Testing, Reaching the Undiagnosed and Linkages to Care: "REACHing" for Impact

Rates of sexually transmitted and bloodborne infections (STBBI) are on the rise in Canada. Hepatitis C virus and syphilis are curable, and HIV is treatable. Most concerning, 44% of those with HCV and 16% with HIV infection are not diagnosed. This represents 9,090 individuals with HIV who are unaware, whom account for over half of new HIV infections. Testing is the entry point to care and treatment, and a required element of any elimination strategy. Current testing options have failed to reach many marginalized Canadians. The major aim of this CIHR Team in "REACHing" for Impact will be to bring together national leadership network of interdisciplinary experts. This includes biomedical scientists and clinical investigators, public health practitioners, policy-makers, industry partners, and community-based organizations. Our innovative research will address major "knowledge to action" gaps in testing, reaching the undiagnosed, and linkages to care. We propose five complementary biomedical and clinical/public health implementation and evaluation research projects: 1) accuracy, usability and acceptance of INSTI and OraQuick HIV self-tests, and validation for HCV and other tests; 2) HIV self-testing strategies in clinic and community-based settings using innovative App technology; 3) dried blood spot testing with Indigenous communities and gbMSM through targeted scale-out, peer linkage to biomedical prevention, and self-testing at home; 4) community-based intervention with peers to diversify HIV testing for gbMSM and ACB; and 5) pharmacy-based STBBI testing through integration with existing infrastructure. Our team is focused on new STBBI testing being available, accessible and implemented, specifically for hard-to-reach priority populations. We will formalize linkage to care to improve biomedical and clinical prevention/public health impacts. Through this team grant, we can significantly reduce, and eventually eliminate, the burden and impact of STBBIs on Canadians.