The results of the CIHR Fall 2023 Project Grant Competition have just been announced. CTN Investigators are leading thirteen of the projects funded in this round, including seven projects under this competition’s Priority Announcement. An additional fourteen projects are being supported by CTN Investigators as co-investigators.
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Our Health: A community-based participatory study of sexual and reproductive health of Two-Spirit and LGBTQQIA+ people across Canada
Indigenous Two-Spirit and all Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex, Asexual and other sexual and gender minoritized people (2S/LGBTQQIA+) have been overlooked in mainstream sexual and reproductive health research. Using a participatory epidemiology approach nationwide, CTN Investigator Dr. Nathan Lachowsky is co-leading a project aiming to fill knowledge gaps related to limited surveillance information on sexual and reproductive health among 2S/LGBTQQIA+ communities in Canada.
Innovation in health services in response to a rapidly changing illicit drug toxicity crisis in BC: Investigating the role of supervised inhalation sites and novel harm reduction interventions
Despite the success of Overdose Prevention Sites and Supervised Consumption Sites in providing safe and supportive spaces for people who inject drugs, reducing the risks of fatal overdoses, they lack provisions for those who smoke drugs. This is significant because, unfortunately, the majority of overdose deaths in B.C. in 2023 were due to smoking drugs and there is little knowledge about supervised inhalation services. CTN Investigators Drs. Kate Salters and Julio Montaner are co-PIs for a project investigating the role of supervised inhalation sites and novel harm reduction interventions to learn how to best respond to the overdose crisis across Canada. CTN Postdoctoral Fellow Dr. Katherine Kooij is a co-investigator for this project.
Crystal methamphetamine use and its associations with sexually transmitted infections among GBM: Identifying modifiable treatment targets
There has been an increase in the use of crystal methamphetamine (CM) use among gay, bisexual, and other men who have sex with men (GBM), with evidence showing that using CM is linked to bacterial sexually transmitted infections (STIs). CTN Investigators Drs. Trevor Hart and Ann Burchell, supported by co-investigators Drs. Darrell Tan, David Brennan, Daniel Grace, David Moore, Shayna Skakoon-Sparling, and Jeffrey Wardell, are co-leading this multiphase biopsychosocial study to examine the relationship between CM use and bacterial STIs, as well as explore promising interventions to address the CM use and STI syndemics in the GBM population.
Identifying immune markers of HPV viral clearance
The human papilloma virus (HPV), which causes nearly all cases of cervical cancer, is the most common sexually transmitted disease worldwide, with 80% of the total population acquiring an HPV infection at least once in their lifetime. Approximately half of HPV infections can be cleared by the body within 6–12 months. A project co-led by CTN Investigators Drs. Keith Fowke and Julie Lajoie are looking to study different immune cells to understand and identify markers of natural HPV clearance. This research aims to understand the blood and tissue immune environment among women who clear HPV infection in the presence or absence of HIV co-infection.
Disentangling medicinal and recreational cannabis use among young adults
Roughly 1 in 4 young adults who use cannabis report doing so to self-medicate physical and mental health symptoms; however, most young adults who use cannabis for medicinal reasons also engage in recreational cannabis use. As a result, behaviours and outcomes specific to medicinal cannabis use in young adults remain poorly understood. CTN Investigator Dr. Jeffrey Wardell is leading a project aiming to disentangle medicinal and recreational cannabis use among young adults to better inform ongoing developments in cannabis-related policies in Canada and will also inform interventions designed to support young adults who use cannabis for medicinal reasons.
Identifying the effects of the anti-homosexuality act on HIV prevention and care outcomes among gay, bisexual and other men who have sex with men in Uganda
Knowledge gaps remain regarding the immediate effects of criminalization of gay, bisexual and other men who have sex with men (gbMSM) on HIV prevention (testing, PrEP) and care (viral suppression) outcomes. CTN Investigators Drs. Carmen Logie and Lawrence Mbuagbaw are co-leading an innovative prospective longitudinal mixed-methods study based in Uganda, where an Anti-Homosexuality Act was passed in May 2023, to document the immediate and long-term effects on HIV prevention and care with gbMSM. This study will create novel knowledge of mechanistic pathways from criminalization of same sex practices to gbMSM HIV prevention and care outcomes with actionable findings to inform policy and practice.
Examining pathways from extreme weather events to HIV prevention outcomes among gay, bisexual, and other men who have sex with men in climate-affected regions in Kenya
Knowledge gaps persist regarding how extreme weather events impact HIV prevention outcomes with gay, bisexual, and other men who have sex with men (gbMSM) in high HIV prevalence and climate-affected contexts. CTN Investigators Drs. Carmen Logie and Lawrence Mbuagbaw are co-leading a 3-year mixed-methods study collaborating with community-based agencies and clinics engaged in HIV prevention with gbMSM in Kenya. This research aims to create new knowledge of pathways and mechanisms through which climate change-related factors shape HIV prevention needs among gbMSM in HIV and climate-affected regions.
Optimizing the vaginal microbiome in African, Caribbean and other Black women from Toronto, Canada: defining clinical endpoints and community priorities
An overly diverse vaginal microbiome, defined as Bacterial Vaginosis (BV), can cause increased inflammation and an enhanced risk of HIV/STIs, premature birth, and other adverse reproductive health outcomes. While BV is more common among African, Caribbean and other Black (ACB) women, not all ACB women with BV have vaginal inflammation and not all may need treatment. In this Priority Announcement: Intersectionality in Sex, Gender and Health Research project, CTN Investigator Dr. Rupert Kaul, with co-investigators Drs. Wangari Tharao and Mark Yudin, will evaluate vaginal health symptoms and community acceptability of future vaginal interventions. This group will also evaluate the microbiome for presence of inflammation to correlate with an in-depth assessment of vaginal and sexual symptoms.
Identification of aryl hydrocarbon receptor as a novel druggable modulator of HIV-1 latency
The major barrier to HIV-1 cure is the persistence of viral reservoirs in long-lived immune cells, necessitating life-long treatment in people living with HIV. Understanding molecular mechanisms of HIV transcription and latency is key for achieving HIV remission and eradication. HIV replication is regulated by transcription factors, including the recently identified aryl hydrocarbon receptor (AhR) which inhibits HIV replication in CD4+ T cells. In this Priority Announcement: Infection and Immunity project, CTN Investigator Dr. Petronela Ancuta, with co-investigators Drs. Éric Cohen and Jean-Pierre Routy, aims to uncover the mechanisms of action of AhR in immune cells targeted by HIV-1 for infection and persistence.
Dolutegravir, impaired vascular remodelling, and hypertension in pregnancy
Dolutegravir is an HIV antiviral druge that is widely used by pregnant women, where it is well tolerated and highly effective. However, it has been associated with certain side effects in pregnancy, including weight gain and hypertension. In this Priority Announcement: HIV/AIDS and STBBI project, CTN Investigator Dr. Lena Serghides will examine whether dolutegravir affects the blood vessels in the mother, the placenta, and the fetus. This project will also examine if changes observed in the blood vessels correlate with the mom developing hypertension in pregnancy or later in life.
Interplay between IL-17-producing pulmonary mucosal tissue-resident memory T-cells (Trm) and regulatory T-cells (Tregs) in HIV/SIV infections: impact on the lungs inflammation
Increases in inflammatory CD8 T-cells in the lungs may partially explain why people living with HIV are more susceptible to chronic lung diseases compared to those who are HIV-negative. T-regulatory cells (Tregs) suppress the immune response to prevent excessive reactions and prior research has shown abnormalities in the molecules regulating Tregs in the lungs in people with chronic inflammatory diseases like HIV. In this Priority Announcement: HIV/AIDS and STBBI project, CTN Investigator Dr. Mohammed Ali-Jenabian is leading a team, supported by co-investigators Drs. Cecilia Costiniuk and Madeleine Durand, that will examine the immunological functions and regulation of lung CD8 T-cells by Tregs, as well as their relationship with the microorganisms that live in the lungs in people living with HIV.
Feasibility of AnkaSmart!: a wearable-based innovation to improve sexual and reproductive health of young adult populations in India
Widespread misconceptions and misinformation regarding sexual and reproductive health persist among young populations, posing risks that could be mitigated through evidence-based education and care. Without these interventions, young people may face unfavourable reproductive health problems including sexually transmitted infections, pelvic inflammatory disease, and infertility. AnkaSmart!, a connected digital platform involving a wearable device, mobile application, and website, facilitates education, health tracking, and connection to health care for menstruators, allowing them to make informed, proactive decisions about their sexual, menstrual, and reproductive health. In this Priority Announcement: HIV/AIDS and STBBI project, co-led by CTN Investigator Dr. Nitika Pai, AnkaSmart! will be offered to cis-gender women and gender diverse people in India, who will use it over a period of six months to track their sexual and reproductive health while seeking evidence-based education through the platform and connecting to care when necessary.
Investigating the genomic epidemiology, transmission, and infectivity of the non-influenza respiratory viruses
Respiratory viruses are a significant cause of morbidity and mortality and a burden to the health care system, as demonstrated by the COVID-19 pandemic. However, the pandemic also highlighted the potential of molecular testing and sequencing to advance the understanding of respiratory viruses. In this Priority Announcement: Pandemic Preparedness and Health Emergencies Research project, CTN Investigator Dr. Robert Kozak, supported by co-investigator Dr. Mia Biondi, aims to develop tools for identifying and characterizing non-influenza respiratory viruses in circulation in different patient groups in addition to collecting real-world data on transmission and infectivity in hospital settings.
Infant and child health outcomes following SARS-CoV-2 infection in pregnancy
New data suggest that there may be lasting effects of COVID-19 infection in pregnancy on both mothers and their children, however, these data come from small studies that lack detailed information on the timing of COVID-19 diagnoses in pregnancy and the presence or severity of symptoms. This Priority Announcement: Prevention/Response to Covid-19/Similar Future Pandemics project, co-led by CTN Investigator Dr. Jason Brophy and supported by co-investigator Dr. Bill Cameron, will investigate the association between COVID-19 infection in pregnancy and the child’s risk of hospitalization, emergency department visits, and immune-related health care use. The association between COVID-19 infection in pregnancy and child risk of hearing and sight deficits, speech and language delays, and neurodevelopmental disorders will also be assessed.
An international repository of individual patient data to predict development of chronic post-surgical pain after knee replacement surgery
Approximately one in four patients who have surgery to replace their knee joint report chronic postoperative pain at 3–24 months after surgery. Despite the prevalence, the factors causing this chronic pain are not understood, however preliminary research suggests associations with biological, surgical, and psychosocial factors. CTN Investigator Dr. Lawrence Mbuagbaw is co-leading a project focused on developing a database of individual patient data from observational studies and randomized trials of patients undergoing knee replacement surgery. The objective is to assess perioperative predictors of chronic pain after surgery and develop a prediction model and risk assessment tool.
Projects supported by CTN Investigators
CTN Investigator Dr. Marissa Becker is a co-investigator in the development of the Manitoba STBBI Epidemiology Platform (MB-STEP) which aims to leverage epidemiology to transform public health responses to STBBIs.
CTN Investigators Drs. Sofia Bartlett, Kathleen Darling, and Kate Shannon are co-investigators in a qualitative study looking to gain a better understanding of how evolving criminal legal system approaches shape the relationships between substance use, violence, and HIV/AIDS trajectories in criminalized and marginalized women over time and to characterize how community-led interventions may mitigate the harms of criminalization.
CTN Investigator Dr. Richard Lester is a co-investigator on the ongoing Cedar Project, which has received funding to use the Strengthening Our Spirit Intervention for Indigenous peoples who use drugs in Vancouver, B.C.
CTN Investigators Drs. Mia Biondi and Giada Sebastiani are co-investigators for a study leveraging novel statistical methods to determine an optimal liver fibrosis screening strategy for people living with type 2 diabetes.
CTN Investigators Drs. Sarah Khan, Lehana Thabane, and Mark Smieja are co-investigators for a multicenter randomized control trial promoting optimal treatment for community-acquired pneumonia in emergency rooms.
CTN Investigator Dr. Lawrence Mbuagbaw is a co-investigator for a project developing a digital chronic pain recommendations map based on the consolidation and systematic appraisal of guideline recommendations regarding management of chronic pain.
CTN Investigator Dr. Julio Montaner is a co-investigator for a study evaluating accelerated lung aging in people living with HIV.
CTN Investigator Dr. Kellie Murphy is a co-investigator for a pilot trial to test whether induction of labour between 38- and 39-weeks’ gestation reduces the risk of adverse outcomes among people with gestational diabetes mellitus.
CTN Investigator Dr. Giada Sebastiani is a co-investigator for a project aiming to address inequity in liver transplantation by applying artificial intelligence to optimize waitlist prioritization.
CTN Investigator Dr. Lehana Thebane is a co-investigator for two projects. The first is a randomized controlled trial evaluating the metabolic adaptation to weight loss in response to a behavioural lifestyle program with or without semaglutide in adolescents with obesity. The second project evaluates participatory engagement of older adults in dementia prevention in rural African and Montreal contexts.
CTN Investigator Dr. Fiona Smaill is a co-investigator for a project investigating the mechanisms of disease progression in HIV/TB co-infection to design interventions for better clinical outcomes.
CTN Investigator Dr. Isabelle Boucoiran is a co-investigator for work which will conduct a Phase 1 study across Canada enrolling pregnant people on opioid agonist therapy and collect surveys from a web-based online platform, information from medical charts, genetic information from saliva, and opioid levels from blood samples and breastmilk, to better understand perinatal opioid exposures, trajectories, insights, and concentrations.
