Optimizing outcomes at critical points in the HIV care cascade
Summary
The health outcomes of people living with HIV are largely governed by the interplay of personal and systemic factors along the cascade of care that may lead to favorable or less favorable outcomes. This program of research seeks to fill knowledge gaps at critical points along the continuum of care that will inform policy and practice in Ontario, Canada: drug resistance testing, initiation of treatment, adherence to treatment and retention in care. Methodologies employed include a controlled interrupted time series, an overview of systematic reviews and a sequential explanatory mixed methods study.
Publications
1. Mbuagbaw L, Jhuti D, Zakaryan G, El-Kechen H, Rehman N, Youssef M, Garcia MC, Arora V, Zani B, Leenus A, Wu M and Makanjuola O. A Database of Randomized Trials on the HIV Care Cascade (CASCADE Database): Descriptive Study. JMIR Data 2022, 3(1):e36874.2. Mbuagbaw L, Logie CH, Thabane L, Smaill F, Smieja M, Burchell AN, Rachlis B, Tarride JE, Kroch A, Mazzulli T, Alvarez E, Lawson DO, Nguyen F, Perez R, Seow H.. The impact of routine HIV drug resistance testing in Ontario: A controlled interrupted time series study. PLOS ONE. 2021;16(4):e0246766.
3. Mbuagbaw L, Mertz D, Lawson DO, et al. Strategies to improve adherence to antiretroviral therapy and retention in care for people living with HIV in high-income countries: a protocol for an overview of systematic reviews. BMJ Open 2018; 8(9): e022982.
4. Mbuagbaw L, Hajizadeh A, Wang A, Mertz D, Lawson DO, Smieja M, Benoit AC, Alvarez E, Puchalski Ritchie L, Rachlis B, Logie C, Husbands W, Margolese S, Zani B, Thabane L: Overview of systematic reviews on strategies to improve treatment initiation, adherence to antiretroviral therapy and retention in care for people living with HIV: part 1. BMJ Open 2020, 10(9):e034793.
5. Mbuagbaw L, Jhuti D, Zakaryan G, El-Kechen H, Rehman N, Youssef M, Garcia MC, Arora V, Zani B, Leenus A, Wu M and Makanjuola O. A Database of Randomized Trials on the HIV Care Cascade (CASCADE Database): Descriptive Study. JMIR Data 2022, 3(1):e36874.
6. Rehman N, Wu M, Garcia C, Leenus A, El-Kechen H, Bhandari M, Zakaryan G, Zani B, Hajizadeh A, Wang A, Morassut RE, Bartoszko JJ, Makanjuola O, Jhuti D, Arora V, Kapoor A, Jones A, Djiadeu P, Mbuagbaw L. Measures of Retention in HIV Care: A Study Within a Review. AIDS Patient Care STDS. 2023 Apr;37(4):192-198.
Other knowledge translation products
CASCADE is a repository of clinical trials on the HIV care cascade (initiation of treatment, adherence to antiretroviral therapy and retention in care). The studies have been curated by income level, vulnerable population, who delivered the intervention, the setting in which it was delivered, the intervention type and the level of pragmatism of the intervention (i.e., how close it is to real-world care). You can use it to learn about interventions, create evidence maps, conduct methodological research, and conduct systematic reviews). You can access CASCADE here: https://hivcarecascade.com
Funding
The Ontario HIV Treatment Network (OHTN) grant number EFP-1096-Junior Inv., Constantine Douketis New Researcher Award of The Research Institute of St. Joe’s Hamilton
Developing guidelines for methodological studies
Summary
Studies that report on the design, analyses and reporting of research do not have any universally accepted nomenclature, classification or reporting guidance. This program of research will catalogue methodological studies, and seek consensus on nomenclature, classification, and reporting requirements. Methodologies include a scoping review and a mixed methods study.
Publications
1. Lawson DO, Leenus A, Mbuagbaw L. Mapping the nomenclature, methodology, and reporting of studies that review methods: a pilot methodological review. Pilot and Feasibility Studies 2020; 6(1): 13.2. Mbuagbaw L, Lawson DO, Puljak L, Allison DB, Thabane L. A tutorial on methodological studies: the what, when, how and why. BMC Medical Research Methodology 2020; 20(1): 226.
3. Lawson DO, Puljak L, Pieper D, Schandelmaier S, Collins GS, Brignardello-Petersen R, Moher D, Tugwell P, Welch VA, Samaan Z, Thombs BD, Nørskov AK, Jakobsen JC, Allison DB, Mayo-Wilson E, Young T, Chan A-W, Briel M, Guyatt GH, Thabane L, Mbuagbaw L: Reporting of methodological studies in health research: a protocol for the development of the MethodologIcal STudy reportIng Checklist (MISTIC). BMJ Open 2020, 10(12):e040478.
Funding
N/AThe A/C study
Summary
African, Caribbean, and Black (ACB) people experience a disproportionately incidence and prevalence of HIV in Ontario. The A/C study is a cross-sectional study of first and second generation ACB people in Toronto and Ottawa area, exploring HIV epidemiology and the factors associated with key outcomes (HIV infection, testing behaviours, knowledge about HIV transmission and acquisition, HIV vulnerability, access and use of health services). You can learn about the A/C study here : https://acstudy.ca
Publications
1. Etowa J, Tharao W, Mbuagbaw L, Baidoobonso S, Hyman I, Obiorah S, Aden M, Etowa EB, Gebremeskel A, Kihembo M, Nelson L and Husbands W. Community perspectives on addressing and responding to HIV-testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) among African, Caribbean and Black (ACB) people in Ontario, Canada. BMC Public Health 2022, 22(1):913.2. Mbuagbaw L, Tharao W, Husbands W, et al. A/C study protocol: a cross-sectional study of HIV epidemiology among African, Caribbean and Black people in Ontario. BMJ Open 2020; 10(7): e036259.
3. The A/C study community report: https://acstudy.ca/wp-content/uploads/2021/02/A_C_report2020.pdf
4. Mbuagbaw L, Husbands W, Baidoobonso S, Lawson DO, Aden M, Etowa J, Nelson L, Tharao WE. A cross-sectional investigation of HIV prevalence and risk factors among African, Caribbean and Black people in Ontario: The A/C Study. Can Commun Dis Rep 2022;48(10):429–37.
5. Husbands W, Lawson DO, Etowa EB, Mbuagbaw L, Baidoobonso S, Tharao W, Yaya S, Nelson LE, Aden M and Etowa J. Black Canadians’ Exposure to Everyday Racism: Implications for Health System Access and Health Promotion among Urban Black Communities. Journal of Urban Health 2022.
Funding
Ontario HIV Treatment Network (OHTN), Canadian Institutes for Health Research (CIHR)Developing guidelines for studies of drug resistance (CEDRIC-HIV)
Summary
Studies reporting the prevalence of HIV drug resistance are reporting inconsistently and incompletely. This hampers our ability to generalize, compare and interpret prevalence estimates. We will a sequential explanatory mixed methods design to develop a reporting checklist for studies reporting on HIV drug resistance: ChEcklist for studies of Drug ResIstanCe in HIV (CEDRIC-HIV).
Publications
1. Garcia C, Rehman N, Lawson DO, Djiadeu P, Mbuagbaw L. Developing Reporting Guidelines for Studies of HIV Drug Resistance Prevalence: Protocol for a Mixed Methods Study. JMIR Res Protoc. 2022 May 13;11(5):e35969.2. Mbuagbaw L, Garcia C, Brenner B, Cecchini D, Chakroun M, Djiadeu P, Holguin A, Mor O, Parkin N, Santoro MM, Ávila-Ríos S, Fokam J, Phillips A, Shafer RW, Jordan MR: Checklist for studies of HIV drug resistance prevalence or incidence: rationale and recommended use. The Lancet HIV 2023; 10(10): e684 - e689.
Funding
N/A
Other knowledge translation products
The CEDRIC-HIV website hosts information about the checklist, related publications and translations (French, Spanish, Italian, Portuguese, Chinese). It can be accessed here: http://cedric-hiv.comThe HIV Case Management Acuity Assessment Tool (HICMAAT)
Summary
Many African, Caribbean, and Black (ACB) people living with HIV in Canada are not adequately engaged in care. This is in part due to limited access to care, systemic barriers, and poor knowledge on how to engage them in the care cascade. Intensive case management is a service that provides care to individuals based on their medical and non-medical needs. It has been shown to help address many problems that affect the care cascade for marginalized populations by considering demographic, social and contextual factors. There are no tools designed to determine how much case management is needed for ACB people in Ontario. We are going to develop a tool; the HIV Case Management Acuity Assessment Tool (HICMAAT) identify and categorize case management needs among ACB people living with HIV in Ontario.
Publications
N/A
Funding
The Ontario HIV Treatment Network (OHTN) Breaking New Grounds Award (EFP-1130-BNG)Cameroon Health Research and Evidence Database (CAMHRED)
Summary
To optimize and promote the use of locally generated evidence on health we developed the CAMHRED database, a centralized database of health research from Cameroon published since 1999. This local evidence mapping, and gap analysis can contribute to improving national research production and use in decision-making. You can access CAMHRED here: http://camhred.org/
Publications
Ongolo-Zogo C, El-Khechen H, Morfaw F, Djiadjeu P, Zani B, Darzi A, Nji PW, Nyambi A, Youta A, Zaman F, Youmbi CT, Siani IN, Mbuagbaw L: The Cameroon Health Research and Evidence Database (CAMHRED): tools and methods for local evidence mapping. Health Research Policy and Systems 2023, 21(1):58.