Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada - January 28 - January 29, 2010 - Toronto, Ontario

Public Record of Meeting

Present:

Ministerial Advisory Council: Brian Conway (Co-Chair), John Plater (Co-Chair), Jonathan Angel, Monique Doolittle-Romas, Jacqueline Gahagan, Faye Katzman, Ken Monteith, Gerry Mugford, Anita Rachlis, Sheena Sargeant and Edith Wambayi.

Regrets: Michelle George, Frank McGee, David Nelson and Grafton Spooner.

Public Health Agency of Canada (PHAC): David Kerr, Program Consultant, External and Government Relations Section; Patricia Hurd, Senior Policy Analyst HIV/AIDS Policy, Coordination and Programs Division; and Susan Maves, Committee Coordinator, HIV/AIDS Policy, Coordination and Programs Division, PHAC.

Facilitation and Note Taking: Doug Bateson and Diane Finkle-Perazzo.

Guests: Dr. Chris Archibald, Director, HIV/AIDS Surveillance and Risk Assessment Division, PHAC, Ottawa; Richard Elliott, LLB, LLM, Canadian HIV/AIDS Legal Network, Toronto; Marc-André Gaudreau, Manager, Program Development and Evidence-Based Intervention, PHAC, Ottawa; Jessica Halverson, Manager, Surveillance and Risk Assessment Division, PHAC, Ottawa; Gillian Kolla, Research Assistant, Centre for Addiction and Mental Health (CAMH), Toronto; Dr. Alan Li, Program Director, Regent Park Community Health Centre, Toronto; Stephanie Mehta, Senior Policy Analyst, Accountability and Awareness Section, PHAC, Ottawa; Maureen Owino, Program Coordinator, Regent Park Community Health Centre, Toronto; Dr. Carol Strike, Centre for Addiction and Mental Health (CAMH), Toronto; Donald Wong, Senior Planning and Financial Analyst, Resource Management and Analysis Division, PHAC, Ottawa; and Qiuying Yang, Senior Epidemiologist, Surveillance and Risk Assessment Division, PHAC, Ottawa.

1. Welcome

Brian Conway and John Plater, Co-Chairs, welcomed the Members and thanked them for their work since the last meeting. The Meeting Agenda was approved with a minor modification.

2. September 30-October 2, 2009, Meeting Reports

The Ministerial Advisory Council on the Federal Initiative to Address HIV/AIDS in Canada approved the Record of Decision and the Public Record of Meeting from its meeting held in Ottawa September 30-October 2, 2009, with minor amendments.

3. Immigrants, Refugees and Non-Status PHAs: Complex Challenges and Innovative Strategies

Dr. Alan Li, Program Director and Maureen Owino, Program Coordinator, of Regent Park Community Health Centre in Toronto provided a presentation that focused on the key challenges affecting immigrants, refugees and non-status PHAs. They identified a number of key policy, program and service gaps as well as gaps in capacity building and research for these target groups.

Council Members agreed this discussion was timely given the recent earthquake in Haiti, which could result in an increase of immigrants with HIV arriving in Canada. This will inform Council’s ongoing interest in the plight of HIV positive people coming to Canada.

4. Federal Initiative to Address HIV/AIDS in Canada Financial Update

Stephanie Mehta, Senior Policy Analyst, Accountability and Awareness Section and Donald Wong, Senior Planning and Financial Analyst, Resource Management and Analysis Division, PHAC joined the meeting and presented a financial update regarding actual spending in 2008 – 2009 based on year-end information and results for Federal Initiative to Address HIV/AIDS in Canada. Members of Council stressed the need for timely reporting and discussed a schedule for reporting during the coming year.

5. Legal Issues Related to HIV Non-Disclosure: Legal Developments and Community Responses

Richard Elliott, Executive Director of the Canadian HIV/AIDS Legal Network, joined the meeting and provided an update on legal issues related to HIV non-disclosure. Mr. Elliott provided an update on the number of documented criminal prosecutions for HIV non-disclosure and the impact of the 1998 Supreme Court decision that PHAs have a duty to disclose their HIV positive status. He discussed the relationship between criminal and public health law and pointed out that there is virtually no (systematically reported) evidence about how these laws can reduce HIV risk behaviours. There has been very little public policy debate about Canada’s legal approach to HIV non-disclosure.

Council members stressed the need for more research; especially regarding the over represented communities that appear to be most involved in this issue. They also considered the importance of a numerical threshold of risk and the lack of awareness about protection against HIV. They acknowledged the concern that legal issues related to HIV non-disclosure may deter individuals from being tested for HIV. Council decided to review the Canada Communicable Diseases Report: Volume 31, Number 5, 1 March 2005: “Persons Who Fail to Disclose Their HIV Status: Conclusions Reached by an Expert Working Group” at an upcoming meeting to explore the public health approach to the issue.

6. Harm Reduction Report

Council discussed the proposal for the harm reduction report in order to provide evidence-informed advice to the Minister. Council stressed the importance of including a definition and examples of harm reduction that extended beyond the use of illicit drugs.

7. Update on AIDS 2010 Vienna

Patricia Hurd, Senior Policy Analyst, HIV/AIDS Policy, Coordination and Programs Division, PHAC provided an update on planning for the AIDS 2010 Conference which will take place from July 18 to 23, 2010 in Vienna, Austria. Council Members discussed a variety of possible involvements including participating in the Canada Booth and the submission of an abstract. They also stressed the importance of providing scholarships through the appropriate means and considered possible activities for the Minister of Health during the Conference.

8. Report from the Foresight Document Committee

Gerry Mugford provided a report regarding the activities of the Foresight Document Committee. Several meetings of the committee have taken place and an agreement has been developed for planning meetings that will precede the June and October Council meetings. A statement of work is being prepared that will outline the expectations of possible consultants and it is hoped that a Request for Proposal (RFP) will be sent out in July, 2010.

9. Grants and Contributions Process

Marc-André Gaudreau, Manager, Program Development and Evidence Based Interventions, PHAC, joined the Council meeting via teleconference to discuss the study of the Federal Initiative’s PHAC Funding Programs Structure. It aims to ensure that the funding programs remain aligned with PHAC’s public health goals, and are relevant to the needs of the HIV/AIDS community, populations most affected by HIV, as well as PHAs. An RFP to hire a third-party firm has been posted on MERX and bids are currently being assessed.

Stakeholder consultations will be a critical part of the work and should take place during the fall of 2010 with results expected in 2011. PHAC is looking forward to engaging its partners and stakeholders and will keep Council informed as plans are finalized.

10. HIV/AIDS Surveillance Data through 2008 and Estimates of HIV Prevalence and Incidence in Canada 2008

Dr. Chris Archibald, Director; Jessica Halverson, Manager, HIV/AIDS Surveillance; and Qiuying Yang, Senior Epidemiologist Surveillance and Risk Assessment Division, PHAC joined the meeting and provided information about HIV/AIDS Surveillance Data through 2008 and Estimates of HIV Prevalence and Incidence in Canada, 2008.

Following their presentation, Council discussed issues related to data limitations and it was suggested that ethnicity data be compared with actual ethnicity figures for each province where that data is available. The estimates data indicates that there is a need for outreach to younger users and those who do not use needle exchange programs. It is also important that individuals are tested frequently if they are at risk. There are serious challenges in getting the message out and the data speaks to the importance of prevention in order to decrease the incidence of HIV in Canada.

11. Report from the Research Committee

Jonathan Angel reported on his attendance at a Canadian Institutes of Health Research HIV/AIDS Research Advisory Committee (CHARAC) meeting and the development of a national research inventory for HIV/AIDS.

12. Meeting Wrap Up, Summary and Adjournment

The Co-Chairs thanked Council Members and the Secretariat for their hard work and dedication.