Background: People who use drugs (PWUD) have an elevated risk of acquiring sexually transmitted and blood-borne infections (HIV, HCV, and syphilis) yet often face barriers to routine testing. In this study, we characterized recent STBBI testing behaviours and assessed self-reported barriers and facilitators among a cohort of PWUD in Vancouver.
Methods: This analysis utilizes data from the longitudinal Health Connect study in the Downtown Eastside of Vancouver, BC. Health Connect participants are 19 years and older and clients of a supervised consumption site (SCS). For this analysis, we utilize baseline and 1-month follow-up data collected between January-November 2024. A logistical regression model was used to characterize STBBI testing practices in the previous 12-months (p12m) and we provide descriptive statistics on self-reported barriers and facilitators to testing.
Results: Among 299 study participants, 116 (39%) were women and the median age was 41 (34-48). Among 277 participants with available data, 133 (48%) had received an STBBI test in the p12m. Sexual activity in the p12m (aOR 2.05, 95% CI (1.22, 3.44) and frequent use of an SCS in the previous three months (aOR 2.25, 95% CI (1.05,4.84) were associated with receipt of STBBI testing in the p12m. Odds of STBBI testing did not vary by age, gender or housing status. Facilitators to STBBI testing included identifying this as a health priority (53%), just wanting to know their status (54%), and worries around onward transmission (29%). Reported barriers to STBBI testing included a fear of invasive procedures (11%), having no perceived risk (9%), and judgement/stigma (6%).
Conclusion: Half of our cohort had engaged in STBBI testing in the p12m. Factors associated with testing included more frequent SCS use and sexual activity. This study underscores the need to develop and implement low barrier models for STBBI testing in supervised consumption sites.

Background:
Women represent 33% of new HIV diagnoses in Canada, yet only 2% have accessed PrEP. Persistent social and systemic barriers limit their access to HIV-related care, with critical evidence gaps in HIV testing and prevention. The I’m Ready digital program offers low-barrier HIV self-testing (HIVST) while generating essential evidence on women’s first-time testing and PrEP awareness in Canada.

Methods:
Participants accessed the I’m Ready mobile app to order HIVST and completed a pre-test survey. We assessed demographics, testing history, HIV positive results, and PrEP awareness among women participants. Chi-square tests compared first-time cis-women testers with those who had previously tested.

Results:
Between June 2021 and October 2025, 14,904 individuals ordered HIVST, of which 3,768 were women. Majority of women participants were cis-women (96%), under age 30 (54%), heterosexual (66%), from racialized communities (58%) and urban residents (68%); 40% were first-time testers. There were significant differences among cis-women first-time testers and those who had previously tested by age, location and race (p < 0.01), with higher proportion of first-time testers among youth, rural and Asian cis-women. 24% of women submitted results through the app, with a 1.9% positivity rate, compared to the program’s overall 1.7% positivity rate. Over half of women who tested positive were first-time testers. Among 70% women at high HIV risk (due to sexual behavior or injection drug use), one-third were first-time testers. Although nearly half were aware of PrEP, only 6% reported ever using it. PrEP awareness was lower among younger (<25), rural, heterosexual, and racialized women.

Conclusion:
This digital, low-barrier HIVST program revealed significant unmet testing and prevention needs among underserved and racialized women, while successfully reaching first-time testers, high-risk, and women with undiagnosed HIV. This actionable evidence can inform more responsive HIV programming to strengthen HIV testing and prevention for women in Canada.

Background: ReportNeedles.ca is a community-driven initiative addressing alarming HIV, syphilis, hepatitis C, and overdose rates in Saskatchewan. Geographic service gaps limit equitable access to prevention and care. Given the decentralized nature of substance use, geospatial tools can identify areas of concentrated need and inform responsive harm-reduction deployment. This study examines four years of needle-report data to assess evolving hotspot patterns and emerging service gaps relevant to AIDS Programs South Saskatchewan (APSS).

Methods: Geospatial data from all needle reports submitted in Regina between April 2021 and September 2025 were analyzed using ArcGIS. Reports were mapped to assess spatial clustering and seasonal variation. Walk-time buffers were applied to evaluate the reach of APSS and HIV services. Spatiotemporal trends were visualized to identify changes in geographic distribution.

Results: A total of 1,108 needle reports were submitted resulting in 40,688 discarded needles. Overall, 95.1% of submissions resulted in APSS successfully locating and discarding needles, indicating strong responsiveness to community submissions. Analyses revealed persistent clustering in downtown neighbourhoods, with seasonal and year-to-year variation. Several high-activity areas fell outside a 15-minute walking radius of existing services (See Figure 1), indicating geographic misalignment between need and service location. While APSS deployed pop-up services in high-need clusters, capacity to reach more dispersed areas was limited. These findings informed expanded mobile outreach and re-evaluate placement of pop-up services.

Conclusions: Integrating community-generated geospatial data with service-accessibility analysis supports responsive, targeted harm-reduction planning. This approach strengthens APSS’s ability to identify emerging hotspots, address service gaps, and optimize outreach in Regina.

Introduction: Awareness of the Undetectable equals Untransmittable (U=U) message is crucial in improving well-being of People Living with HIV. U=U awareness has been assessed among gay, bisexual, and other men who have sex with men, but little is known among other groups living with HIV. We sought to establish the prevalence of U=U awareness and knowledge in British Columbia and associated sociodemographic factors.

Methods: People Living with HIV ≥19 years were included from two ongoing community-based studies, BCC3 (2021-present) and ReEvaluating antiretroviral Drug cOncentrations and Side Effects (REDOSE; 2024-present). U=U awareness and knowledge were assessed by two questions: “Have you heard of U=U?” and “How do you think taking antiretrovirals change your risk of transmitting HIV?”, with “makes transmission a lot lower” considered full knowledge. Logistic regression was conducted to examine factors associated with awareness and knowledge.

Results: Among 474 participants (56% cis women, average age 49 years), the overall prevalence of U=U awareness and knowledge was 76.8% and 89.0%, respectively. In bivariate analysis, both U=U awareness and knowledge were lower among individuals identifying as Indigenous or heterosexual, and among those with lower education and income (Table 1). Multivariate analysis showed that having ≥high-school education and ≥$20,000 household income were associated with higher odds of U=U awareness (adjusted odds ratio (aOR)=2.68[1.29-5.58]; 2.14[1.18-3.89], respectively) and knowledge (aOR=2.68[1.15-6.23]; 2.05[0.99-4.29], respectively).

Conclusion: Despite high prevalence, important gaps in U=U awareness and knowledge persist among subgroups of People Living with HIV. Accessible and culturally appropriate knowledge mobilization efforts are needed in low barrier settings.

Background: New HIV diagnosis are on the increase in Black communities in Canada. Effective tools to prevent HIV infection exist but awareness, acceptance and uptake is low among Black communities. To address this gap, we developed an intervention to increase the awareness, acceptance and uptake of HIV prevention tools among Black communities in Ontario. We present a description of the model and preliminary outcomes from the ongoing effectiveness-implementation study.
Method: Using the self-determination theory and behavioral change wheel framework, we co-developed a culturally responsive, theory-informed HIV prevention model -Safe Steps Program (SSP)- with Black-led community agencies in Toronto – BLACK CAP, TAIBU CHC and APAA to increase the awareness, acceptance and uptake of HIV prevention tools . The model consists of four components: outreach strategy to reach at-risk individuals; HIV awareness and risk perception tool to increase HIV risk perception; HIV pre-exposure prophylaxis decision support tool to improve quality decision-making regarding PrEP, and a care coordination system to facilitate linkage to clinical care and social determinants of health services. HIV service providers were trained to deliver the intervention. To evaluate the impact of the model, we designed an effectiveness-implementation hybrid type 2 study using a post-test-only design. Data collection for the implementation study began in November 2025.
Result: To date, 35 Black participants have been engaged through group-based interventions. Among participants reached, the majority (65.4%;19/29) identify as gay, lesbian, queer or bisexual, and were mostly women (56.7%;17/30) or men (40%;12/30). Approximately30.2% (10/33) of participants reported a preference for regular use of a condom or PrEP alone or PrEP plus condom use for HIV prevention. One in three participants (28% -7/25) indicated interest in starting PrEP.
Conclusion: Study findings indicate that a culturally responsive, theory-informed model could potentially enhance acceptance and adoption of HIV prevention tools within Black communities in Ontario.