Background
Manitoba continues to experience high—and recently increasing—rates of HIV and sexually transmitted and blood-borne infections (STBBIs), driven by intersecting structural factors including substance use, housing instability, geographic inequities, stigma, and colonial systems. In response, the Manitoba HIV-STBBI Collective Impact Network (CINetwork) was established in 2016 to strengthen system coordination, community-based research, innovation, and cross-sector collaboration. This presentation examines what a decade of collective impact achieved, what it revealed about system limitations, and how these learnings inform CINetwork’s future direction.
Approach
We present a retrospective, system-level case study drawing on CINetwork documentation, a PHAC mid-term evaluation, community-based research outputs (including the Northern HIV Journey Mapping Project), and synthesis from large-scale, multi-sector convenings held between 2016 and 2025. Analysis focused on CINetwork’s role as a coordination, learning, and capacity-building backbone rather than a direct service delivery or policy-making body.
Key Contributions
Over its first decade, CINetwork contributed to system transformation by advancing community-based and non-clinical HIV testing models; elevating people with lived and living experience as leaders, researchers, and facilitators; serving as Manitoba’s community-based HIV research coordinating hub within the national REACH-Nexus network; contributing knowledge through research projects, strengthening workforce and organizational capacity through sustained knowledge exchange and trauma-informed, anti-stigma, and culturally safe practice initiatives; and using participatory facilitation as a core intervention to build trust and enable candid system dialogue.
Critical Reflections
Significant foundational contributions have made an impact, but not on HIV and STBBI rates. This highlights a central learning: collective insight and innovation are necessary but insufficient without aligned authority, resourcing, and accountability. Mechanisms to advance the system are needed.
Implications
Findings point to the need for CINetwork to evolve toward a co-governed, action-oriented system mobilization platform capable of coordinated, Indigenous-led, and accountable system response.

Trans and gender diverse refugees face layered barriers to HIV prevention in Canada, including stigma, limited culturally relevant information, mistrust of clinical environments, and settlement precarity (Murray 2015; Lee and Brotman 2011). This study examines how newcomer led community spaces strengthen HIV literacy, PrEP comfort, stigma reduction, and healthcare navigation. The project uses community based qualitative methods informed by transnational feminist and queer migration scholarship (Tambe and Thayer 2021; Luibhéid 2008), and integrates the author’s autoethnographic reflections as a trans refugee researcher affected by HIV and co-founder of LubunTO, a grassroots collective for queer and trans migrants from Turkey and Beyond. Data include semi structured interviews, participant observation, collective thematic analysis, and reflexive fieldnotes documenting community organizing practices and positionality.

Preliminary findings show that community belonging is a critical structural component of HIV prevention for trans refugees. Participants describe nonprofits organizing as some of the only environments where they feel safe discussing HIV, and challenging misinformation. This relational safety increases comfort exploring PrEP, navigating testing, and engaging care providers, echoing evidence that community belonging among trans people is linked to more positive attitudes toward PrEP and prevention engagement (D’Avanzo et al. 2021). Community-based knowledge also fills major gaps in Ontario’s prevention landscape, particularly around insurance coverage for PrEP and navigating eligibility during status transitions, documentation changes and periods of legal uncertainty where access pathways are inaccessible. Members also share strategies for accessing integrated HIV/GAHT, addressing barriers related to transphobia, racism, and complex injustices documented for trans refugees living with HIV (Arora et al. 2021; Mah and Ives 2010).

Findings indicate that newcomer led, trans led organizations are informal yet powerful HIV prevention infrastructures. Autoethnographic insights further show how shared lived experience strengthens relational safety and community rooted prevention pathways.

Keywords: trans refugees; HIV prevention; PrEP; autoethnography; community belonging; queer migration.

Background: The disproportionate rates of HIV/STBBI experienced among Indigenous (First Nations, Inuit, and Métis) people in Manitoba highlights the ongoing colonial violence within health care systems. Kotawêw explored the role of Indigenous doulas in HIV and STBBI care for Indigenous women and Two-Spirit people in Manitoba. Kotawêw, derived from the Ininew (Cree) language, translates to making a fire and represents the sacred act of bringing warmth and light into the world. HIV/STBBI doulas, a provincially funded project at the Ka Ni Kanichihk Sexual Wellness Lodge, ignite a flame of hope and healing.

Method: Kotawêw is rooted in Indigenous methodologies including kinship, stories, and land. A community-guiding circle of 6 Indigenous women and Two-Spirit people living with HIV/STBBI, an Indigenous Elder and cultural knowledge holder guided the project. Stories were collected using Indigenous storywork principles from people with lived experience of HIV/STBBI (n = 20), relatives of people living with HIV/STBBI (n = 7), Elders/Cultural Knowledge Holders (n = 5), and service providers/helpers (n = 8) Stories were thematically analyzed.

Findings: Shared stories described four primary domains, organized into themes essential to Indigenous HIV/STBBI doula practice: 1) Immediate emotional support at diagnosis, 2) Cultural and ceremonial grounding, 3) Harm reduction and practical support, 4) Advocacy within systems shaped by racism and stigma. Together, these interconnected domains illustrated the need for HIV/STBBI doulas to move beyond biomedical models towards relational, trauma-informed, culturally grounded care.

Conclusions: Indigenous HIV/STBBI doula work is wholistic, culturally grounded, and harm-reduction–oriented that integrates relational and cultural care. Findings underscore the need for care to elevate Indigenous knowledges, prioritize peer-led models, and address structural barriers faced by people living with or newly diagnosed with HIV/STBBIs. Resultingly, these findings have helped develop a curriculum to further train and implement additional Indigenous HIV doulas into the care cascade within Manitoba.

Stigma within health and social service settings remains a major barrier to HIV and sexually transmitted and blood-borne infection (STBBI) prevention, testing, treatment, and care. This challenge is particularly urgent in Manitoba, which has shifted from having the second highest to the highest rates of HIV infection in the country. Addressing stigma at this scale requires approaches that move beyond one-time training toward sustained, system-level change.

This presentation draws on implementation learnings from the Manitoba site, where Nine Circles Community Health Centre is a collaborating organization in a national initiative led by the Canadian Public Health Association and Centre for Sexuality, to pilot test standardized STBBI stigma-reduction training for health and social service providers. The presentation focuses on site-level implementation learning related to delivery, sustainability, and systems integration.

Implementation emphasized capacity strengthening at local and regional levels to support longer-term stigma-reduction efforts. Rather than treating workshops as stand-alone activities, a systems-oriented approach was adopted that recognizes stigma reduction as an ongoing process requiring periodic reinforcement. Full-day workshops were co-facilitated by a health educator and a person with lived and living experience, supporting sustained reflection and applied learning.

Quantitative indicators demonstrated broad reach and engagement, including nine workshops delivered since 2024, over 180 providers engaged, and more than 40 hours of training delivered. Post-workshop surveys indicated increased understanding of stigma and its drivers, greater self-reflection, and increased comfort applying stigma-reduction concepts, with approximately 80% of participants reporting gains across these areas. Qualitative feedback highlighted the value of lived-experience co-facilitation and activity-based learning, with participants reporting increased ability to create safer, more respectful services by reducing power imbalances, minimizing re-traumatization, and reframing stigma as structural violence rather than individual failure.

Overall, these implementation learnings highlight a systems-oriented, capacity-strengthening approach for embedding stigma-reduction practices within health systems facing high HIV burden.

Background: Canadian STI guidelines recommend extragenital testing in men who have sex with men (MSM) and trans women – among others. Research indicates that 65–70% of chlamydia and gonorrhea infections among MSM are exclusively extragenital and would be missed with urogenital testing alone. However, access to timely extragenital testing remains a barrier.
Methods: In Ontario, GetaKit is an online service that allows individuals to obtain requisitions for STI testing at local laboratories, often enabling same-day testing. While urogenital specimens could be collected at labs, extragenital swabs required mailing, resulting in delays for individuals at elevated risk. In August 2025, GetaKit partnered with MAX Ottawa, a community-based health organization serving MSM to establish the first community distribution pathway in Ontario for in-person pick-up of swabs. We describe early outcomes from this pilot.
Results: Between August-December 2025, 78 testing orders were placed through the service, averaging 15.6 swab pickups per month. Sixteen individuals (20.5%) had positive STI results, yielding 22 infections: 7 syphilis, 10 gonorrhea, and 5 chlamydia cases. Among gonorrhea infections, 8 of 10 were detected exclusively at extragenital sites; fewer than five chlamydia infections were extragenital. Seven individuals requested extragenital swabs but did not submit samples, signalling a completion rate of 91.0% (n=71/78). Only one swab order was cancelled by the laboratory (for an error rate of 1.3%), likely due to transport issues rather than patient error.
Conclusion: Community-based distribution of extragenital swabs through partnerships such as MAX Ottawa appears feasible and acceptable, with low specimen loss and a high yield of extragenital gonorrhea detection. This model may reduce delays in testing for those with negative healthcare who feel more comfortable going to a community agency and help identify infections that would otherwise remain undiagnosed. It is also likely a more sustainable model for service delivery than specialized STI clinics.

Background: “Healthy Aging Talks” was a series of community-based Knowledge Mobilization (KM) events designed to share personalized health results from the BCC3 study to participants. Led by Community Research Associates (CRAs), “Healthy Aging Talks” approached KM as a shared process, one that values lived experiences, relationships, and dialogue, not just information delivery. The Evaluation Toolkit was collaboratively adapted to understand how this KM project was received and its impact.
Methods: Our evaluations were informed by the “Engage with Impact” Toolkit. We worked collaboratively through toolkit modules: Planning, Tailoring, Data collection, Refinement, and Reporting. Three tailored evaluations were developed for the event participants, team members, and community partners. Measures were adapted from eight domains: knowledge and skills, confidence and trust, equity and inclusivity, priorities and decisions, effectiveness and efficiency, patient-centeredness, cultural change, personal outcomes, and experiences. Evaluations were distributed in person or electronically for virtual events. Learning was additionally evaluated through pre- and post-presentation trivia. Participants provided informed consent for their responses to be used for research.
Results: We hosted 12 events, engaging over 150 women in person and virtually. Based on evaluations, women valued the KM approaches that centre lived experiences and the integration of clinical expertise alongside community voices (>80% agree/strongly agree). There was strong interest in the event topics, which included stress and wellness, liver, heart, and kidney health. Women joined events from across BC and the Yukon, demonstrating the reach of virtual KM for rural and remote communities. Improved scores in the second round of trivia reflected successful knowledge uptake.
Conclusions: Our findings suggest that community-led, comprehensively evaluated KM supports learning while fostering strong relationships and equity. “Healthy Aging Talks” highlight the value of collaborative knowledge sharing where participants and facilitators learn together, strengthen peer connection, and affirm participants’ central role in shaping the research they informed.