Grant: CIHR New Investigator

HIV is a major public health problem. Since the start of the HIV epidemic, there have been over 30 million people infected with HIV and 30 million related deaths. In Canada, 71,000 people are estimated to be living with HIV. My research aims to identify and respond to gaps in the HIV prevention and treatment continuum, using a Program Science framework. Although developing and developed countries are different, the underlying drivers of the HIV epidemics are similar, as are the vulnerabilities faced by marginalized populations. As well, lessons learned in either setting can benefit each other. I have three central projects in my research agenda: Study 1 aims to understand the HIV risk and vulnerability faced by young women as they transition into sex work in Kenya, Ukraine and India. Female sex workers (FSWs) experience a much higher risk of HIV than the general population, and programs targeted to FSWs are a critical component of HIV prevention. The goal of this research is to estimate HIV risk, and characterize the behaviours that influence this risk, during the transition period from first sex until self-declared entry into sex work and during the early period of sex work. The findings will contribute significantly to our understanding of HIV risk and will inform the strategic design of HIV prevention programs. Studies 2 and 3 of my research plan focus on HIV care outcomes. These studies establish cohorts and use a combination of clinical and provincial health care data in Manitoba. Study 2 aims to identify where there have been missed opportunities for earlier diagnosis of HIV. This will identify where to expand testing options in order to ensure earlier diagnosis and linkage to care. Study 3 builds on this with the development of a prospective cohort of HIV positive persons across Canada to understand health care patterns and explore models of HIV care. Through these cohorts, we will better understand the health care needs of this vulnerable population.