippe.julien@utoronto.ca
367
THE ADJUVANCY OF OX40 LIGAND (CD252) ON AN HIV-1 CANARYPOX VACCINE
Jun Liu 1 ; Nicholas Ngai 2 ; Geoffrey W. Stone 1,4 ; Feng Yun Yue 1 ; Mario Ostrowksi 1,2,3
1-Clinical Sciences Division, University of Toronto; 2-Department of Immunology, University of Toronto; 3-Li Ka Shing Knowledge Institute,
St. Michael's Hospital; 4-Department of Microbiology and Immunology, University of Miami
Plain Language Summary: The efficacy of current HIV-1 ALVAC vaccine, a vaccine using canarypox virus as vector, needs to be improved.
Using mice as model, we found OX40L (CD252), a molecule that naturally present in humans could improve the immune responses induced by
an HIV-1 ALVAC vaccine.
Objective: To test whether OX40L could be used as an adjuvant for HIV-1 canarypox vaccine and addition of CD40L could further augment the
adjuvancy of OX40L.
Methods: Female Balb/c mice were vaccinated 3 times with 2-week intervals according to the following schedule: group 1: naïve unimmunized
mice; group 2: 1E7 pfu of vCP1452 + 1E7 pfu empty vector ALVAC II; group 3: 1E7 pfu of vCP1452 + 1E7 pfu vCPmOX40L; group 4: 1e7 pfu
of vCP1452 + 5E6 pfu vCPmOX40L + 5E6 pfu vCPmCD40L.
Six weeks after the last immunization, mice were sacrificed and spleens and sera were collected for immunological analysis, including IFN-γ
ELISPOT,tetramer staining, ICS, CFSE proliferation assay, and anti-Gag ELISA.
Results: Co-immunization of mice with OX40L-expressing canarypox and vCP1452 augmented HIV-1 specific CD8 T cell responses in terms of
frequency and cytokine expression. OX40L-expressing canarypox enhanced the frequency of antigen specific CD8 T cells with an effector
(CD127-CD62L-) phenotype, which was associated with an ex vivo expansion of HIV-1 specific CD4 T cells. Surprisingly, OX40L did not
enhance antibody responses elicited by the HIV-1 canarypox vaccine. We saw no added benefit by combining OX40L and CD40L vectors as an
adjuvant strategy for vCP1452.
Conclusions: Our results indicate that, similar to CD40L, OX40L.can enhance the cellular but not humoral immunogenicity of HIV-1 canarypox
vaccines. In summary, our findings show that OX40L can be used as a molecular adjuvant to enhance T cell immune responses.
Contact Information: jun liu, Tel: 416-9460120, Email: junut.liu@gmail.com
368
ENDOGENOUS RETROVIRAL ELEMENT (ERV) ANTIGENS: IMMUNOLOGICAL TARGETING OF HIV-INFECTED CELLS
Angie Marsh 1 ; David Willer 2,3 ; Aruna Ambagala 2,3 ; Jacqueline Chan 2,3 ; Kelly S. MacDonald 2,3
1-University of Toronto, Department of Immunology; 2-University of Toronto, Division of Clinical Sciences; 3-Mt. Sinai Hospital, Department
of Microbiology, Toronto, Canada
Plain Language Summary: The very nature of HIV poses significant challenges to the development of a successful HIV vaccine. The rapid
evolution and generation of new strains provides a moving target for the host’s immune system. Human endogenous retroviruses (HERVs) are

germline encoded host genes that are upregulated following HIV-1 infection. We propose to generate a novel vaccine capable of eliciting an
immune response in non-human primates that specifically targets Simian ERV (SERV) antigens on infected cells instead of targeting the everchanging
virus.
Objective: It is hoped that this approach will focus the immune response to a stable and ubiquitous target, ultimately leading to a universal
vaccine that could offer protection irrespective of the infecting strain or clade. The SERV antigens may effectively act as a surrogate marker for
HIV 1 infection to which cytotoxic lymphocytes can target. The priming of the immune system shall be vaccine-derived from a herpesvirus
vector (Varicella Zoster virus [VZV]) which may provide for long-lasting immunity from periodic reactivation, thus “self-boosting” the immune
system.
Methods: Routine molecular biology and cloning techniques will be employed to isolate and clone cynomolgus macaques (CYNO) SERV gag
and env antigens into targeting vectors. Codon-optimized derivatives will also be synthesized. SERV antigen expression cassettes will be
targeted to the VZV-BAC using “allelic exchange” bacterial recombination. Transgene expression will be assessed by Western Blot. Tissue
culture growth curves will reveal the growth characteristics of the vaccine constructs and immunogenicity will be assessed in guinea pigs.
Subsequently, the measurement of cellular and serological immune responses to the immunogen will be assessed in non-human primates.
Results: Using peripheral blood mononuclear cells from cynomolgus macaques, we have isolated endogenous SERV gag and env genes.
Currently, we are in the process of characterizing the isolated genes through comparison to other non-human primate SERVs and human HERV
genes. Cloning of CYNO SERV gag and env into expression plasmids in ongoing. It is expected that these constructs will deliver high-level
antigen production and exhibit immunogenicity and safety in small animal models.
Conclusions: The research described herein, represents only the initial phase of a comprehensive program for the development of novel vaccines
using SERV antigens in combination with novel viral vector delivery systems. These efforts will lay the necessary groundwork for subsequent
large-scale vaccination and multi low-dose mucosal SIVmac239 challenge trials in cynomolgus macaques.
Contact Information: Angie Marsh, Tel: 416-946-3732, Email: angie.marsh@utoronto.ca
369
HIV PREVENTION AND THE AFRICAN AND CARIBBEAN DIASPORA
Keisa Campbell 1 ; Angeline Jones 1
1-Interagency Coalition on AIDS and Development (ICAD), Ottawa, Ontario, Canada
Plain Language Summary: While African and Caribbean Diaspora communities comprise less than 8% of all Black populations in Canada, the
USA and the UK, these populations are over-represented in terms of HIV prevalence, incidence and AIDS cases. As part of ICAD’s continued
involvement in addressing HIV and AIDS within the African and Caribbean Diaspora, ICAD commissioned a report on prevention initiatives that
specifically address the African and Caribbean Diaspora that have taken place in these three countries. While the information presented in the
report is not exhaustive, it is an excellent portrait of current successes within these developed countries. It also provides analysis of the strengths
and obstacles faced when addressing HIV prevention within theses Diaspora communities. ICAD proposes a presentation of the key findings of
the report at the OHTN conference.
Objective: The objective of the report was to create a relevant document that would explore a variety of prevention initiatives which targeted the
African and Caribbean Diaspora in Canada, the United States and the United Kingdom.
Methods: The information from the report was compiled through on-line research and through interviews with key stakeholders within relevant
organizations.
Results: A number of clear obstacles for the development and implementation of HIV prevention work with African and Caribbean communities,
emerged. These included:
• Attitudes and beliefs (HIV-related stigma, fear and discrimination, myths about HIV/AIDS, homophobia);
• Immigration policies;
• Poverty and unemployment;
• The lack of culturally and linguistically appropriate HIV prevention services and materials;
• Insufficient funding for prevention programs for the Diaspora.
Conclusions: African and Caribbean communities in Canada, the USA and the UK are more likely to experience challenges that place them at
higher risk for HIV infection. These challenges are numerous and include socioeconomic issues, HIV-related stigma, discrimination and denial,
immigration and migration, racism, sexism, sexual and physical violence, heterosexism and homophobia, sexual risk factors, social exclusion,
attitudes towards sex, health and well-being, lack of awareness of HIV serostatus, operationalization of terms like African American, and cultural
and personal hygiene practices. While each of these countries has developed a national initiative to address HIV/AIDS that include efforts
focused on people from countries where HIV is endemic or native-born Black populations,only the UK has created a plan of action specific to

African Diaspora populations that identifies obstacles to HIV prevention, and focuses on how to overcome these barriers in order to achieve
change.
Contact Information: Angeline Jones, Tel: 613-233-7440 ex.15, Email: ajones@icad-cisd.com
370
TAKING SERIOUSLY OUR OBLIGATIONS TO SHARE RESEARCH RESULTS: ONE APPROACH TO KNOWLEDGE
TRANSFER AND EXCHANGE WITH ADOLESCENTS
Stephanie Nixon 1,2 ; Marisa Casale 2 ; Michael Rogan 2 ; Sarah Flicker 3
1-Department of Physical Therapy, University of Toronto, Canada; 2-Health Economics and HIV/AIDS Research Division (HEARD), University
of KwaZulu-Natal, South Africa; 3-Faculty of Environmental Studies, York University
Plain Language Summary: This presentation describes a creative way to report HIV survey results back to adolescent participants in a way that
takes advantage of a ‘teachable’ moment.
The Challenge: This presentation describes a novel approach to reporting back research results to school-going adolescent participants of an HIV
prevention programme evaluation, conducted in a poor urban area in South Africa. Our objective is to reflect critically on our dissemination
strategy in order to advance the fields of (a) knowledge transfer and exchange (KTE) and (b) research ethics.
Our Approach: In 2008 we reported back results of a self-administered demographic and sexual health survey conducted with 809 Grade 11
learners in four schools. We embedded school-level survey results within HIV prevention and health messaging, through: interactive classroom
sessions; dissemination booklets; and colour posters displayed in the schools. The classroom sessions were conducted in the local language
(isiZulu) by bilingual field research assistants and guided by a script which had been developed collaboratively by the research team.
Key Findings: “Shared ownership of results”, which is a tenet of KTE, was achieved through nesting the survey results in the interactive guessing
game scenario. Young, experienced isiZulu facilitators added to the engagement of the youth. Youth were eager to express opinions and to
correct each other’s knowledge around HIV and sexual health during report-back. However, ground rules were important for handling sensitive
issues, especially the discussion of violence. The two-way exchange also held significant benefits for the researchers. Participants’ explanations
of analyses served to enhance our understanding of why certain results were achieved. Boys’ and girls’ differing responses to and explanations for
our results provided insight into the entrenched gendered positions amongst the youth. This experience also laid more favourable groundwork for
future research with this community. Finally, this form of report-back session served to unearth novel research questions emerging from the youth
themselves that we had not previously considered.
Impact on Policy and Practice: Ethical review processes typically require that research results be shared with study participants, but there is
little documented work on how to achieve this aim in practice. By creatively expanding the potential for our report back sessions, we were able to
take advantage of an opportunity for two-way information exchange. We hope this presentation will prompt further dialogue on practical
strategies for more effectively feeding back research results to participants.
Contact Information: Stephanie Nixon, Tel: 416-946-3232, Email: stephanie.nixon@utoronto.ca
371
MOVING FROM PARADIGM TO PRACTICE: THE ASHODAYA SEX WORKER EMPOWERMENT PROJECT IN MYSORE
INDIA AND ITS PROMISE FOR HIV/AIDS PREVENTION
Nadia O'Brien 1
1-Master of Public Health, Simon Fraser University, Vancouver, British Columbia.
Plain Language Summary: Ashodaya Samithi, a sex worker collective in Mysore India, is a powerful example of the promise empowermentbased
projects hold for subverting vulnerabilities, transforming risk, and preventing the spread of HIV.
The Challenge: In recent years, empowerment has gained more prominence in the field of public health. The empowerment framework provides
useful strategies for creating enabling environments, which is increasingly being conceptualized as fundamental to marginalized populations’
ability to enact public health messages [1]. Yet its application from theory to practice requires further investigation in order to comprehend how
successful strategies may be applied in future contexts [2]. Furthermore, understanding how empowerment projects positively impact sex workers
in India, is imperative, as rates of HIV prevalence range from 11 percent to 90 percents, and existing collectives such as the Sonagachi project of
Kolkata indicate the promise of this model [3,4].

Our Approach: Ashodaya Samithi, a sex worker collective in Southern India produced positive health advances through empowerment
processes. Established in 2004 by the India AIDS Initiative (Avahan), Ashodaya Samithi is funded through the Bill and Melinda Gates
Foundation and implemented by Karnataka Health Promotion Trust (KHPT). Four years into its inception, the project already lays claim to
significant successes. The collective has reported a reduction in sexually transmitted infections (STI), an increase in condom use, and the
mobilization of 1,500 sex workers from the Mysore area [5].
Qualitative, community-based research methodologies were utilized to explore the results gathered from previous behavioral and biological
surveys. Interviews, participant observations and focus groups were conducted from May-July, 2008. Research findings were based on 40 openended
interviews.
Key Findings: Qualitative research with the Ashodaya collective demonstrates the promise empowerment-based projects hold for subverting
vulnerabilities, transforming risk, and preventing the spread of HIV. Ashodaya’s success depends on its ability to set new community norms, to
create a safer environment in which sex workers earn their living, in creating relationships with key stakeholders, and providing a supportive
network. Findings demonstrate how complex subverting vulnerabilities to HIV remains, and the complex interrelated strategies that must be
applied in order to enable change.
Impact on Policy and Practice: Ashodaya’s ability to transform the very vulnerability that endangers sex workers’ health demonstrates
community empowerment’s effectiveness as a strategy for HIV prevention. Ashodaya serves as a reminder of how paradigms of empowerment
must be applied in order for their strategies to remain viable options for improving the lives and health of marginalized populations.
Contact Information: Nadia O'Brien, Tel: 604-910-0920, Email: nco@sfu.ca
372
CLINICAL OUTCOMES PRIOR TO THE ERA OF ANTIRETROVIRAL THERAPY IN CAMBODIA
Phan Sok 1 ; Sean Rourke 2,3 ; Joseph Harwell 4 ; Stephen McGarvey 5 ; Timothy Flanigan 4 ; Kenneth Mayer 4
1-Institute of Medical Science, University of Toronto, Canada; 2-Department of Mental Health Service and Inner City Health Research Unit, St.
Michael’s Hospital, Canada; 3-Department of Psychiatry, University of Toronto, Canada; 4-Department of Immunology, The Miriam Hospital,
U.S.A.; 5-International Health Institute, Brown University, U.S.A.
Plain Language Summary: In Cambodia, antiretroviral therapy was not available until 2004. Many HIV patients delayed seeking care because
of a lack of confidence in the health care system and other social obstacles. Clinical outcomes among people living with HIV (PLH) are not well
documented in Cambodia.
Objective: To measured for the relationship between length of illness prior to receiving care, common clinical complaints, clinical
manifestations, numbers of opportunistic infections (OIs) and other conditions, risk for OIs and clinical outcomes.
Methods: One hundred seventy-nine adults with HIV infection were surveyed between 1999 and 2000 at the Sihanouk Hospital Center of HOPE,
Phnom Penh, Cambodia.
Results: Mean follow up was 81 weeks (SD = 59.3) (n = 95). Clinical outcomes were: return (32%), loss to follow up (29%), referral (16%) and
reported death (23%). Length of illness was associated with weight loss ≥10% (rs = 0.24, p < .01). Also, length of illness was significantly
associated with common clinical complaints (rs = 0.34, p < .01). Weight loss ≥10% had a linear relationship with common clinical complaints,
risk for OIs, and numbers of OIs and other conditions (rs = 0.52, p < .01), (rs = 0.34, p < .01) and (rs = 0.35, p < .01), respectively. Both length of
illness and risk for OIs were associated with clinical outcomes (rs = 0.23, p < .01), (Pearson rs = 0.20, p < .01), respectively.
Conclusions: These findings from the recent past suggest that contemporary research is needed to evaluate health care system performance and
other social obstacles in order to improve clinical outcomes among PLH in Cambodia.
Contact Information: Phan Sok, Tel: 905-884-3695, Email: phan.sok@gmail.com
373
ACCESS TO HIV/AIDS RESOURCES BY MOTHERS AND CHILDREN: LESSONS FROM RURAL COMMUNITIES IN UGANDA
Paul Tenywa 1 ; Irene Andia 2 ; Joshua Kitakule 3
1-St. Michael’s Hospital, Toronto, Canada; 2-London, United Kingdom, former employee of the Inter-Religious Council of Uganda; 3-Kampala,
Uganda, current Secretary General of the Inter-Religious Council of Uganda

Plain Language Summary: Inequality in the provision of HIV/AIDS resources denies mothers and children access to early diagnosis, treatment
and care in developing countries like Uganda. In addition, non involvement of women and community members in decision making contributes to
increased stigma and discrimination. The study aimed to explore how HIV/AIDS resources could better be targeted to HIV/AIDS infected rural
mothers and children.
Objective: To provide lessons on how to increase access to HIV/AIDS resources to mothers and children in rural communities in Uganda.
Methods: Structured questionnaires and focused group discussions from a purposively selected sample of districts identified for funding from the
Presidential Emergency Plan for AIDS Relief (PEPFAR) were used. Questionnaires were administered to health providers at the rural health
facilities and focused groups comprised of the selected community members, local leaders and health facility management committee members.
Results: 28 health facilities and 14 focused groups participated in the study. 16 (57%) of the health units had less than 10% of women and
children that received care and treatment. 11 (39%) units had a mean of 16 (80%) men on treatment, 4 (20%) women and no children. And, 1
(4%) unit had 11(55%) men, 7 (35%) women and only 2 (10%) children receiving treatment and care. The main reason was more HIV/IADS
infected men sought health services compared to infected females or children.
In the focused groups, the reasons mentioned for less women and children receiving care included less motivated and few health personnel, illequipped
laboratories, and long distances to health facilities, insufficient medicines to cover increasing number patients and fear of being
identified as HIV/AIDS patients. Further, leaders mentioned the government rationing strategy favoured men as compared to women. Women
had less involvement in financial decisions and lacked personal income. Less involvement of the community appears to increase stigma and
discrimination
Conclusions: Strategies that increase access of HIV/AIDS resources for mothers and children need to be adopted like strengthening health
services, involving communities and empowering women economically.
Contact Information: Paul Tenywa, Tel: 647 869 3769 (mobile), Email: patenywa.tenywa4@gmail.com
374
UPTAKE OF ATAZANAVIR (ATZ) IS SUSCEPTIBLE TO INHIBITION BY ANTIRETROVIRAL DRUGS IN CACO-2 CELLS, A
MODEL OF HUMAN INTESTINAL EPITHELIUM
Olena Kis 1 ; Jason Zastre 2 ; Manisha Ramaswamy 1 ; Reina Bendayan 1
1-Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto; 2-Department of Pharmaceutical and
Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia
Plain Language Summary: ATZ, a protease inhibitor (PI) used in first-line HAART regimens, is implicated in many antiretroviral drug-drug
interactions. We evaluated the role intestinal transporters play in ATZ uptake by Caco-2 cells and examined relevant antiretroviral drug-drug
interactions. ATZ uptake by Caco-2 cells was pH dependent and susceptible to inhibition by the standard organic anion transporting polypeptide
(OATP) family inhibitors and pravastatin. Ritonavir, amprenavir, and tipranavir potently inhibited ATZ uptake by Caco-2 cells at clinically
relevant concentrations.
Objective: Clinical studies have demonstrated several drug-drug interactions that lower ATZ plasma levels involving nucleoside analogs (i.e.,
tenofovir DF) or statins (i.e., pravastatin). At present, limited information is available on the mechanism of intestinal absorption of atazanavir
and other PIs. In this study, we examined the interactions of ATZ with intestinal drug uptake transporters and relevant antiretroviral drug-drug
interactions.
Methods: Cellular accumulation of [3H]atazanavir by Caco-2 cells was measured in the absence (control) or presence of standard inhibitors for
solute carrier transporters (OCTs, OATs, OATPs, and PEPT transporters). The effect of pH on ATZ uptake in Caco-2 cells was evaluated at
several extracellular pH (5.5, 7.4, 8.5) and by intracellular acidification to reverse the proton gradient. Specific uptake of [3H]ATZ was assessed
by measuring ATZ accumulation in transporter-overexpressing and wild type cell lines. The effect of other PIs and NRTIs was evaluated by
measuring ATZ uptake by Caco-2 cells in the absence (control) or presence of several concentrations of each drug or drug combinations.
Results: ATZ uptake by Caco-2 cells was pH dependent (uptake at pH 5.5 > pH 7.4 = pH 8.5) and susceptible to inhibition by established OATP
family inhibitors, estrone-3 sulfate, rifamycin SV, MK571, and pravastatin. Ritonavir, amprenavir, and tipranavir demonstrated potent
concentration-dependent inhibition of ATZ uptake by Caco-2 cells at concentrations bellow 10 µM. NRTIs tenofovir DF, abacavir, lamivudine,
and emtricitabine did not inhibit atazanavir uptake by Caco-2 cells at clinical concentrations.
Conclusions: ATZ uptake by Caco-2 cells is pH dependent, mediated by an OATP transport system, and susceptible to inhibition by other PIs
(i.e., ritonavir, amprenavir, and tipranavir), which could result in clinically important drug-drug interactions at peripheral sites. NRTIs did not
inhibit atazanavir uptake by Caco-2 cells at clinical concentrations, suggesting this is not a mechanism for interaction between atazanavir and
tenofovir DF. This knowledge will further our understanding of intestinal absorption of PIs and mechanisms of antiretroviral drug-drug
interactions. (Supported by an OHTN Studentship Award and CANFAR)
Contact Information: Olena Kis, Tel: 647-802-6513, Email: olena.kis@utoronto.ca

375
ONLINE SEX SEEKING AMONG MSM: SUBCULTURE AND SOCIALIZATION
Anthony Lombardo 1
1-University of Toronto
Plain Language Summary: The Internet is a popular place for men who have sex with men to meet casual sex partners for offline encounters.
This process may seem simple, but findings from the Men, Internet and Sex with Men (MISM) Study illustrate the existence of an online sexseeking
“subculture.” This subculture provides rules for how men can behave online, and it plays a role in teaching men about sexual health. As
such “subcultures” grow on the Internet, questions are raised about what men learn about safe and unsafe sex online and how they use that
knowledge in sexual decision-making.
The Challenge: The Internet is a popular place for men who have sex with men to arrange offline casual encounters. The Men, Internet and Sex
with Men (MISM) Study was a qualitative exploration into the contexts of men’s Internet use for sexual purposes, about which little has been
said. Qualitative work has considered the role of the Internet in socializing men into gay communities offline. However, there has been little
focus on how men encounter and navigate the online sex-seeking process.
Our Approach: Twenty-three semi-structured interviews with men (gay, bisexual and heterosexual) in the Greater Toronto Area who use the
Internet for same-sex sexual purposes. Ages ranged from 20 - 61; 6 men were HIV-positive and 15 men were HIV-negative (2 were untested).
Interview data were analyzed inductively from an interactionist perspective.
Key Findings: The participants' responses made evident an online sex-seeking subculture that prescribed rules of engagement. Men learned to
give "legitimated" performances to attract their desired partner and sexual encounter, including rules about presenting one's "self" and interacting
with others. Performances were governed by discourses about age, race and physical beauty, as in the offline gay community. Over time, men’s
experiences changed on where they sought partners; how they chose partners; and their expectations of partners met online. Men talked of
learning about sex between men and sexual health through online interactions.
Impact on Policy and Practice: These findings argue the existence of an online sex-seeking subculture which men must engage with when
seeking sex. This subculture provides norms for behaviour, and also socializes men into gay "life" and sexual health and risk. The interactional
rules reflected offline discourses that circulate in gay communities, questioning the Internet as a place for a "liberated self." Questions remain
about what and how men learn about sexual risk through this subculture, and how subcultural norms may promote or hinder safer sex.
Contact Information: Anthony Lombardo, Tel: 647-219-0984, Email: anthony.lombardo@utoronto.ca
376
A COMPARISON OF ANTIRETROVIRAL TREATMENT UPTAKE IN HIV PATIENTS THAT ARE CANADIAN-BORN AND
THOSE BORN OUTSIDE CANADA
Sean O'Loghlen 1 ; Amir Rumman 1 ; Kathryn Rutherford 1 ; Mary Preisman 1 ; Janet Raboud 2 ; Wendy Wobeser 1,3
1-Department of Medicine, Queen’s University, Kingston, ON; 2-Division of Clinical Investigation & Human Physiology, Toronto General
Research Institute, Toronto, ON; 3-Clinical Immunology Outpatient Clinic, Hotel Dieu Hospital, Kingston, ON
Plain Language Summary: Predictors of antiretroviral treatment (ART) initiation are not well characterized for heterogeneous populations in
Ontario. CD4 cell count at ART initiation was compared for Canadian-born and foreign-born patients. Foreign-born persons were found to have
lower CD4 cell counts at the initiation of ART, to be more likely to be older and female, and to be receiving treatment after 1997.
Objective: Inequalities in the provision of ART to racial minorities and foreign-born patients have been documented in the developed world.
However, there has been no evidence-based survey of this phenomenon in Ontario. This study aims to explore whether treatment inequalities
exist between Canadian-born and foreign-born persons living with HIV in Ontario by assessing immunologic status at initiation of ART.
Methods: We conducted a retrospective analysis of HIV-infected patients registered in the Ontario Cohort Study. Patients were stratified
according to region of birth. Median CD4 cell count at ART initiation was compared for Canadian-born and Foreign-born patients. Bivariate
analysis of sex, age at diagnosis, age at ART initiation, most recent CD4 cell count, time from diagnosis to ART initiation, proportion of patients
initiating ART at CD4 cell count

Conclusions: The findings indicate shifting demographic trends in the population of persons afflicted by HIV. The successes of domestic
awareness campaigns and continued growth in immigration are likely behind the increased proportion of HIV patients born abroad since 1997.
This can hold serious implications for treatment as the results indicate that these persons are more likely to be older, female, and to be more
immunocompromised when initiating ART (indicated by lower median CD4 counts). New treatment stratagems and policies will have to be
implemented to reflect the changing face of HIV in Ontario.
Contact Information: Sean O'Loghlen, Tel: (613)217-7221, Email: sean.b.ologhlen@gmail.com
377
ROLE OF MEMBRANE DRUG TRANSPORTERS IN THE PERMEABILITY OF MICROBICIDES
Maria Fabiana De Rosa 1 ; Reina Bendayan 1
1-Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto
Plain Language Summary: Sexual transmission of HIV through mucosal barriers is the most common mode of transmission worldwide, with
women presenting the majority of new infections. Since the discovery of a safe and effective HIV vaccine is still likely to be years away, topical
microbicide formulations applied vaginally or rectally are being investigated as another strategy for HIV prevention. We propose that, in part,
treatment failure and/or toxicity of microbicides, may result from the interaction of these agents with drug efflux membrane transporters, P-
glycoprotein (P-gp), Multidrug Resistance-Associated Proteins (MRPs) and/or Breast Cancer Resistance Protein (BCRP), that could deplete the
levels of compound at genital and rectal tracts; and/or interactions with drug influx membrane transporters, i.e., organic anion transporting
polypeptide (OATP), organic anion transporter (OAT) and/or organic cation transporter (OCT), that on the contrary, will tend to accumulate these
compounds at these sites. At present, there are very few studies documenting the functional expression of these transporters in the female genital
tract and/or in recto-sigmoid colon, sites of HIV-transmission.
Objective: To investigate the expression of drug influx/efflux transporters in human vaginal and in primary and established cervical cell lines, as
well as in recto-sigmoid colon explants from HIV (+) and HIV (-) individuals.
Methods: The mRNA expression of drug influx/efflux transporters in human cell culture systems representative of the genital tract (VK2 E6/E7
vaginal epithelial cell line, primary endometrium, and Hec1A endometrium epithelial cell line) and in recto-sigmoid colon tissues from HIV (+)
treated and HIV (+) naive patients as well as HIV (-) individuals was evaluated by RT-PCR.
Results: We detected mRNA expression of multiple MRP transporters in the vaginal and endometrial cell lines. Furthermore, mRNA expression
of uptake transporters, OATPC and OATP8, was detected in the endometrium cell lines. In the sigmoid colon of HIV (+) treated or naïve, mRNA
expression of MDR1, MRP3 and MRP4 was observed.
Conclusions: mRNA expression of MRP2, MRP4 and MRP5 in the genital tract as well as in HIV (+) treated and naïve sigmoid colon samples
could alter the permeability and bioavailability of tenofovir, an anti-retroviral agent, well used as microbicide and known to be effluxed by these
transporters. MDR1 mRNA expression in HIV naïve sigmoid colon could regulate the permeability of maraviroc, another potential microbicide,
known to be a substrate of this transporter. These results suggest novel therapeutic strategies that could optimize genital bioavailability and
efficacy of microbicides.
(Supported by a CIHR-CTN’s Postdoctoral Fellowship).
Contact Information: Maria Fabiana De Rosa, Tel: 905-997-0500, Email: maria.derosa@utoronto.ca
378
EFFECT OF SEMINAL PLASMA FROM HIV-INFECTED MEN ON FEMALE GENITAL EPITHELIAL CELL RESPONSES
Jessica Kafka 1 ; Aisha Nazli 1 ; Prameet Sheth 2 ; Rupert Kaul 2 ; Charu Kaushic 1
1-Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada; 2-Department of Medicine, University of
Toronto, Toronto, Canada
Plain Language Summary: Over 90% of HIV infections are through sexual transmission, however the role of the fluid portion of semen
(seminal plasma) in this process is unclear. We added seminal plasma from uninfected and infected men in acute and chronic stages of HIV
infection to epithelial cells of the female genital tract and examined their responses. There was a reduction in secreted inflammatory proteins from
genital cells after exposure to seminal plasma from late stages of HIV infection. We found that seminal plasma from chronically infected men
have large concentrations of an immunosuppressive protein compared to uninfected men and men in early stages of HIV infection. This may
contribute to our knowledge of why transmission of HIV from an infected man to a woman is lower during chronic stages of HIV infection.
Objective: Over 90% of HIV is transmitted sexually. However the role of seminal plasma in HIV transmission is unclear. Our objective is to
investigate the role of seminal plasma from uninfected men and men in acute and chronic stages of HIV infection in eliciting cytokine responses
using an ex-vivo female primary genital epithelial cell model.

Methods: Seminal plasma was added to primary genital epithelial cells (GEC) cultures and proinflammatory cytokine expression was analyzed
by Luminex kits. Cytokine profiles in uninfected and infected seminal plasma were also measured. Since HIV transcription can be initiated by
host cell transcription factors, we looked for NF-kappaB activation and translocation in epithelial cells following seminal plasma exposure by
confocal microscopy.
Results: TGF-beta concentrations in seminal plasma from men in chronic stages of HIV infection were significantly higher compared to seminal
plasma from uninfected men and men in acute stages of infection. Proinflammatory cytokines, IL-1alpha and IL-6 expression were significantly
reduced in GECs exposed to seminal plasma from men in chronic stages of HIV infection compared to uninfected seminal plasma and seminal
plasma from men in acute stages of HIV infection. To examine the role of seminal plasma in HIV replication, we visualized NF-kappaB
translocation in GECs. NF-kappaB translocation was observed in GECs 30 minutes following exposure to uninfected seminal plasma.
Conclusions: Our studies suggest that seminal plasma may play a role in heterosexual transmission of HIV differs depending on the stage of HIV
infection in the male partner. Seminal plasma from men in chronic stages of infection may contribute to reduced HIV transmission during this
stage of infection.
Contact Information: Jessica Kafka, Tel: 905-525-9140 x22589, Email: kafkajk@mcmaster.ca
379
JOB SECURITY IS ASSOCIATED WITH QUALITY OF LIFE IN MEN LIVING WITH HIV: THE OHTN COHORT STUDY.
Sergio Rueda 1,2 ; Tsegaye Bekele 1 ; Janet Raboud 3,4 ; Alan Li 1,5 ; Murray Jose 6 ; Winston Husbands 7,8 ; Barry Adam 1,9 ; Jean Bacon 1 ; Kelly O'Brien
10 ; Anita Rachlis 3,11 ; Nicole Mittmann 3,11 ; John Cairney 10 ; Sean B Rourke 1,2,3 ; The OCS Study Team 1
1-Ontario HIV Treatment Network; 2-St. Michael's Hospital; 3-University of Toronto; 4-University Health Network; 5-Regent Park Community
Health Centre; 6-Toronto People with AIDS Foundation; 7-African and Caribbean Council on HIV/AIDS Ontario; 8-AIDS Committee of
Toronto; 9-University of Windsor; 10-McMaster University; 11-Sunnybrook Health Sciences Centre
Plain Language Summary: The positive impact of employment on health is well documented in the general population, but very little is known
about the additional benefits of having a secure job on health-related quality of life in HIV. Men living with HIV provided baseline data in the
context of the OHTN Cohort Study. Findings showed that job security provides additional benefits to both physical and mental health-quality of
life beyond the contribution of employment alone.
Objective: To evaluate the association between employment and health-related quality of life in men living with HIV, and to determine whether
job security offered additional quality of life benefits beyond participation in employment alone.
Methods: The OHTN Cohort Study (OCS) is an ongoing longitudinal observational cohort study that collects data on the clinical profile and
social determinants of health of people with HIV in the province of Ontario. This study presents baseline data from 1,660 men who provided
baseline data on demographic status (age, gender, sexual orientation, marital status, ethnicity, country of birth), socioeconomic factors (education,
employment status, job security, personal income), HIV disease markers (recent CD4 counts, viral load, AIDS-defining conditions, time since
HIV diagnosis), substance use (non-medicinal drug use and heavy alcohol consumption), and health-related quality of life (SF-36). We performed
multivariate regression analyses to determine the contribution of employment and job security on physical and mental health-quality of life after
controlling for potential confounders.
Results: In univariate analyses, both employment and job security were significantly associated with both physical and mental health-related
quality of life. In multivariate analyses, both employment (ß = 5.13, 95% CI 3.63 to 6.64) and job security (ß = 1.76, 95% CI 0.27 to 3.25) were
associated with physical health-quality of life while only job security (ß = 4.81, 95% CI 3.11 to 6.51) was associated with mental-health quality
of life. Being gay or bisexual, non-white, having a higher level of education, more income, higher CD4 counts, and having lived with HIV for a
shorter period of time were also associated with better physical health. Being older, heterosexual, married or living in a common-law relationship
and not using non-medicinal drugs were also associated with better mental health.
Conclusions: Job security has a significant contribution to physical and mental health-quality of life, suggesting that with better jobs come better
health. Employment policies that promote job security may not only offer income stability but also health benefits to people with HIV.
Contact Information: Sergio Rueda, Tel: 647-280-5002 ext 2247, Email: srueda@ohtn.on.ca
401
IS IT WORTH IT? USING EVIDENCE ON COST-EFFECTIVENESS TO INFORM PRIORITIES FOR HIV PREVENTION
Jonathan Anderson
1-University of Sydney Medical School

Objective: Rising rates of HIV in Australia have prompted calls for the introduction of new prevention technologies, however competing
demands on limited resources have prompted vigorous debate on their widespread introduction.
Methods: In the Assessing Cost-Effectiveness in HIV project (ACE-HIV), a group of national stakeholders from government, community,
clinicians and academics selected prevention and healthcare interventions for a series of economic evaluation focused on evidence of
effectiveness, benefits and cost. Interventions evaluated included early antiretroviral treatment as prevention (test and treat), pre- and postexposure
prophylaxis, adult male circumcision for men having sex with men, needle syringe programs and anal cytology. After considering the
economic implications of the results the group re-ordered them in light of non-economic factors such as equity, ethics, culture, feasibility and
acceptability.
Results: The economic evaluation results showed that some of the newer prevention technologies such as circumcision and pre-exposure
prophylaxis have the potential to be cost-effective or even cost-saving. Needle syringe programs are cost-saving and could be doubled in scale
and still save money. On the other hand, established programs such as non-occupational post-exposure prophylaxis are not good value for money
in their current form.
Conclusions: The ACE-HIV project has helped inform policy and assist in decision making about priorities for research and implementation of
new prevention technologies using an explicit stakeholder process. Early antiretrovirals for prevention, adult male circumcision and pre-exposure
prophylaxis could be valuable as part of a combination prevention program for HIV, but require careful consideration of all the issues before
widespread adoption.
Contact Information: Jonathan Anderson
402
THE IMPLICATIONS OF SYNDEMICS AND STRENGTHS ON INCREASING HIV INTERVENTION EFFICACY AMONG GAY
MEN
Ron Stall
1-Graduate School of Public Health, University of Pittsburgh
Plain Language Summary: The bulk of the research that has been done on gay men focuses on the health implications of sexual risk behaviors,
even though it is now well known that there are multiple epidemics for which gay men have higher prevalence rates than their heterosexual male
counterparts. This presentation will present evidence to document some of these health disparities as well as a theory to explain why these
disparities exist. Data that have now been collected to test the theory will then be presented. Finally, the presentation will end with a discussion
of the importance of resilience or strengths in explaining health profiles among gay men, and why a focus on strengths, rather than vulnerabilities,
may be a more productive research agenda in addressing health disparities among gay men.
Contact Information: Ron Stall, Tel: 412.624.7933, Email: rstall@pitt.edu
403
REDUCING RISK IN MARGINALIZED POPULATIONS: WHAT CAN THE NORTH LEARN FROM THE SOUTH?
Robert Carr
1-International Council of AIDS Service Organizations
Plain Language Summary: The issue of HIV prevention is a complex one that once seemed so straightforward but has proven to raise a number
of challenges. The presentation will look at some of the key lessons learned in effective prevention work at the individual, group and community
levels. Inter-relationships between these areas of intervention will be explored as well as some of the challenges that still need innovative
solutions. Of particular interest with be the challenges of prevention in the context of concentrated and mixed epidemics and the role of stigma
and human rights approaches in creating an environment in which progress on prevention becomes possible, including legal and political barriers,
seen as symptoms of deeper, underlying issues that impact on our responses to HIV.
Contact Information: Robert Carr
404
LESSONS LEARNED FROM DISSEMINATION OF EVIDENCE-BASED INTERVENTIONS FOR HIV PREVENTION
Charles Collins
1-Centers for Disease Control and Prevention

Objective: The US Centers for Disease Control and Prevention Division of HIV/AIDS Prevention began disseminating evidence-based
behavioral interventions to both community-based and clinic-based HIV prevention providers in 2002. Prior to this dissemination, it was
estimated that 70% of all HIV prevention practice was street-outreach condom distribution.
Methods: HIV prevention in the USA has undergone a major change as prevention providers were encouraged to adopt evidence-based
prevention interventions. Over the last 7 years, 23 unique evidence-based interventions have been disseminated to over 3388 HIV prevention
agencies. The degree to which the field of prevention practice is willing to adopt evidence-based interventions is dependent on a range of factors
including the complexity of the interventions selected for dissemination, the establishment of a customer centered philosophy that honors
prevention agency stakeholder’s ability to select, adopt, adapt, and implement the interventions; the costs of implementation; and the agency
capacity to successfully implement the interventions.
Results: There are multiple lessons learned through this process that may inform other nations considering the use of evidence-based behavioral
interventions as their standard of HIV prevention practice. These lessons include such areas as: determination of the standards for evidence based
prevention practice; planning a national dissemination infrastructure as well as individualized plans for the interventions disseminated through
that infrastructure; development of policy supports to reinforce and regulate evidence-based practice; promote health marketing to adopting
agencies to include support in the selection process of an EBI; consumer focused approaches to intervention materials development and
packaging; designing a training infra-structure that includes train-the-trainer as well as train-the-facilitator options; implementing a capacity
building strategy to strengthen prevention providers ability to implement EBIs with fidelity; development of a quality-control strategy that is
sensitive to adaptation and resource limitations; and, establishing an evaluation structure that is appropriate for agencies that are implementing
interventions that have already been determined to be efficacious.
Conclusions: The transfer of scientific research into prevention practice is context dependent because what constitutes prevention practice is
molded and influenced by the social structures and social capital for each capitalistic, industrial, democratic nation. The lessons learned in the
USA may be of benefit when considering strategies to increase the scientific basis for HIV prevention practice in Canada.
Contact Information: Charles Collins
405
EFFECTIVENESS OVER 36 MONTHS FOLLOW-UP OF FOCUS ON YOUTH IN THE CARIBBEAN ON HIV RISK REDUCTION
AMONG EARLY ADOLESCENT BAHAMIAN YOUTH
Bonita Stanton 1 ; Lynette Deveaux 2
1-Children's Hospital of Michigan; 2-Ministry of Health, Government of Bahamas
Plain Language Summary: A 10-session HIV prevention program targeting grade sixth youth entitled “Focus on Youth in the Caribbean”
(FOYC) which is based on Protection Motivation Theory (PMT). FOYC was developed, implemented and evaluated by a team of investigators
from the United States and The Bahamas. Two programs were also developed for their parents: Caribbean Informed Parents and Children
Together (CImPACT) is a 22-minute video emphasizing the importance of parent-child communication about sexuality followed by structured
role-play and condom practice; and, “Goal for It” is a 22 minute video emphasizing the importance of planning ahead and is followed by
supervised discussion and answers. The US-Bahamian team evaluated the these interventions through a randomized, controlled three-celled
longitudinal trial (36 months follow-up) involving 15 elementary schools in The Bahamas.
Objective: To determine the effectiveness of an HIV behavioral prevention program (FOYC) was sustained through 36 months post intervention.
Methods: 1360 sixth-grade youth attending 15 government elementary schools in The Bahamas were randomly assigned by school to three
conditions: (1) FOYC plus CImPACT, (2) FOYC plus GFI, and (3) an environmental protection intervention plus GFI. Program effect was
assessed using the Mixed Model and the Generalized Linear Mixed Model (GLIMMIX). Mediation analysis for the PMT-based intervention and
feedback analysis were conducted.
Results: Significant program effect was detected for the two intervention groups from 6 months through 36 months post intervention, including
increases in coping appraisal (self-efficacy and response efficacy); enhancement in HIV/AIDS knowledge, condom-use skills, intention to use
condom; and increases in condom-use. HIV/AIDS knowledge, condom-use skills, self-efficacy and response efficacy significantly mediate the
intervention effect on intention to use condom. There was a significant positive feedback effect from condom-use to self-efficacy and from
intentions to use condoms to self-efficacy and condom-use skills.
Conclusions: Delivery of FOYC to preadolescents in combination with a parent intervention showed sustained effect three years later in
enhancing coping appraisal to deal with HIV risk behaviors, in increasing HIV/AIDS knowledge, condom-use skills, intention to use condom,
and, most importantly, in actual condom-use behavior. The sustained program effect appears to relate in part from positive feedback from
intentions to use condom and actual condom-use on condom-use skills and self-efficacy. We recommend adaption and utilization of FOYC
among preadolescents in Caribbean nations for HIV prevention.
Contact Information: Bonita Stanton, Tel: 313.745.5870, Email: bstanton@med.wayne.edu

406
HAVING SEX WHILE DRUNK OR HIGH: DO MEN WHO HAVE SEX WITH MEN WANT TO CHANGE?
Tim Guimond 1 ; Carol Strike 2,3 ; Peter Hall 1 ; Zoe Consta VonAesch 4 ; Exploring Choices Team
1-Rainbow Services, Centre for Addiction and Mental Health; 2-Health Systems Research, Centre for Addiction and Mental Health; 3-Dalla Lana
School of Public Health, University of Toronto; 4-Faculty of Medicine, McGill University
Plain Language Summary: To reduce HIV transmission among men who have sex with men (MSM), we developed a seven session harm
reduction group intervention based on motivational interviewing (MI). Men participated in the intervention to explore their willingness to change
unsafe sexual behaviours and/or substance use. Results emphasize the need for unsafe sexual behavior and substance use harm reduction support
and skill development, as provided by MI group intervention.
Objective: To assess the readiness to change unsafe sexual and substance use behaviours among MSM.
Methods: Using advertisements, we recruited MSM to participate in an intervention conducted by community-based facilitators trained in MI
techniques. Men were asked during interviews to complete psychometric assessments before and after the intervention. Preliminary data included
information regarding: HIV status, sexual behaviour, condom use, substance use, and mental health status..Analyses are ongoing and focus on
descriptive statistics and regression techniques.
Results: 27 men were recruited, including 59% living with HIV. Participant ages ranged from 22 to 61 years (mean=40) and 31% screened
positive for moderate/severe symptoms of depression. Using data from the Readiness Ruler (score 0=not important, 10=very important), the
following means were found: importance of changing sexual behaviour was 8.04 (range 2-10); confidence in ability to change sexual behaviour
was 6.54 (range 2-10); assessment of how realistic it might be to change sexual behaviour was 6.64 (range 2-10). Mean importance of reducing
the frequency of unprotected anal intercourse (UAI) was 7.3 (range 1.5-1); confidence in not having UAI was 5.3 (range 0-10); perception of how
realistic it is not to have UAI in the future was 5.6 (range 0 to 10). Mean ratings related to substance use included: importance of staying ‘quit’
was 6.9 (range 0 to 10); confidence in not using substances was 5.3 (range 0-9); readiness to change was 7.0 (range 0-10). Comparison of the
means by self reported HIV status revealed no differences, however, men who screened positive for moderate to severe symptoms of depression
attached greater importance and confidence to reduce the frequency of UAI and to say ‘quit’ from drugs and alcohol.
Conclusions: MSM recruited for interventions targeted at changing unsafe sexual behaviour and/or substance use attach importance to changing
their behaviour but feel less confident in the ability to change. Preliminary results suggest that MI holds promise as a group-based intervention
able to equip MSM with the motivation required to realize their sexual and substance use harm reduction ambitions.
Contact Information: Tim Guimond, Tel: 416-535-8501 x. 7192, Email: tim_guimond@camh.net
407
RE-ENVISIONING THE WHEEL
David Lewis-Peart 1
1-Black Coalition for AIDS Prevention
Objective: With large numbers of HIV infection rates in Toronto among Black men who have sex with men, and with an absence of
programming focused on BMSM youth specifically, there is an urgent need for evidence-based HIV prevention intervention programming for
this community youth. Interventions must not only work to build BMSM youth knowledge about HIV and other STIs but also work at building
youths’ feelings of self-efficacy and esteem in order to ensure long term behaviour change.
Methods: In June 2009, Black CAP launched a modified version of the Many Men, Many Voices (3MV) program. 3MV is a 7-session grouplevel
intervention meant to assist BMSM and Hispanic youth in preventing HIV and other sexually transmitted infections. 3MV also addresses a
range of factors that include cultural, social, and religious norms; interactions between HIV and other sexually transmitted infections; sexual
relationship dynamics; and the social influences that racism and homophobia have on HIV risk behaviors. Black CAP’s modifications included:
shortened format, supplementary exercises focused on cognition, the inclusion of adult mentors and increased emphasis on testing. Up until Black
CAP’s adoption of 3MV.
Recruitment strategies included engaging community gate keepers, youth peer leaders, and using online social network tools such as Facebook.
Entrance criteria were also revised to open the intervention to HIV positive youth. A total of 15 BMSM youth participated ranging from 16 to 26
years old. Pre- and post-intervention behavioral self-surveys, and exit interviews were administered to participants to assess youth’s overall
experience of the intervention.
Results: All participants reported identifying as gay or bisexual, while none reported being open about their sexual orientation. Nearly half
reported being Canadian citizens, 1/5 in process, 1/5 as refugee, and 1/5 reported being without status. The majority were Caribbean born, with a
small number identifying as being from the African continent. Most had graduated high school, some were in college or university, and one had

completed college. Approximately one third worked full or part-time, the rest being contractually employed, unemployed or full-time students.
Participants tended to live with their families or with roommates, with two participants living in shelters. Most reported having an HIV test within
the last year and reporting as either HIV negative or declining to report status. Many reported enjoying the retreat because it gave them the
opportunity to "connect" with other BMSM youth and adult mentors who spoke about their experiences as Black gay men. Participants enjoyed
hearing stories of resilience from mentors ("they got what wanted in life without the negatives that were surrounding them"). Some found the
HIV prevention information they received as useful ("I had never seen actual diagrams of STIs. I also didn’t know you could take an HIV test and
get results in 30 seconds"), and others valued discussing the pros and cons of openly identifying as gay ("That being gay doesn’t really define you
as a person, and to think positive, and one day you can be a mentor to someone else."), and how to negotiate sexual relationships.
Conclusions: Key findings suggest that 3MV is a viable program to prevent HIV and STIs among BMSM youth in Toronto. Further evaluation
should be conducted on the impact of this intervention on this population. Internally, these findings will better inform the next iteration of 3MV,
and be used to build Black CAPs capacity to implement evidence based programming and conduct community based research. Externally, these
findings will add to the body of knowledge around BMSM, which could inform the work of other ASOs working with similar populations.
Contact Information: David Lewis-Peart, Tel: 416 977 9955 x229, Email: david.davidlewis@gmail.com
408
OPERATION HAIRSPRAY 2- SPRAY THE WORD ABOUT HEALTH – AN AFRICAN AND CARIBBEAN COMMUNITY
PARTNERSHIP.
Suzanne O'Byrne 1 ; Zhaida Uddin 2
1-Somerset West Community Health Centre, Ottawa, ON; 2-Ottawa Public Health, Ottawa ON
Plain Language Summary: This unique community partnership, focussing on HIV prevention with the African and Caribbean community in
Ottawa, promises interesting findings that can be shared and duplicated. African and Caribbean Hair Salons were invited to receive HIV/AIDS
awareness training in order to pass the information on to their clients while receiving services in the salons.
Objective:
- To share the most significant knowledge transfer results from the client impact survey.
- To share the responses from peer volunteers regarding their involvement in the project.
- To evaluate the impact that stigma and discrimination have on community development approaches to the delivery of prevention strategies.
Methods: The project seeks to increase community capacity, increase access/reduce barriers to health information on STI’s and HIV/AIDS
prevention, identify and document strategies to engage and reach African and Caribbean men in HIV/AIDS prevention and evaluate the impact of
the prevention approach of peer volunteers by asking community members who receive the information for feedback via a confidential survey.
Data collection tools include: Training evaluation forms, Satisfaction survey, Focus group of peer volunteers, Conversation recording forms with
specific questions related to discussions on stigma and discrimination etc
Results:
- The client impact survey reached the identified target group with over 63% of respondents being African and/or Caribbean males.
- Over 80% of respondents reported an increase in knowledge about HIV/AIDS.
- 81% pf peer volunteers reported an increase in knowledge about HIV/AIDS.
- The issues of stigma and discrimination continue to be evident in the community.
Conclusions: The top three responses recorded by the community, conclude that information will be shared with family and friends (75.5%),
make a conscious effort to protect themselves against HIV infections (56.6%) and change thoughts, behaviours and feelings about HIV/AIDS
(35.8%). This is a successful partnership model that is easy to duplicate in other cities and also should be expanded.
Contact Information: Suzanne O'Byrne, Tel: 1 613 2388210, Email: sobyrne@swchc.on.ca
409
HIV VACCINE DISCOVERY: LESSONS FROM STEVEN SPIELBERG
Mario Ostrowski 1
1-Clinical Sciences Division, University of Toronto
Plain Language Summary: HIV has devised multiple strategies to evade and disarm the human immune response that is trying to control the
virus, behaving like a trojan horse in tricking the immune system. Thus, there is no clearly effective vaccine to prevent HIV infection; nor can the
infection be completely eradicated. These conditions have discouraged scientists, but has also allowed some of us to take drastic if not unusual

approaches that do not fit current paradigms of vaccine development. With the help of Steven Spielberg, we will describe one strange approach
that our laboratory has embarked upon.
Contact Information: Mario Ostrowski
410
REBUILDING HEALTH: ONE T-CELL AT A TIME
Juan Carlos Zuniga-Pflucker
1-Department of Immunology, University of Toronto
Plain Language Summary: T cells develop within the thymus, and their differentiation involves a series of commitment events and
developmental checkpoints including T-lineage commitment, T cell receptor (TCR) gene recombination and positive/negative selection to yield
functionally mature T cells. These events occur in a sequential, temporal and spatial fashion, as developing thymocytes migrate through the
thymus. My laboratory has developed a simple approach that makes use of a bone marrow stromal cell line (OP9) expressing the Notch receptor
ligand Delta-like 1 (OP9-DL1) that effectively replicates the key functions of the thymus, by inducing and supporting the generation of large
numbers of human progenitor T cells from hematopoietic stem cells in vitro. This cell culture system has several important advantages for the
generation and study of human T cell development. In particular, emphasis on how in vitro-generated progenitor T cells can be used to
regenerate T cell function in animal models, and their potential implications for the treatment of immune-related diseases such HIV-induced
immunodeficiency will be discussed.
Contact Information: Juan Carlos Zuniga-Pflucker
411
CO-INFECTIONS AND CO-MORBIDITIES: MEETING THE CHALLENGES OF A MATURING EPIDEMIC
Marina Klein
1-Division of Infectious Diseases and Immunodeficiency Service, McGill University Health Centre
Plain Language Summary: Since the advent of effective combination anti-retroviral therapy (ART) there have been dramatic reductions of
morbidity and mortality among HIV infected persons. With this increased survival, non-AIDS related illnesses, co-infections and co-morbidities
that were once rare have emerged as important causes of illness and death among HIV infected persons. Recent studies have highlighted the
importance of chronic viral hepatitis which leads to more rapid progression to endstage liver disease among HIV infected persons. Human
papilloma virus is another important viral co-infection that has been associated with a growing epidemic of anal and cervical dysplasia and
malignancies. Other non-AIDS related malignancies, cardiovascular disease and neurocognitive dysfunction represent examples of other
important emerging concerns. Furthermore, the HIV-infected population is aging and living with long-term exposure to antiretrovirals both which
may modify the risk for disease and complicate its management. This presentation will review the current understanding of non-AIDS related
conditions and co-morbidities and highlight the challenges that HIV-infected persons and their caregivers face in understanding and managing
these conditions with a focus on future directions for research and intervention work in this area.
Contact Information: Marina Klein
412
THE RESEARCHER AS ADVOCATE
Thomas Kerr 1,2
1-BC Centre for Excellence in HIV/AIDS; 2-University of British Columbia
Plain Language Summary: Drawing on personal experiences researching and advocating for harm reduction and HIV prevention programs in
Canada and Thailand, Dr. Kerr will explore the tensions that can arise when researchers seek to promote change by advocating with their
research. These case examples will also be used to shed light on the various actors and activities that are central to ensuring that research leads to
action and evidence-based decision-making. Dr. Kerr will also explore the role researchers can play in instances where traditional forms of
knowledge translation and transfer are likely to have little impact.
Objective: The role of the scientist in modern society has increasingly become an issue of discussion and debate. While classic notions of the
scientist call for objective, value-free, and dispassionate scientific contributions, a growing frustration with the irrelevance of conventional
research products has prompted a renewed focus on scientists becoming more engaged with the broader community and the policy development
process. In turn, this has led to the creation of funding mechanisms and other incentives to support knowledge translation and transfer of research
to affected communities, policy-makers, and the general public. While knowledge translation has an important role to play in bridging the gap

etween research and action, within the realm of HIV/AIDS research, policy, and programming there exists many areas of work where existing
models of knowledge transfer may have little relevance or influence, especially those instances where ideology and dominant cultural norms
trump scientific evidence. In such situations, researchers may need to move beyond traditional forms of dissemination and knowledge transfer.
Contact Information: Thomas Kerr
413
INVOLVED, INVESTED & INSPIRED: SHARED LEADERSHIP AND COLLECTIVE EMPOWERMENT IN THE THIRD SPACE
OF RESEARCH-POLICY-PRACTICE
Alan Li
1-Committee for Accessible AIDS Treatment
Plain Language Summary: GIPA (Greater Involvement of People Living with HIV/AIDS), a grassroots movement that began in the early 1980s
and formalized at the 1994 Paris AIDS Summit, has created a “third” space whereby PHAs, service providers, policy-makers and researchers
gathered to find solutions to the physical, social, political, economic and spiritual impact of HIV on individuals and communities affected.
Advances of HIV treatment, globalization and societal changes have given rise to the changing contexts of HIV/AIDS and GIPA. The third space,
rooted in critical postcolonial and race theories, refers to the dynamic space between the centre and the margins where the historically oppressed
or socially excluded communities dialogue, interact and develop new thinking, hybrid cultures and innovative practices that challenge the status
quo and the dominant discourse.
Contact Information: Alan Li

INDEX
A
Abddulghani, Omer
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Abdelkader, Monica
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Adam, Barry
Developing a coordinated research agenda for ethno-racial Men who have Sex with Men in Ontario 116
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Adebajo, Sylvia
HIV, Sexually Transmitted Infections and Men who have Sex with Men (MSM) in Sub-Saharan Africa - The Case of Nigeria 167
Ahluwalia, Amrita
A House is not a Home: the impact of gender, race and stigma on the housing experiences of African and Caribbean mothers living
with HIV
Aitken, Debbie
The Ottawa HIV Quit Smoking Program 340
Al-Dabbagh, Raed
The Ottawa HIV Quit Smoking Program 340
Alexander, Rob
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Alhetheel, Abdulkarim
Regulation of Programmed Cell Death in Monocytes from HIV+ Patients by Interferon-γ and Interleukin-10 343
Ali, Firdaus
Stigma and Discrimination among Canadians of South Asian Descent in Toronto 141
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Alix, Holtby
Making the invisible, visible: The promise of Photovoice for engaging LGBT youth in sexual health research 203
Allard, Johane P
HIV-associated non-alcoholic fatty liver in the era of highly active antiretroviral therapy: a review 312
Allard, Patricia
“Injecting realities”: Effective advocacy for HIV prevention in Canadian prisons 161
Allen, Matthew
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Allman, Dan
HIV, Sexually Transmitted Infections and Men who have Sex with Men (MSM) in Sub-Saharan Africa - The Case of Nigeria 167
Altenberg, Jason
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
104
Users
Exploring the context of injecting for the first time – a qualitative study 162
Giving someone their first hit – implications for HIV prevention programming 164
Ambagala, Aruna
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Endogenous Retroviral Element (ERV) Antigens: Immunological Targeting of HIV-Infected Cells 368
Andany, Nisha
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Anderson, Joan
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Anderson, Jonathan
Is it worth it? Using evidence on cost-effectiveness to inform priorities for HIV prevention 401
Andia, Irene
Access to HIV/AIDS Resources by Mothers and Children: Lessons from Rural Communities in Uganda 373
Anema, Aranka
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
207
207
127

Angel, Jonathan
From stigma to disability: The role of depression among PHAs 334
The Ottawa HIV Quit Smoking Program 340
Effects of HIV-1 on the maturation and antigen presentation of monocyte derived dendritic cells. 347
In vitro HIV Infection Results in Impaired IL-7 Signaling in Primary Human Thymocytes. 356
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Interleukin-4 downregulates CD127 expression on human thymocytes and mature CD8+ T-cells 121
The Role of IL-7 in the Survival and Function of Memory CD8+ T cells in Health and HIV Disease 123
Antoniou, Tony
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Arendt, Bianca M
HIV-associated non-alcoholic fatty liver in the era of highly active antiretroviral therapy: a review 312
Arthur, Jacqueline
Mobilizing Evidence at the Front Lines: Improving HIV/AIDS Policy and Care in Canada 342
Aryee, Edna
Providing affordable housing and improving the quality of life of African-Canadian women living with HIV/AIDS in Ontario 125
Ashraf, Tamima
Regulation of P-glycoprotein expression by the viral envelope protein gp120 and pro-inflammatory cytokines in human glial cells 357
Au-Yeung , Christopher G.
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
Avalos, Charlene
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Aykroyd, Gloria
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
Azizi, Ali
Maturation of dendritic cells by liposomal-delivery of multivalent HIV antigens 149
B
Bacon, Jean
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
Spaces, Healthy Places Study
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
(PSHP) Study
Mobilizing Evidence at the Front Lines: Improving HIV/AIDS Policy and Care in Canada 342
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Baidoobonso, Shamara
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Balfour, Louise
High rates of smoking and depression co-occur among people living with HIV in Canada 314
From stigma to disability: The role of depression among PHAs 334
The Ottawa HIV Quit Smoking Program 340
Balian, Raffi
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
104
Users
Exploring the context of injecting for the first time – a qualitative study 162
Giving someone their first hit – implications for HIV prevention programming 164
Bauer, Greta
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
HIV-Related Risk in Ontario’s Trans Communities: Trans PULSE Project 201
Lessons Learned from Implementing Respondent-Driven Sampling: Trans PULSE Project 201
Community Control in Community-Based Research: Trans PULSE Project 201
Best Practices for Including Trans Participants in Research: Trans PULSE Project 201
Social Determinants of Trans Health in Ontario: Trans PULSE Project 201
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Bayoumi, Ahmed
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Toronto Drug Users Willingness to Use a Supervised Consumption Site and Their Preferred Service Models 145
Where Do Injection Drug Use and Crack Smoking Occur in Toronto? 147
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
The diagnostic utility of serum RPR titer and peripheral CD4 cell count for neurosyphilis among patients with HIV: A systematic
316
review
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
Bekele, Tsegaye
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places 204
204
204

(PSHP) Study
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Bello, Khalidah
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Bendayan, Reina
Regulation of P-glycoprotein expression by the viral envelope protein gp120 and pro-inflammatory cytokines in human glial cells 357
Expression of ABC Drug Efflux Transporters in a HIV-1 Transgenic Rat Model 361
Uptake of atazanavir (ATZ) is susceptible to inhibition by antiretroviral drugs in Caco-2 cells, a model of human intestinal
374
epithelium
Role of Membrane Drug Transporters in the Permeability of Microbicides 377
Benoit, Anita
Cytokine mediated regulation of the transcriptional repressor, Growth Factor Independent – 1 and Interleukin-7Ra in human CD8
344
T cells.
Bereket, Tarik
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Bergeron, Michele
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Betancourt, Gerardo
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
Betteridge, Glenn
The Criminalization of HIV Non-disclosure in Canada: A Preliminary Analysis of Trends and Patterns 107
Betts, Adrian R.
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Bhanich Supapol, Wendy
Investigation of an increase in infectious syphilis cases in Ontario, 2009 174
Binder, Louise
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Bisaillon, Laura M.
Implications of mandatory HIV screening as pre-condition for immigration to Canada 105
Blahoianu, Maria
Regulation of IL-23 in Human Monocytes Following HIV Infection 345
Boerner, Scott
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Bogdanovic, Dragica
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Borwein, Alexandra
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
Boyce, Michelle
Best Practices for Including Trans Participants in Research: Trans PULSE Project 201
Lessons Learned from Implementing Respondent-Driven Sampling: Trans PULSE Project 201
Social Determinants of Trans Health in Ontario: Trans PULSE Project 201
Boyd, Rob
Implementing an anonymous code in a Needle Exchange/Safer Inhalation Program: What we have learned. 157
Brandson, Eirikka
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Predictors of Emergency Department use by individuals on HAART 160
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Brennan, David
Disordered Eating, Body Image and Sexual Risk among Gay and Bisexual Men 113
Brown, Glen
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
Bryson, Steve
Probing the promiscuity displayed by the broadly neutralizing anti-HIV-1 antibody 2F5 in recognizing a variety of gp41 MPERrelated
peptides: a basis for the design of small molecule vaccines.
366
Buhler, Shayna
The Impact of AIDS Vaccine Research on Health Systems Strengthening 365

Bullock, Sandra L.
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Sexual Risk-Behaviour among Canadian Snowbirds who winter in Florida: Who is HIV Testing? 156
Burchell, Ann
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Burton, Karen
Giving someone their first hit – implications for HIV prevention programming 164
Busca, Aurelia
TLR-9 Agonist Protects Human Monocytic Cells against HIV-Vpr-induced Apoptosis: A Critical Role for Calmodulin-dependent
354
Protein Kinase-II and an Anti-apoptotic cIAP-2 Gene
Monocytes to Macrophages Differentiation Confers Resistance to HIV-VPR Induced Apoptosis: Role of Anti-Apoptotic BCL2
358
and Inhibitors of Apoptosis (IAP) Proteins
Byers, Steve
Migrant Farm Workers in Ontario: Health and HIV 143
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
C
Cabrera, Christine
From stigma to disability: The role of depression among PHAs 334
Cadano-Mellado, Jose
Migrant Farm Workers in Ontario: Health and HIV 143
Cain, Roy
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Cairney, John
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Calla, Domenico
Condoms and Community: Enhancing community engagement to inform public health practice and condom distribution 338
Calzavara, Liviana
Understanding the Epidemic and Strengthening Prevention Efforts in China: Condoms Use and Knowledge among Migrants in
Shanghai
HIV, Sexually Transmitted Infections and Men who have Sex with Men (MSM) in Sub-Saharan Africa - The Case of Nigeria 167
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Cameron, Cathy
HIV and Aging – An Emerging Landscape for Consideration and Care 155
Cameron, D. William
The effect of multiple dose lopinavir/ritonavir on intestinal mRNA expression of ABCB1, ABCC1, ABCC2, CYP2B6, CYP3A4,
SLCO1B1, CAR, FXR, PXR and RXR in healthy volunteers
From stigma to disability: The role of depression among PHAs 334
The Ottawa HIV Quit Smoking Program 340
The Effect of Mixed Carotenoids Supplementation on CD4 T Lymphocyte Count in HIV/AIDS 355
Campbell, Keisa
HIV Prevention and the African and Caribbean Diaspora 369
Campbell, Lisa
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Canada-China Project Team
Understanding the Epidemic and Strengthening Prevention Efforts in China: Condoms Use and Knowledge among Migrants in
Shanghai
Carr, Robert
Reducing Risk in Marginalized Populations: What can the North Learn from the South? 403
Carvalhal, Adriana
The wHEALTH Project: Access to care and mental health issues of HIV-positive women 101
HIV-HCV Co-Infection Service in Ontario: An Evaluation of Resources and Deficiencies 117
50+ Years as Women Living With HIV –Case Managers provide a ‘wHEALTH’ of Experience 307
Casale, Marisa
Taking Seriously Our Obligations to Share Research Results: One Approach to Knowledge Transfer and Exchange with
Adolescents
165
131
165
370

Casipullai, Amy
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Caswell, Janet
50+ Years as Women Living With HIV –Case Managers provide a ‘wHEALTH’ of Experience 307
Cattaneo, Jessica
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Capturing conversations: Implementing a comprehensive service reporting system for MSM Bathhouse Outreach 159
Cavalieri, Walter
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
Users
Cedano, Jose
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Ceranto, Andre
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Chalin, Catherine
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Challacombe, Laurel
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
Users
Toronto Drug Users Willingness to Use a Supervised Consumption Site and Their Preferred Service Models 145
Where Do Injection Drug Use and Crack Smoking Occur in Toronto? 147
Increasing Community Knowledge of HIV and Legal Disclosure in an Era of Criminalization. 339
Building a Collection of “Evidence”-Based HIV Front-Line Practices: The Programming Connection – Shared experience.
341
Stronger programs.
Chambers, Lori
A House is not a Home: the impact of gender, race and stigma on the housing experiences of African and Caribbean mothers living 127
with HIV
Chan, Jacqueline
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Endogenous Retroviral Element (ERV) Antigens: Immunological Targeting of HIV-Infected Cells 368
Chan, Keith
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Che Mat, Nor Fazila
Regulation of IL-23 Induced Signaling and Receptor Expression in Human CD4 T Cells Isolated from HIV Positive Patients 346
The Effect of HIV Infection on Expression Levels of the Interleukin-27 Heterodimeric Cytokine and Receptor. 350
Chege, Duncan
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
Sigmoid Colon.
Cheung, Matthew
Changes in the Incidence and Outcomes of Hematologic Malignancies in Individuals with HIV in the cART Era 319
Chew, Derek
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Chieza, Lisungu
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Chihrin, Stephen
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Chu, Sandra Ka Hon
“Criminalization Creep”: Legal developments and community responses to criminal prosecutions for HIV exposure 106
“Injecting realities”: Effective advocacy for HIV prevention in Canadian prisons 161
Chun, Tae-Wook
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
Clayton, Kiera
Detecting novel Sam68ΔC-associated proteins involved in disrupting HIV-1 replication 360
Clout, Jerri
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Co, Herbert
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Cochrane, Alan
207
207
104
207
104
130

Composition of HIV-1 RNP Confers Differential Regulation of Viral Gene Expression 133
HIV-1 and Gonorrhea Co-infection: A disconnect between responses in cell lines and primary cells 134
Clk SR Protein Kinases and Drugs Modulating Alternative Splicing Demonstrate Potent Inhibition of HIV-1 Viral Replication 136
Detecting novel Sam68ΔC-associated proteins involved in disrupting HIV-1 replication 360
Different roles of hnRNP D isoforms in modulating HIV-1 gene expression 362
Coleman, Todd
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
Community Control in Community-Based Research: Trans PULSE Project 201
Lessons Learned from Implementing Respondent-Driven Sampling: Trans PULSE Project 201
HIV-Related Risk in Ontario’s Trans Communities: Trans PULSE Project 201
Coleman, William D.
Living in "transnational spaces": An exploration of the influence of the home country on the HIV risk facing recent Chinese
144
immigrants in Canada
Collaborator, Safe n’ Sexy
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Collins, Charles
Lessons Learned from Dissemination of Evidence-Based Interventions for HIV Prevention 210
Lessons Learned from Dissemination of Evidence-Based Interventions for HIV Prevention 404
Collins, Evan
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Committee, Advisory
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Consta VonAesch, Zoe
Having sex while drunk or high: do men who have sex with men want to change? 406
Cook, Katie
Making the invisible, visible: The promise of Photovoice for engaging LGBT youth in sexual health research 203
Cooper, Curtis
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
HIV-HCV Co-Infection Service in Ontario: An Evaluation of Resources and Deficiencies 117
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
From stigma to disability: The role of depression among PHAs 334
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
The Ottawa HIV Quit Smoking Program 340
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
Cooper, Diana
Increasing Community Knowledge of HIV and Legal Disclosure in an Era of Criminalization. 339
Corace, Kim
High rates of smoking and depression co-occur among people living with HIV in Canada 314
The Ottawa HIV Quit Smoking Program 340
From stigma to disability: The role of depression among PHAs 334
Coulter, Suzy
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Craig, Shelley
The Importance of Provider Endorsement to Voluntary HIV Counseling and Testing for Older Minority Women 153
Crath, Rory
Disordered Eating, Body Image and Sexual Risk among Gay and Bisexual Men 113
Crawley, Angela M
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Interleukin-4 downregulates CD127 expression on human thymocytes and mature CD8+ T-cells 121
The Role of IL-7 in the Survival and Function of Memory CD8+ T cells in Health and HIV Disease 123
Cubillos, Miguel
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
Cullen, Jim
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
D
Daniel, Judy
“Can We Talk”: a multi-sectoral collaborative innovative training program to facilitate empowered PHA/health provider
207
communication
Davidson, David
Identification of the oligomerization interface in the transmembrane domain of HIV-1 Vpu 359
De Rosa, Maria Fabiana
Role of Membrane Drug Transporters in the Permeability of Microbicides 377
De Rubeis , Emily

If We Build It, Would They Come? The Feasibility of a Supervised Injection Facility in Ottawa 163
Decker, Wendy
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Defend, Mark
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
Degani, Naushaba
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
Demetrakopoulos, Anna
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Desbians, Marisol
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Deveaux, Lynette
Enduring Partnerships: Focus on Youth in The Caribbean 205
Effectiveness over 36 months follow-up of Focus on Youth in the Caribbean on HIV Risk Reduction among early adolescent
405
Bahamian youth
Dias, Giselle
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
104
Users
Diaz-Mitoma, Francisco
Maturation of dendritic cells by liposomal-delivery of multivalent HIV antigens 149
Dickson, Brett
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Ding, Erin
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
Ding, Tao
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Diong, Christina
Perianal Bowen's Disease in HIV-Infected Men Who Have Sex with Men 112
DiPrima, Alessandro
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Dobson-Belaire, Wendy
HIV induces a unique cytokine profile with delayed interferon alpha production in plasmacytoid dendritic cells 351
HIV-1 and Gonorrhea Co-infection: A disconnect between responses in cell lines and primary cells 134
Dolan, Le-Ann
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Capturing conversations: Implementing a comprehensive service reporting system for MSM Bathhouse Outreach 159
Drannik, Anna
Trappin-2/Elafin is Associated with Antiviral Activity and Reduced Production of Pro-Inflammatory Factors in Human Genital
150
Epithelial Cells
Understanding the Role of Innate Factors in Mother-to-Child HIV-Transmission through Breast Milk. 308
Druyts, Eric
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
Duffy, Simon
Detecting novel Sam68ΔC-associated proteins involved in disrupting HIV-1 replication 360
Dunn, Jim
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
E
E, Iris
Mutational Analysis of the HIV Tat Protein and Its Ability to Down Regulate CD127 on CD8 T cells 124
Edmiston, Laurie
Increasing Community Knowledge of HIV and Legal Disclosure in an Era of Criminalization. 339
Building a Collection of “Evidence”-Based HIV Front-Line Practices: The Programming Connection – Shared experience.
341
Stronger programs.
Egdorf, Thomas
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207

Elliott, Richard
“Criminalization Creep”: Legal developments and community responses to criminal prosecutions for HIV exposure 106
“Injecting realities”: Effective advocacy for HIV prevention in Canadian prisons 161
Elsageyer, Musa
Regulation of Programmed Cell Death in Monocytes from HIV+ Patients by Interferon-γ and Interleukin-10 343
Erlich, Leah
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Ewert, Ruth
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Exploring Choices Team
Having sex while drunk or high: do men who have sex with men want to change? 406
F
Fairman, Peter
Effects of HIV-1 on the maturation and antigen presentation of monocyte derived dendritic cells. 347
Faller, Elliott
JAK/STAT signaling mediates regulation of IL-7R Expression on CD8 T cells by both transcriptional and non-transcriptional
122
mechanisms.
Effects of Interleukin-7 on Notch-1 Expression in CD8 T-Cells 349
Fang, Hui
Understanding the Epidemic and Strengthening Prevention Efforts in China: Condoms Use and Knowledge among Migrants in
165
Shanghai
Faucher, Syvie
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Fenta, Haile
Developing a coordinated research agenda for ethno-racial Men who have Sex with Men in Ontario 116
Fernandes, Kimberly
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Ferreira, Victor
The Effect of HSV-2 infection on HIV replication in the female genital tract 315
Fisher, Mark
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Flanigan, Timothy
Clinical outcomes prior to the era of antiretroviral therapy in Cambodia 372
Flicker, Sarah
Unpack the Black: Exploring Black youth sexual behaviours in the TDOT 169
Unpack the Black: Exploring access to clinical sexual health services for Black youth in the TDOT 170
Why do Toronto youth learn so much and yet not know so much about HIV/AIDS? Results and Recommendations from the
171
Toronto Teen Survey
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Taking Seriously Our Obligations to Share Research Results: One Approach to Knowledge Transfer and Exchange with
370
Adolescents
Flynn, Susan
Why do Toronto youth learn so much and yet not know so much about HIV/AIDS? Results and Recommendations from the
171
Toronto Teen Survey
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Forbes, Rosemary
The Broader Determinants of Health in an Aboriginal Context 322
Forrest , Moiya
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Fournier, Jocelyn
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Franco, Jose
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Fraser, Chris
Predictors of Emergency Department use by individuals on HAART 160
Fulco, Tiziana
HIV Risk Behaviour among Undergraduate Students during Reading Week Vacation 330

Fung, Kenneth
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Furlotte, Charles
Health and Social Service Experiences of Eleven Older Adults Living with HIV/AIDS in the National Capital Region 154
Optimizing Prenatal HIV Testing in Ontario 311
“Got a room for me?” Housing Experiences of Eleven Older Adults Living with HIV/AIDS in Canada’s Capital City 327
G
Gadalla, Tahany
Disordered Eating, Body Image and Sexual Risk among Gay and Bisexual Men 113
Gahagan, Jacqueline
Title: HIV Prevention and Women in Canada: A Meta-Ethnographic Synthesis of Current Knowledge. 128
Gajanayaka, Nirangala
Regulation of IL-23 in Human Monocytes Following HIV Infection 345
Garber, Gary
The Ottawa HIV Quit Smoking Program 340
From stigma to disability: The role of depression among PHAs 334
Gardner, Sandra
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
Gee, Katrina
Regulation of IL-23 Induced Signaling and Receptor Expression in Human CD4 T Cells Isolated from HIV Positive Patients 346
The Effect of HIV Infection on Expression Levels of the Interleukin-27 Heterodimeric Cytokine and Receptor. 350
Germain, Andree
If We Build It, Would They Come? The Feasibility of a Supervised Injection Facility in Ottawa 163
Ghazawi, Feras
JAK/STAT signaling mediates regulation of IL-7R Expression on CD8 T cells by both transcriptional and non-transcriptional
122
mechanisms.
Effects of Interleukin-7 on Notch-1 Expression in CD8 T-Cells 349
Ghunaim , Haitham
Maturation of dendritic cells by liposomal-delivery of multivalent HIV antigens 149
Giambrone, Broden
Community Control in Community-Based Research: Trans PULSE Project 201
Giguere, Pierre
The Ottawa HIV Quit Smoking Program 340
Globerman, Jason
Developing a coordinated research agenda for ethno-racial Men who have Sex with Men in Ontario 116
HIV-HCV Co-Infection Service in Ontario: An Evaluation of Resources and Deficiencies 117
Go, Avvy
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Goldstein, Tara
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Gough, Kevin
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
The diagnostic utility of serum RPR titer and peripheral CD4 cell count for neurosyphilis among patients with HIV: A systematic
316
review
Gould, Judy
HIV and Aging – An Emerging Landscape for Consideration and Care 155
Gray, Kimberly
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Gray, Trevor
The MaBwana Black Men’s Study 202
Gray-Owen, Scott D.
HIV-1 and Gonorrhea Co-infection: A disconnect between responses in cell lines and primary cells 134
Effect of a Novel, Neisseria-specific Immune-Stimulatory Factor on HIV-1 Expression and Lymphocyte Activation 135
Green, Michelle
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Greene, Saara
A House is not a Home: the impact of gender, race and stigma on the housing experiences of African and Caribbean mothers living
with HIV
207
127

The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
Greenspan, Nicole
Condoms and Community: Enhancing community engagement to inform public health practice and condom distribution 338
Public Health, Condoms and Bathhouses: A cost-effectiveness analysis of providing condoms to reduce the spread of syphilis at
158
bathhouses in Toronto
Griffiths, Neela
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Gruslin, Andre
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
Guenter, Dale
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Guimond, Tim
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
104
Users
Having sex while drunk or high: do men who have sex with men want to change? 406
Gunaratnam, Siva
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
Guzzo, Christina
Regulation of IL-23 Induced Signaling and Receptor Expression in Human CD4 T Cells Isolated from HIV Positive Patients 346
The Effect of HIV Infection on Expression Levels of the Interleukin-27 Heterodimeric Cytokine and Receptor. 350
Gysler, Matt
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIVpositive
118
Individuals
H
Hall, Peter
Having sex while drunk or high: do men who have sex with men want to change? 406
Haller , Silke
Harm Reduction Theatre Troupe Project 301
Hallman , Jazmyn
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Hammond, Rebecca
Community Control in Community-Based Research: Trans PULSE Project 201
Best Practices for Including Trans Participants in Research: Trans PULSE Project 201
HIV-Related Risk in Ontario’s Trans Communities: Trans PULSE Project 201
Disclosure Work: Trans youth negotiating relationships, sexuality, and safety in a cisnormative social world 206
Hanass-Hancock, Jill
HIV and Disability in a Global Context: Into the Spotlight At Last 168
Hard, Julie
Interprofessional mentorship as a means to build capacity among rehabilitation professionals and people living with HIV in
335
Ontario.
Hart, Trevor
Disordered Eating, Body Image and Sexual Risk among Gay and Bisexual Men 113
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Correlates of Psychological Distress in HIV Positive (HIV+) Women 310
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
HIV Risk Behaviour among Undergraduate Students during Reading Week Vacation 330
Harwell, Joseph
Clinical outcomes prior to the era of antiretroviral therapy in Cambodia 372
Hav, Houl
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Hayhoe, Beth
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Heaslip, Ashley

Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
Hendriks, Andrew
“Did You Spot The Banana? An Evaluation of a Sexually Transmitted Infection campaign for Ottawa youth”. 140
Henrick, Bethany
Trappin-2/Elafin is Associated with Antiviral Activity and Reduced Production of Pro-Inflammatory Factors in Human Genital
150
Epithelial Cells
Understanding the Role of Innate Factors in Mother-to-Child HIV-Transmission through Breast Milk. 308
Henshaw, Christe
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Hintzen, Devica
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Ho, Meghan
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Hoch, Jeffrey
Cost-effectiveness of anal cancer screening in HIV-positive men 332
Hoe, David
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Hoffman, Nikki
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Hogg, Robert
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Predictors of Emergency Department use by individuals on HAART 160
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Holditch, Sara
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Hopkins, Shaun
Toronto Drug Users Willingness to Use a Supervised Consumption Site and Their Preferred Service Models 145
Where Do Injection Drug Use and Crack Smoking Occur in Toronto? 147
Hove, Precious
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Huibner, Sanja
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Hunt, Neil
Exploring the context of injecting for the first time – a qualitative study 162
Giving someone their first hit – implications for HIV prevention programming 164
Hunter, Diana
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Induction of Tim-3 expression by the common gamma-chain cytokines IL-2, IL-7, IL-15 and IL-21 352
Husbands, Winston
Migrant Farm Workers in Ontario: Health and HIV 143
The MaBwana Black Men’s Study 202
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Hussien, Sherin
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Hwang, Stephen W
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Hynes, Rosemary
Probing the promiscuity displayed by the broadly neutralizing anti-HIV-1 antibody 2F5 in recognizing a variety of gp41 MPERrelated
peptides: a basis for the design of small molecule vaccines.
366
Hyrcza, Martin
HIV induces a unique cytokine profile with delayed interferon alpha production in plasmacytoid dendritic cells 351
I
Ieshchenko, Olena

HIV Epidemic in Ukraine - Challenges and Opportunities 208
Imrie, Kevin
Changes in the Incidence and Outcomes of Hematologic Malignancies in Individuals with HIV in the cART Era 319
Ion, Allyson
50+ Years as Women Living With HIV –Case Managers provide a ‘wHEALTH’ of Experience 307
Isakov, Viktor
HIV Epidemic in Ukraine - Challenges and Opportunities 208
Isogai, Pierre
Changes in the Incidence and Outcomes of Hematologic Malignancies in Individuals with HIV in the cART Era 319
J
Jackson, Ed
Building a Collection of “Evidence”-Based HIV Front-Line Practices: The Programming Connection – Shared experience.
341
Stronger programs.
Jackson, Randy
Title: HIV Prevention and Women in Canada: A Meta-Ethnographic Synthesis of Current Knowledge. 128
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
Reading Decolonizing Methodologies: Towards an Aboriginal HIV/AIDS Research Approach 206
Jain, Sumiti
Trappin-2/Elafin is Associated with Antiviral Activity and Reduced Production of Pro-Inflammatory Factors in Human Genital
150
Epithelial Cells
Targeting gp41 as a strategy to induce mucosal humoral immunity against HIV-1 151
Jairam , Jennifer
Toronto Drug Users Willingness to Use a Supervised Consumption Site and Their Preferred Service Models 145
Where Do Injection Drug Use and Crack Smoking Occur in Toronto? 147
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
James, LLana
The Way Forward: African, Caribbean and Black Canadian HIV/AIDS Research Think Tank 142
Janssen, Jesse
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Jasnos, Jan
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Jaworsky, Denise
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Jessup, Linda
Sexual Risk-Behaviour among Canadian Snowbirds who winter in Florida: Who is HIV Testing? 156
Johns, Ashley
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Johnson, Dylan
HIV induces a unique cytokine profile with delayed interferon alpha production in plasmacytoid dendritic cells 351
Johnston, Christine
Building a Collection of “Evidence”-Based HIV Front-Line Practices: The Programming Connection – Shared experience.
341
Stronger programs.
Jolly, Cindy
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Jolly, Rosemary
Uncensoring Stigma: Research and Response-ability 206
Jones, Angeline
HIV Prevention and the African and Caribbean Diaspora 369
Jones, Brad
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Induction of Tim-3 expression by the common gamma-chain cytokines IL-2, IL-7, IL-15 and IL-21 352
Jones, Bradley
HIV-1 increases non-LTR associated long interspersed element 1 expression by retrotransposition 363
Jose, Murray
The Criminalization of HIV Non-disclosure in Canada: A Preliminary Analysis of Trends and Patterns 107
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Julien, Jean-Philippe
Probing the promiscuity displayed by the broadly neutralizing anti-HIV-1 antibody 2F5 in recognizing a variety of gp41 MPERrelated
peptides: a basis for the design of small molecule
366
vaccines.

K
K, Anjali
Best Practices for Including Trans Participants in Research: Trans PULSE Project 201
Kaay, Matthias
Social Determinants of Trans Health in Ontario: Trans PULSE Project 201
Best Practices for Including Trans Participants in Research: Trans PULSE Project 201
Kafele, Kwasi
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Kafka, Jessica
Effect of Seminal Plasma from HIV-Infected Men on Female Genital Epithelial Cell Responses 378
Kain, Taylor
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
Sigmoid Colon.
Kakal, Juzer
Regulation of the IL-7 Receptor Alpha Chain in Primary Human Cytotoxic T-cells 304
Kandel, Gabor
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
Sigmoid Colon.
Kang, Laiyi
Understanding the Epidemic and Strengthening Prevention Efforts in China: Condoms Use and Knowledge among Migrants in
Shanghai
Kapac, Jack
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Kaul, Rupert
Asymptomatic shedding of herpes simplex viruses (HSV) despite successful antiretroviral therapy in HIV-1, HSV co-infection 111
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Effect of Seminal Plasma from HIV-Infected Men on Female Genital Epithelial Cell Responses 378
Kaushic, Charu
The Effect of HSV-2 infection on HIV replication in the female genital tract 315
Effect of Seminal Plasma from HIV-Infected Men on Female Genital Epithelial Cell Responses 378
Kavazanjian, Myda
HIV and Employment Activity in Canada: A 2009 Survey 324
Kefele, Kwasi
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Kerr, Thomas
The Researcher as Advocate 412
Khobzi, Nooshin
Lessons Learned from Implementing Respondent-Driven Sampling: Trans PULSE Project 201
Kim, Connie
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
Sigmoid Colon.
King, Ken
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Kis, Olena
Uptake of atazanavir (ATZ) is susceptible to inhibition by antiretroviral drugs in Caco-2 cells, a model of human intestinal
epithelium
Kitakule, Joshua
Access to HIV/AIDS Resources by Mothers and Children: Lessons from Rural Communities in Uganda 373
Klein, Marina
Co-Infections and Co-morbidities: Meeting the Challenges of a Maturing Epidemic 411
Kobyshcha, Yuri
HIV Epidemic in Ukraine - Challenges and Opportunities 208
Kolla, Gillian
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
Exploring the context of injecting for the first time – a qualitative study 162
130
130
165
207
207
130
374

Giving someone their first hit – implications for HIV prevention programming 164
Koornstra, Jay
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
Kovacs, Colin
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Krahn, Thomas
The diagnostic utility of serum RPR titer and peripheral CD4 cell count for neurosyphilis among patients with HIV: A systematic
316
review
Kros, Sarath
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Kryworuchko, Marko
Regulation of Programmed Cell Death in Monocytes from HIV+ Patients by Interferon-γ and Interleukin-10 343
Cytokine mediated regulation of the transcriptional repressor, Growth Factor Independent – 1 and Interleukin-7Ra in human CD8
344
T cells.
Kumar, Ashok
Maturation of dendritic cells by liposomal-delivery of multivalent HIV antigens 149
Regulation of Programmed Cell Death in Monocytes from HIV+ Patients by Interferon-γ and Interleukin-10 343
Cytokine mediated regulation of the transcriptional repressor, Growth Factor Independent – 1 and Interleukin-7Ra in human CD8
344
T cells.
Regulation of IL-23 in Human Monocytes Following HIV Infection 345
TLR-9 Agonist Protects Human Monocytic Cells against HIV-Vpr-induced Apoptosis: A Critical Role for Calmodulin-dependent
354
Protein Kinase-II and an Anti-apoptotic cIAP-2 Gene
Monocytes to Macrophages Differentiation Confers Resistance to HIV-VPR Induced Apoptosis: Role of Anti-Apoptotic BCL2
358
and Inhibitors of Apoptosis (IAP) Proteins
l
la Porte, Charles
The effect of multiple dose lopinavir/ritonavir on intestinal mRNA expression of ABCB1, ABCC1, ABCC2, CYP2B6, CYP3A4,
SLCO1B1, CAR, FXR, PXR and RXR in healthy volunteers
Lakhani, Ali
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
Lam, Jonathan
Cost-effectiveness of anal cancer screening in HIV-positive men 332
Laporte, Audrey
Public Health, Condoms and Bathhouses: A cost-effectiveness analysis of providing condoms to reduce the spread of syphilis at
bathhouses in Toronto
laPorte, Charles
The Ottawa HIV Quit Smoking Program 340
Larkin, June
Why do Toronto youth learn so much and yet not know so much about HIV/AIDS? Results and Recommendations from the
Toronto Teen Survey
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
Larocque, Marlene
The Broader Determinants of Health in an Aboriginal Context 322
Lavis, John
Mobilizing Evidence at the Front Lines: Improving HIV/AIDS Policy and Care in Canada 342
Lawson, Erica
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Le, Thanh
Maturation of dendritic cells by liposomal-delivery of multivalent HIV antigens 149
Leahy, Robert
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Leduc, Derek
Title: HIV Prevention and Women in Canada: A Meta-Ethnographic Synthesis of Current Knowledge. 128
Lee, Craig
The Ottawa HIV Quit Smoking Program 340
Lee, Daniel
131
158
171

TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Leece, Pamela
The Effectiveness of Harm Reduction Programs to Prevent HIV and HCV Transmission Among People who Smoke Crack: A
146
Systematic Review of the Evidence 1990-2008
Leonard, Lynne
The Effectiveness of Harm Reduction Programs to Prevent HIV and HCV Transmission Among People who Smoke Crack: A
146
Systematic Review of the Evidence 1990-2008
If We Build It, Would They Come? The Feasibility of a Supervised Injection Facility in Ottawa 163
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
Optimizing Prenatal HIV Testing in Ontario 311
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Lester, Brian
Migrant Farm Workers in Ontario: Health and HIV 143
Giving someone their first hit – implications for HIV prevention programming 164
Leung, Isabel
Identification of the oligomerization interface in the transmembrane domain of HIV-1 Vpu 359
Lewis, David
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
Lewis-Peart, David
Re-envisioning the Wheel 407
Li, Alan
Developing a coordinated research agenda for ethno-racial Men who have Sex with Men in Ontario 116
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
“Can We Talk”: a multi-sectoral collaborative innovative training program to facilitate empowered PHA/health provider
207
communication
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Involved, Invested & Inspired: Shared Leadership and Collective Empowerment in the Third Space of Research-Policy-Practice 413
Li, Maggie
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Lister-Haggerty , Jimi
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
Liu, Jun
The Adjuvancy of OX40 Ligand (CD252) on an HIV-1 Canarypox Vaccine 367
Lo, Calvin
HIV induces a unique cytokine profile with delayed interferon alpha production in plasmacytoid dendritic cells 351
Induction of Tim-3 expression by the common gamma-chain cytokines IL-2, IL-7, IL-15 and IL-21 352
Lombardo, Anthony
Online Sex Seeking Among MSM: Subculture and Socialization 375
Longman, Roxanne
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Loutfy, Mona
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIVpositive
Individuals
118
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Correlates of Psychological Distress in HIV Positive (HIV+) Women 310
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Lubek, Ian
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Luce, Janine
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
Lund, Nicole
Different roles of hnRNP D isoforms in modulating HIV-1 gene expression 362
Luyombya, Henry
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study

Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Lytwyn, Alice
Perianal Bowen's Disease in HIV-Infected Men Who Have Sex with Men 112
M
Ma, Vanna
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
MacArthur, Rodger D.
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
MacDonald, Kelly S.
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Endogenous Retroviral Element (ERV) Antigens: Immunological Targeting of HIV-Infected Cells 368
MacKay, Robert
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Mackie, David
HIV-HCV Co-Infection Service in Ontario: An Evaluation of Resources and Deficiencies 117
MacLachlan, Duncan
Capturing conversations: Implementing a comprehensive service reporting system for MSM Bathhouse Outreach 159
Macpherson, Barbara
Condoms and Community: Enhancing community engagement to inform public health practice and condom distribution 338
MacPherson, Paul
JAK/STAT signaling mediates regulation of IL-7R Expression on CD8 T cells by both transcriptional and non-transcriptional
122
mechanisms.
Mutational Analysis of the HIV Tat Protein and Its Ability to Down Regulate CD127 on CD8 T cells 124
Regulation of the IL-7 Receptor Alpha Chain in Primary Human Cytotoxic T-cells 304
High rates of smoking and depression co-occur among people living with HIV in Canada 314
From stigma to disability: The role of depression among PHAs 334
The Ottawa HIV Quit Smoking Program 340
Effects of Interleukin-7 on Notch-1 Expression in CD8 T-Cells 349
Expression of the interleukin-7 receptor is down regulated on CD4 T-Cells by the HIV Tat protein 353
Maggi, Julie
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Maio, Andrew
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Mairs, Katie
Sexual Risk-Behaviour among Canadian Snowbirds who winter in Florida: Who is HIV Testing? 156
Major, Carol
HIV Epidemic in Ukraine - Challenges and Opportunities 208
Majumdar, Basanti
Living in "transnational spaces": An exploration of the influence of the home country on the HIV risk facing recent Chinese
immigrants in Canada
Makoroka, Lydia
The MaBwana Black Men’s Study 202
Malott, Rebecca J.
Effect of a Novel, Neisseria-specific Immune-Stimulatory Factor on HIV-1 Expression and Lymphocyte Activation 135
Margolese, Shari
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIVpositive
Individuals
Marsdin, Bridget
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Marsh, Angie
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Endogenous Retroviral Element (ERV) Antigens: Immunological Targeting of HIV-Infected Cells 368
Marsh, Kim
Composition of HIV-1 RNP Confers Differential Regulation of Viral Gene Expression 133
Martin, Eric
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Martin, James
207
207
207
144
118

The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Martin, Phillip
The effect of multiple dose lopinavir/ritonavir on intestinal mRNA expression of ABCB1, ABCC1, ABCC2, CYP2B6, CYP3A4,
131
SLCO1B1, CAR, FXR, PXR and RXR in healthy volunteers
Masinde, Khatundi-Irene
A House is not a Home: the impact of gender, race and stigma on the housing experiences of African and Caribbean mothers living 127
with HIV
Massaquoi, Notisha
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Maticka-Tyndale, Eleanor
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Maxwell, John
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Mayer, Kenneth
Clinical outcomes prior to the era of antiretroviral therapy in Cambodia 372
McCarty-Johnston, Paul
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
McDiarmid, Marney
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
McGarvey, Stephen
Clinical outcomes prior to the era of antiretroviral therapy in Cambodia 372
McGee, Frank
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
HIV Epidemic in Ukraine - Challenges and Opportunities 208
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
McKee, Eileen
Enhancing Labour Force Participation for People Living with HIV in Canada: Scoping Review Results 326
McLaughlin, Denny
Expression of the interleukin-7 receptor is down regulated on CD4 T-Cells by the HIV Tat protein 353
McPherson, Bela
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
104
Users
McWilliam, Sue
The Effectiveness of Harm Reduction Programs to Prevent HIV and HCV Transmission Among People who Smoke Crack: A
146
Systematic Review of the Evidence 1990-2008
If We Build It, Would They Come? The Feasibility of a Supervised Injection Facility in Ottawa 163
Optimizing Prenatal HIV Testing in Ontario 311
Mehes, Mira
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
Melles, Brenda
High-risk Youth, Drug Use and Hepatitis C in Kingston, Ontario 139
Mihajlovic, Vesna
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Miller, Cari
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Mills, Edward J.
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
Millson, Peggy
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
Users
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
HIV-HCV Co-Infection Service in Ontario: An Evaluation of Resources and Deficiencies 117
Toronto Drug Users Willingness to Use a Supervised Consumption Site and Their Preferred Service Models 145
Where Do Injection Drug Use and Crack Smoking Occur in Toronto? 147
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
Exploring the context of injecting for the first time – a qualitative study 162
Giving someone their first hit – implications for HIV prevention programming 164
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
Mishra, Sharmistha
104

The diagnostic utility of serum RPR titer and peripheral CD4 cell count for neurosyphilis among patients with HIV: A systematic
316
review
Mitchell, Claudia
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
Mitterni, Leo
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Mittmann, Nicole
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Changes in the Incidence and Outcomes of Hematologic Malignancies in Individuals with HIV in the cART Era 319
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Mohammed, Saira
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIV-
118
positive Individuals
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Correlates of Psychological Distress in HIV Positive (HIV+) Women 310
Monette, LaVerne
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
Spaces, Healthy Places Study
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Montaner, Julio
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Predictors of Emergency Department use by individuals on HAART 160
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Tuberculosis mortality in HIV-infected individuals: an analytical assessment 313
Moravan, Veronika
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
Muchenje, Marvelous
Immigrant Women’s Experiences with Immigration Medical Examination HIV Testing 108
Mujib, Shariq
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Induction of Tim-3 expression by the common gamma-chain cytokines IL-2, IL-7, IL-15 and IL-21 352
Mukandoli, Chantal
A House is not a Home: the impact of gender, race and stigma on the housing experiences of African and Caribbean mothers living
with HIV
Murangira, Felicite
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
Murray, James
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Developing a coordinated research agenda for ethno-racial Men who have Sex with Men in Ontario 116
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Gay Poz Sex: A Community Based Counselling Intervention for HIV-Positive Men 331
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Mwalwanda, Mary
50+ Years as Women Living With HIV –Case Managers provide a ‘wHEALTH’ of Experience 307
Myers, Ted
HIV, Sexually Transmitted Infections and Men who have Sex with Men (MSM) in Sub-Saharan Africa - The Case of Nigeria 167
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Mykhalovskiy, Eric
The Criminalization of HIV Non-disclosure in Canada: A Preliminary Analysis of Trends and Patterns 107
204
127
N
Nag, Kakon

Understanding the Role of Innate Factors in Mother-to-Child HIV-Transmission through Breast Milk. 308
Nambiar, Devan
Developing a coordinated research agenda for ethno-racial Men who have Sex with Men in Ontario 116
Narushima, Miya
Migrant Farm Workers in Ontario: Health and HIV 143
Nazli, Aisha
The Effect of HSV-2 infection on HIV replication in the female genital tract 315
Effect of Seminal Plasma from HIV-Infected Men on Female Genital Epithelial Cell Responses 378
Ndlovu, Uitsile
Immigrant Women’s Experiences with Immigration Medical Examination HIV Testing 108
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Ndyanabo, Emmanuel
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
“Can We Talk”: a multi-sectoral collaborative innovative training program to facilitate empowered PHA/health provider
207
communication
Nelson, Tiffany
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Newman, Rob
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
Newmeyer, Trent
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Newton, Jennifer
Trappin-2/Elafin is Associated with Antiviral Activity and Reduced Production of Pro-Inflammatory Factors in Human Genital
150
Epithelial Cells
Ngai, Nicholas
The Adjuvancy of OX40 Ligand (CD252) on an HIV-1 Canarypox Vaccine 367
NHPPG Development Team
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIVpositive
Individuals
Nixon, Douglas
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Nixon, Stephanie
HIV and Disability in a Global Context: Into the Spotlight At Last 168
Taking Seriously Our Obligations to Share Research Results: One Approach to Knowledge Transfer and Exchange with
370
Adolescents
Nleya-Ncube, Mercy
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Noeun, Pring
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Norman, Geoff
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
118
O
O’Brien, Katie
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
O'Brien, Kelly
HIV and Aging – An Emerging Landscape for Consideration and Care 155
Enhancing Labour Force Participation for People Living with HIV in Canada: Scoping Review Results 326
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Interprofessional mentorship as a means to build capacity among rehabilitation professionals and people living with HIV in
335
Ontario.
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
O'Brien, Nadia
Predictors of Emergency Department use by individuals on HAART 160
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Moving from Paradigm to Practice: The Ashodaya Sex Worker Empowerment Project in Mysore India and its Promise for
371
HIV/AIDS Prevention
O'Brien-Teengs, Doris
A House is not a Home: the impact of gender, race and stigma on the housing experiences of African and Caribbean mothers living 127

with HIV
O'Byrne, Suzanne
Operation Hairspray 2- Spray The Word About Health – An African and Caribbean Community Partnership. 408
O'Campo, Patricia
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
O'Connor, Alison M.
The Role of IL-7 in the Survival and Function of Memory CD8+ T cells in Health and HIV Disease 123
OCS Team
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Ogunsola, Sade
HIV, Sexually Transmitted Infections and Men who have Sex with Men (MSM) in Sub-Saharan Africa - The Case of Nigeria 167
Oliver, Brent
Enhancing Labour Force Participation for People Living with HIV in Canada: Scoping Review Results 326
O'Loghlen, Sean
A comparison of antiretroviral treatment uptake in HIV patients that are Canadian-born and those born outside Canada 376
Ongoiba, Fanta
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Ostrowksi, Mario
The Adjuvancy of OX40 Ligand (CD252) on an HIV-1 Canarypox Vaccine 367
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
HIV-1 and Gonorrhea Co-infection: A disconnect between responses in cell lines and primary cells 134
Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
HIV induces a unique cytokine profile with delayed interferon alpha production in plasmacytoid dendritic cells 351
Induction of Tim-3 expression by the common gamma-chain cytokines IL-2, IL-7, IL-15 and IL-21 352
HIV-1 increases non-LTR associated long interspersed element 1 expression by retrotransposition 363
HIV Vaccine discovery: Lessons from Steven Spielberg 409
Owen, Andrew
The effect of multiple dose lopinavir/ritonavir on intestinal mRNA expression of ABCB1, ABCC1, ABCC2, CYP2B6, CYP3A4,
SLCO1B1, CAR, FXR, PXR and RXR in healthy volunteers
Owino, Maureen
“Can We Talk”: a multi-sectoral collaborative innovative training program to facilitate empowered PHA/health provider
207
communication
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
131
P
Pai, Emil
Probing the promiscuity displayed by the broadly neutralizing anti-HIV-1 antibody 2F5 in recognizing a variety of gp41 MPERrelated
peptides: a basis for the design of small molecule vaccines.
366
Palmer, Alexis
You’re Breaking My HAART: HIV and Violence Among a Cohort of Women on Antiretroviral Therapy in British Columbia,
126
Canada
Predictors of Emergency Department use by individuals on HAART 160
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Parashar, Surita
Overcoming employment barriers: health and financial worries among a cohort of HIV-positive individuals on HAART. 321
The effect of medication support services on the association between housing and adherence among a cohort of unstably housed
323
people living with HIV/AIDS accessing HAART.
Parks, Angel
The Criminalization of HIV Non-disclosure in Canada: A Preliminary Analysis of Trends and Patterns 107
Parsons, Janet
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Pearce, Nancy
Sexual Risk-Behaviour among Canadian Snowbirds who winter in Florida: Who is HIV Testing? 156
Peck, Ryan
The Criminalization of HIV Non-disclosure in Canada: A Preliminary Analysis of Trends and Patterns 107
Peer Investigators
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Peeva, Valentina
Perianal Bowen's Disease in HIV-Infected Men Who Have Sex with Men 112
Persad, Desmond

Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
Perusini, Stephen
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Peters, Eric
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
Petrovic, Bojana
HIV Risk Behaviour among Undergraduate Students during Reading Week Vacation 330
Pilon, Rick
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Pipe, Andrew
The Ottawa HIV Quit Smoking Program 340
Piran, Siavash
HIV-associated non-alcoholic fatty liver in the era of highly active antiretroviral therapy: a review 312
Pole, Jason
Unpack the Black: Exploring Black youth sexual behaviours in the TDOT 169
Unpack the Black: Exploring access to clinical sexual health services for Black youth in the TDOT 170
Pollock, Gabriel
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Poon, Maurice
Developing a coordinated research agenda for ethno-racial Men who have Sex with Men in Ontario 116
Popiel, Melissa
HIV and Employment Activity in Canada: A 2009 Survey 324
Posadas, Marco
TowelTalk: A Brief Counselling Program For Men Using Bathhouses 114
Positive Spaces, Healthy Places Study Team
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
Preibisch, Kerry
Migrant Farm Workers in Ontario: Health and HIV 143
Preisman, Mary
A comparison of antiretroviral treatment uptake in HIV patients that are Canadian-born and those born outside Canada 376
Prem, Sophiap
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Prentice, Tracey
Title: HIV Prevention and Women in Canada: A Meta-Ethnographic Synthesis of Current Knowledge. 128
Price, Colleen
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
Pritchard, Jennifer
Investigation of an increase in infectious syphilis cases in Ontario, 2009 174
Pugh, Daniel
Qualitative Findings from the Health in Middlesex Men Matters (HiMMM) Project 115
The Black, African and Caribbean Canadian Health (BLACCH) Study: Phase I 320
Pyne, Jake
Community Control in Community-Based Research: Trans PULSE Project 201
R
Raboud, Janet
Asymptomatic shedding of herpes simplex viruses (HSV) despite successful antiretroviral therapy in HIV-1, HSV co-infection 111
Perianal Bowen's Disease in HIV-Infected Men Who Have Sex with Men 112
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Cost-effectiveness of anal cancer screening in HIV-positive men 332
A comparison of antiretroviral treatment uptake in HIV patients that are Canadian-born and those born outside Canada 376
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Rachlis, Anita
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Changes in the Incidence and Outcomes of Hematologic Malignancies in Individuals with HIV in the cART Era 319
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Ragan, Mark
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places 204

(PSHP) Study
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
Spaces, Healthy Places Study
Rahimi, Ali Rahim
Regulation of IL-23 in Human Monocytes Following HIV Infection 345
Ramaswamy , Manisha
Uptake of atazanavir (ATZ) is susceptible to inhibition by antiretroviral drugs in Caco-2 cells, a model of human intestinal
epithelium
Ramsaroop, Chris
Migrant Farm Workers in Ontario: Health and HIV 143
Read, Stanley
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
pregnancy weigh in…
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Rebbapragada, Anu
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Redman, Nik
HIV-Related Risk in Ontario’s Trans Communities: Trans PULSE Project 201
Reid, Robert
The Ottawa HIV Quit Smoking Program 340
Remis, Robert
HIV, Sexually Transmitted Infections and Men who have Sex with Men (MSM) in Sub-Saharan Africa - The Case of Nigeria 167
The MaBwana Black Men’s Study 202
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Restoule, Jean Paul
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Reynolds, Aideen
If We Build It, Would They Come? The Feasibility of a Supervised Injection Facility in Ottawa 163
Rhodes, Chelsey
Predictors of Emergency Department use by individuals on HAART 160
Risebrough, Nancy
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Changes in the Incidence and Outcomes of Hematologic Malignancies in Individuals with HIV in the cART Era 319
Rivas, Carlos
Action as a key stage of the Theory/Practice circle: developing a new intervention to treat HIV diagnosis related trauma. 103
Rivers, Melanie
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
Roberts, Daryle
The Engaging Physicians Project: is to assist General Practitioners (GPs) in creating a non-judgmental and welcoming clinical
119
environment; to allow for the safe disclosure of sexual practices and health concerns of Men who have Sex with Men.
Robillard, Kevin
Expression of ABC Drug Efflux Transporters in a HIV-1 Transgenic Rat Model 361
Rogan, Michael
Taking Seriously Our Obligations to Share Research Results: One Approach to Knowledge Transfer and Exchange with
Adolescents
Ronaldson, Patrick T.
Regulation of P-glycoprotein expression by the viral envelope protein gp120 and pro-inflammatory cytokines in human glial cells 357
Rosenes, Ron
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Rosenthal, Kenneth
Targeting gp41 as a strategy to induce mucosal humoral immunity against HIV-1 151
Understanding the Role of Innate Factors in Mother-to-Child HIV-Transmission through Breast Milk. 308
Trappin-2/Elafin is Associated with Antiviral Activity and Reduced Production of Pro-Inflammatory Factors in Human Genital
150
Epithelial Cells
Rourke, Sean
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Mobilizing Evidence at the Front Lines: Improving HIV/AIDS Policy and Care in Canada 342
204
374
173
370

Clinical outcomes prior to the era of antiretroviral therapy in Cambodia 372
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Roy, Elise
Giving someone their first hit – implications for HIV prevention programming 164
Exploring the context of injecting for the first time – a qualitative study 162
Rubin, Tamar
Immigrant Women’s Experiences with Immigration Medical Examination HIV Testing 108
Rueda, Sergio
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
Job security is associated with quality of life in men living with HIV: The OHTN Cohort Study. 379
Rumman, Amir
A comparison of antiretroviral treatment uptake in HIV patients that are Canadian-born and those born outside Canada 376
Rutherford, Kathryn
A comparison of antiretroviral treatment uptake in HIV patients that are Canadian-born and those born outside Canada 376
Ryan, Shannon Thomas
Migrant Farm Workers in Ontario: Health and HIV 143
The MaBwana Black Men’s Study 202
The Criminalization of HIV Non-disclosure in Canada: A Preliminary Analysis of Trends and Patterns 107
S
Saad, Amin
Maturation of dendritic cells by liposomal-delivery of multivalent HIV antigens 149
Salit, Irving
Perianal Bowen's Disease in HIV-Infected Men Who Have Sex with Men 112
Cost-effectiveness of anal cancer screening in HIV-positive men 332
Samson, Lindy
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
Optimizing Prenatal HIV Testing in Ontario 311
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Sandre, Daniella
High rates of smoking and depression co-occur among people living with HIV in Canada 314
From stigma to disability: The role of depression among PHAs 334
The Ottawa HIV Quit Smoking Program 340
Sandstrom, Paul
HIV, Sexually Transmitted Infections and Men who have Sex with Men (MSM) in Sub-Saharan Africa - The Case of Nigeria 167
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Sanmuganantham, Tharmila
Different roles of hnRNP D isoforms in modulating HIV-1 gene expression 362
Sano, Marie
Perianal Bowen's Disease in HIV-Infected Men Who Have Sex with Men 112
Cost-effectiveness of anal cancer screening in HIV-positive men 332
Saxena, Mansi
TLR-9 Agonist Protects Human Monocytic Cells against HIV-Vpr-induced Apoptosis: A Critical Role for Calmodulin-dependent
354
Protein Kinase-II and an Anti-apoptotic cIAP-2 Gene
Saya-Moore, Kevin
The Engaging Physicians Project: is to assist General Practitioners (GPs) in creating a non-judgmental and welcoming clinical
119
environment; to allow for the safe disclosure of sexual practices and health concerns of Men who have Sex with Men.
Scanlon, Kyle
Social Determinants of Trans Health in Ontario: Trans PULSE Project 201
Community Control in Community-Based Research: Trans PULSE Project 201
Schwartz, Karen
“Got a room for me?” Housing Experiences of Eleven Older Adults Living with HIV/AIDS in Canada’s Capital City 327
Scott, Allison N
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Séguin, Isabelle
The effect of multiple dose lopinavir/ritonavir on intestinal mRNA expression of ABCB1, ABCC1, ABCC2, CYP2B6, CYP3A4,
131
SLCO1B1, CAR, FXR, PXR and RXR in healthy volunteers
Shapiro, Heather
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIVpositive
118
Individuals

Sharpe, Simon
Identification of the oligomerization interface in the transmembrane domain of HIV-1 Vpu 359
Sherring, Alice
Development of a Quantitative Bead Capture Assay for Soluble IL-7 Receptor Alpha in Human Plasma 348
Sheth, Prameet
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
130
Sigmoid Colon.
Effect of Seminal Plasma from HIV-Infected Men on Female Genital Epithelial Cell Responses 378
Shimeles, Helena
Unpack the Black: Exploring Black youth sexual behaviours in the TDOT 169
Unpack the Black: Exploring access to clinical sexual health services for Black youth in the TDOT 170
Shore, Ron
High-risk Youth, Drug Use and Hepatitis C in Kingston, Ontario 139
Silver, Ray (Butch)
Exploring the context of injecting for the first time – a qualitative study 162
Giving someone their first hit – implications for HIV prevention programming 164
Singer, Joel
The Effect of Mixed Carotenoids Supplementation on CD4 T Lymphocyte Count in HIV/AIDS 355
Singhal, Neera
The Effect of Mixed Carotenoids Supplementation on CD4 T Lymphocyte Count in HIV/AIDS 355
Sirskyj, Danylo
Maturation of dendritic cells by liposomal-delivery of multivalent HIV antigens 149
Smieja, Marek
Viral Hepatitis Testing is Deficient in HIV Seropositive Patients: An OHTN Cohort Study Analysis 109
Incidence of Hypertension in an Ontario HIV-positive Cohort 110
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Smillie-Adjarkwa, Christine
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Smith, Alex
Predictors of Emergency Department use by individuals on HAART 160
Smith, Kate
The Effectiveness of Harm Reduction Programs to Prevent HIV and HCV Transmission Among People who Smoke Crack: A
146
Systematic Review of the Evidence 1990-2008
If We Build It, Would They Come? The Feasibility of a Supervised Injection Facility in Ottawa 163
So, Geoffrey
Incidence of Hypertension in an Ontario HIV-positive Cohort 110
So, Nancy S.Y.
Effect of a Novel, Neisseria-specific Immune-Stimulatory Factor on HIV-1 Expression and Lymphocyte Activation 135
Sobota, Michael
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
Soje, Lena
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Sok, Phan
Clinical outcomes prior to the era of antiretroviral therapy in Cambodia 372
Sokhout Huon, Kris
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Solomon, Patricia
Interprofessional mentorship as a means to build capacity among rehabilitation professionals and people living with HIV in
Ontario.
HIV and Aging – An Emerging Landscape for Consideration and Care 155
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Exploring Relationships Between Dimensions and Contextual Factors of Disability: Development of a Measurement Model 336
Song, Haihan
HIV-1 increases non-LTR associated long interspersed element 1 expression by retrotransposition 363
Sriranganathan, Gobika
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Stadnicki, Dan
Involving Youth in Determining Evaluation Needs for Youth Sexual Health Peer Education Programs 172
Stall, Ron
The Implications of Syndemics and Strengths on Increasing HIV Intervention Efficacy among Gay Men 402
Stanley, Cole
335

Comprehensive Elimination of Globally Diverse HIV Primary Isolate Infections by HERV-K-Specific CD8+ T Cells 152
Stanton, Bonita
Enduring Partnerships: Focus on Youth in The Caribbean 205
Effectiveness over 36 months follow-up of Focus on Youth in the Caribbean on HIV Risk Reduction among early adolescent
405
Bahamian youth
Steinmöeller, Jessica
High rates of smoking and depression co-occur among people living with HIV in Canada 314
Mutational Analysis of the HIV Tat Protein and Its Ability to Down Regulate CD127 on CD8 T cells 124
Stinson, Deborah
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Stone, Geoffrey W.
The Adjuvancy of OX40 Ligand (CD252) on an HIV-1 Canarypox Vaccine 367
Strike, Carol
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
104
Users
Toronto Drug Users Willingness to Use a Supervised Consumption Site and Their Preferred Service Models 145
Where Do Injection Drug Use and Crack Smoking Occur in Toronto? 147
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
Exploring the context of injecting for the first time – a qualitative study 162
Giving someone their first hit – implications for HIV prevention programming 164
Having sex while drunk or high: do men who have sex with men want to change? 406
Su, Yinghua
The Effect of Mixed Carotenoids Supplementation on CD4 T Lymphocyte Count in HIV/AIDS 355
Sugden, Scott
Mutational Analysis of the HIV Tat Protein and Its Ability to Down Regulate CD127 on CD8 T cells 124
Regulation of the IL-7 Receptor Alpha Chain in Primary Human Cytotoxic T-cells 304
Sutdhibhasilp, Noulmook
Migrant Farm Workers in Ontario: Health and HIV 143
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
207
discrimination
Swantee, Carol
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Swinton, Marilyn
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333
Switzer, Sarah
Collaging Complexity: Exploring Young Women’s understandings of HIV/AIDS. 203
Symington, Alison
“Criminalization Creep”: Legal developments and community responses to criminal prosecutions for HIV exposure 106
The Criminalization of HIV Non-disclosure in Canada: A Preliminary Analysis of Trends and Patterns 107
T
Taggart, Linda
Changes in the Incidence and Outcomes of Hematologic Malignancies in Individuals with HIV in the cART Era 319
Tan, Darrell
Asymptomatic shedding of herpes simplex viruses (HSV) despite successful antiretroviral therapy in HIV-1, HSV co-infection 111
The diagnostic utility of serum RPR titer and peripheral CD4 cell count for neurosyphilis among patients with HIV: A systematic
316
review
Tangsubutra, Romyen
Migrant Farm Workers in Ontario: Health and HIV 143
Tasca, George
High rates of smoking and depression co-occur among people living with HIV in Canada 314
From stigma to disability: The role of depression among PHAs 334
The Ottawa HIV Quit Smoking Program 340
Taylor, Darien
Increasing Community Knowledge of HIV and Legal Disclosure in an Era of Criminalization. 339
Tebeje , Meskerem
Harm Reduction Theatre Troupe Project 301
Using Art to Educate the Youth and Open-up a Dialogue re: HIV/AIDS in the Ethiopian-Canadian Community 305
Reaching Vulnerable Women in Priority Areas in the Greater Toronto Area: Voices of Positive Women’s Community Connections 306
Project
Developing a New HIV Disability Questionnaire: A Community-Integrated Approach 333

Tecimer, Sandy
The experiences of Ontario HIV-discordant couples (male positive, female negative) in seeking sperm washing fertility services. 120
Teffera , Hiwot
Using Art to Educate the Youth and Open-up a Dialogue re: HIV/AIDS in the Ethiopian-Canadian Community 305
Reaching Vulnerable Women in Priority Areas in the Greater Toronto Area: Voices of Positive Women’s Community Connections 306
Project
Tenywa, Paul
Access to HIV/AIDS Resources by Mothers and Children: Lessons from Rural Communities in Uganda 373
Tharao, Wangari
Immigrant Women’s Experiences with Immigration Medical Examination HIV Testing 108
The Way Forward: African, Caribbean and Black Canadian HIV/AIDS Research Think Tank 142
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
173
pregnancy weigh in…
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
Detection of Human papilloma virus in self collected vaginal and anal samples from Afro-Caribbean women residing in Toronto 318
Risk behaviour among EAST (East African Health Study in Toronto) participants with multiple and concurrent sexual partners 329
Thorne, Julie
Implementation of a Student-Initiated Preclerkship HIV Elective 337
Tinmouth, Jill
Perianal Bowen's Disease in HIV-Infected Men Who Have Sex with Men 112
Cost-effectiveness of anal cancer screening in HIV-positive men 332
Tokawa, Kenji
Best Practices for Including Trans Participants in Research: Trans PULSE Project 201
Traut, Pam
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Travers, Anna
HIV-Related Risk in Ontario’s Trans Communities: Trans PULSE Project 201
Travers, Robb
Why do Toronto youth learn so much and yet not know so much about HIV/AIDS? Results and Recommendations from the
171
Toronto Teen Survey
Community Control in Community-Based Research: Trans PULSE Project 201
Social Determinants of Trans Health in Ontario: Trans PULSE Project 201
Making the invisible, visible: The promise of Photovoice for engaging LGBT youth in sexual health research 203
Tucker, Ruthann
Persisting Disparities of Social Determinants of Health between Aboriginal and Caucasian Persons living with HIV: The Positive
204
Spaces, Healthy Places Study
Worsening of Social Determinants of Health among Aboriginal PHAs: The Positive Spaces, Healthy Places (PSHP) study 204
The Need for Stable and Affordable Housing Among Women Living with HIV in Ontario: The Positive Spaces, Healthy Places
204
(PSHP) Study
U
Uddin, Zhaida
“Did You Spot The Banana? An Evaluation of a Sexually Transmitted Infection campaign for Ottawa youth”. 140
Operation Hairspray 2- Spray The Word About Health – An African and Caribbean Community Partnership. 408
Utama, Richard
PhotoPositive: Exploring HIV-related stigma within communities of gay and bisexual men in Toronto. 302
V
van Heeswijk, Rolf
The effect of multiple dose lopinavir/ritonavir on intestinal mRNA expression of ABCB1, ABCC1, ABCC2, CYP2B6, CYP3A4,
131
SLCO1B1, CAR, FXR, PXR and RXR in healthy volunteers
Vandelinde, Catharine
Implementing an anonymous code in a Needle Exchange/Safer Inhalation Program: What we have learned. 157
Vibert, Michelle
How can youth have meaningful engagement in community-based research? The Safe n’ Sexy Project experience. 137
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Vlassoff, Carol
Stigma and Discrimination among Canadians of South Asian Descent in Toronto 141
Vranjkovic, Agatha
Interleukin-4 downregulates CD127 expression on human thymocytes and mature CD8+ T-cells 121

W
Wagner, Anne
Correlates of Psychological Distress in HIV Positive (HIV+) Women 310
Walker, Diana
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Wallace, Rebecca
From stigma to disability: The role of depression among PHAs 334
Walmsley, Sharon
Asymptomatic shedding of herpes simplex viruses (HSV) despite successful antiretroviral therapy in HIV-1, HSV co-infection 111
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Predictors of Adherence among HIV Positive Individuals on HAART Therapy 132
Wang, Hongwei
Understanding the Epidemic and Strengthening Prevention Efforts in China: Condoms Use and Knowledge among Migrants in
165
Shanghai
Wang, Shuang
Identification of the oligomerization interface in the transmembrane domain of HIV-1 Vpu 359
Watson, Tara Marie
A place to smoke too: Identifying challenges for the design of supervised consumption sites (SCSs) for crack smokers 148
Weaver, James
Enhancing Access to Harm Reduction Mental Health Care and Treatment: An HIV Prevention Strategy for High Risk Substance
Users
Whelan, Michael
Investigation of an increase in infectious syphilis cases in Ontario, 2009 174
Wilkins, Annette
HIV and Aging – An Emerging Landscape for Consideration and Care 155
Willer, David
A self-boosting cytomegalovirus (CMV) vector in the development of a protective human immunodeficiency virus (HIV) vaccine 364
Endogenous Retroviral Element (ERV) Antigens: Immunological Targeting of HIV-Infected Cells 368
Wilson, Michael
Mobilizing Evidence at the Front Lines: Improving HIV/AIDS Policy and Care in Canada 342
Winkler, Chris
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Wobeser, Wendy
Gender and ethnicity differences in body change and distress of HIV-positive individuals taking antiretroviral therapy in Ontario 129
Regulation of IL-23 Induced Signaling and Receptor Expression in Human CD4 T Cells Isolated from HIV Positive Patients 346
The Effect of HIV Infection on Expression Levels of the Interleukin-27 Heterodimeric Cytokine and Receptor. 350
A comparison of antiretroviral treatment uptake in HIV patients that are Canadian-born and those born outside Canada 376
Wolfert, Stephanie
Optimizing Prenatal HIV Testing in Ontario 311
Wong, Joanna
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIVpositive
Individuals
Wong, Josephine
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Wong, Keith
PHALEARNING.ORG: A PHA centered tool to advance coordination and accreditation of community capacity building 207
“Can We Talk”: a multi-sectoral collaborative innovative training program to facilitate empowered PHA/health provider
207
communication
Wong, Mee Lian
Canadian students following up on an HIV/AIDS "primary intervention" program in Cambodia (2006-2009). 166
Wong, Raymond
Clk SR Protein Kinases and Drugs Modulating Alternative Splicing Demonstrate Potent Inhibition of HIV-1 Viral Replication 136
Different roles of hnRNP D isoforms in modulating HIV-1 gene expression 362
Woodruff, Ian
Capturing conversations: Implementing a comprehensive service reporting system for MSM Bathhouse Outreach 159
Woolaway, Kathryn
Different roles of hnRNP D isoforms in modulating HIV-1 gene expression 362
Worthington, Catherine
Peer Investigator experiences in a community based research study: expression through creative projects. 303
Enhancing Labour Force Participation for People Living with HIV in Canada: Scoping Review Results 326
Interprofessional mentorship as a means to build capacity among rehabilitation professionals and people living with HIV in
Ontario.
Wyler, Marilyn
104
118
207
335

Migrant Farm Workers in Ontario: Health and HIV 143
X
Xu, Lei
Understanding the Epidemic and Strengthening Prevention Efforts in China: Condoms Use and Knowledge among Migrants in
165
Shanghai
Xu, Yang
HIV-1 increases non-LTR associated long interspersed element 1 expression by retrotransposition 363
Y
Yang, Meixia
Understanding the Epidemic and Strengthening Prevention Efforts in China: Condoms Use and Knowledge among Migrants in
Shanghai
Yao, Xiao-Dan
Trappin-2/Elafin is Associated with Antiviral Activity and Reduced Production of Pro-Inflammatory Factors in Human Genital
Epithelial Cells
Yee, Jessica
Unpacking the links between HIV and colonization using Hip Hop: Lessons from Taking Action with Aboriginal Youth 203
Yi, Tae-Joon
Impact of Long-Term Highly Active Antiretroviral Therapy (ART) on CD4+ T Regulatory and TH17 cells in the Blood and
Sigmoid Colon.
Young, Charlene
Interleukin-4 downregulates CD127 expression on human thymocytes and mature CD8+ T-cells 121
In vitro HIV Infection Results in Impaired IL-7 Signaling in Primary Human Thymocytes. 356
Youth Interviewers
Predictors of HIV testing among street-involved and homeless youth in Hamilton, Ontario: The Safe n’ Sexy Project results. 138
Youth Warriors
HIV/AIDS and Aboriginal Youth: An Arts-based Knowledge Transfer Strategy for HIV Prevention Education 203
Yu, Monica
HIV induces a unique cytokine profile with delayed interferon alpha production in plasmacytoid dendritic cells 351
Yudin, Mark
Mandatory prenatal HIV testing and the Opt-in vs Opt-out debate: African/Caribbean women diagnosed with HIV during
pregnancy weigh in…
“Nobody tell me and I don’t ask” –The experiences of African/Caribbean Black Muslim women with prenatal HIV testing in
317
Ontario
A Multi-disciplinary Approach to the Development of Canadian Evidence-Based Guidelines on Safe Pregnancy Planning for HIVpositive
Individuals
118
Yue, Feng Yun
The Adjuvancy of OX40 Ligand (CD252) on an HIV-1 Canarypox Vaccine 367
165
150
130
173
Z
Zack, Elisse
HIV and Aging – An Emerging Landscape for Consideration and Care 155
Enhancing Labour Force Participation for People Living with HIV in Canada: Scoping Review Results 326
Interprofessional mentorship as a means to build capacity among rehabilitation professionals and people living with HIV in
335
Ontario.
Zastre, Jason
Uptake of atazanavir (ATZ) is susceptible to inhibition by antiretroviral drugs in Caco-2 cells, a model of human intestinal
374
epithelium
Zhang, Wendy
Predictors of Emergency Department use by individuals on HAART 160
Zhang, Xiubo
Regulation of IL-23 Induced Signaling and Receptor Expression in Human CD4 T Cells Isolated from HIV Positive Patients 346
Zhou, Rachel
Community Engagement Strategy to involve ethno-racial faith-based, media and social justice leaders to address HIV stigma and
discrimination
Coming Out in Research: training to facilitate effective disclosure of PHA researchers working within their own ethno-racial
207
communities: lessons learnt from the CAAT Mobilizing Ethno-racial Leaders Study
Living in "transnational spaces": An exploration of the influence of the home country on the HIV risk facing recent Chinese
144
immigrants in Canada
Zuniga-Pflucker, Juan Carlos
Rebuilding Health: One T-Cell at a Time 410
207