Research into Social Drivers at the OHTN

As part of an overview panel, Sean Rourke, Executive Director of the Ontario HIV Treatment Network, shared information about three of the organization’s research initiatives. He emphasized that frontline workers already understand that the social determinants of health are critically important for people living with HIV, but that research can demonstrate their impact in a more quantifiable way.

Positive Spaces, Healthy Places (PSHP) is a research study that began after executives at Ontario AIDS service organizations identified housing as a critical, unmet need for people living with HIV. The community-based study was a partnership between academics, community members and policy makers, and was rare at the time it began. Rourke reported that, since 2007, there has been a ten-fold increase in housing research and emphasized the study’s findings that stable housing is associated with an overall improvement in physical and mental health-related quality of life, and that even a sense of belonging in one’s neighbourhood is associated with less depression.

Rourke noted that 10% of participants in PSHP, as well as some members of the study team, passed away during the five years the study was underway, indicating a much higher mortality rate than one would expect among the general population.

The Food Security Study involved harmonized data collection in Ontario, British Columbia and Quebec, and demonstrated that the main drivers of food insecurity among people living with HIV were socioeconomic factors, depression and substance use. Participants in the study were eleven times more likely to be food-insecure than the general population.

Finally, the OHTN Cohort Study (OCS), which follows a cohort of Ontarians living with HIV who are actively engaged with treatment, has provided data to inform better program and policy decision-making. Rourke said that, while he initially had some concerns about investing in the OCS, the study has proven its worth over time by providing quantifiable information about treatment outcomes in the province. He noted that, although all participants in the study are receiving care, they have not all reached viral suppression, which is a signal that we need new strategies to address adherence.

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