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  • OHTN: A Consultation to Better Understand and Reach At-risk Audiences 

OHTN: A Consultation to Better Understand and Reach At-risk Audiences 

Partnered with The Ontario HIV Treatment Network on a multi-approach consultation to inform future public awareness campaigns promoting HIV prevention, testing, treatment and ongoing care; particularly among those at higher risk for HIV.

About The Project

The Ontario HIV Treatment Network (OHTN) is a non-profit organization funded by HIV and Hepatitis Programs at the Ontario Ministry of Health. OHTN brings together collaborators across the sector to influence decision-making and improve the lives of all Ontarians living with, and at risk of, HIV.

OHTN embarked on a comprehensive consultation process to inform future public awareness campaigns promoting HIV prevention, testing, treatment and ongoing care; particularly among those at higher risk for HIV. This included historically underserved populations outside the communities that have traditionally been the focus of HIV prevention efforts, but where recent trends point to increasing rates of new infection.

As a partner in this work, Environics Research brought extensive experience in community engagement, research with hard-to-reach populations and a thoughtful approach to collaboration, recruitment and facilitation, informed by best practices and lessons learned from previous projects.

Recognizing that the results of this consultation would shape future public awareness campaigns and provide OHTN with a nuanced understanding of these audiences allows them to be authentically represented and see themselves in future campaigns.


Background

In recent years, the profile of people most affected by HIV in Ontario has evolved, with increasing rates of new infection emerging in communities that have historically been underserved by mainstream HIV prevention efforts. This multi-stage consultation was designed to complement existing evidence with lived experience, ensuring that future campaigns reflect the needs, language and priorities of those most at risk, and that interventions are not only effective, but equitable and grounded in trust.


Objectives of the Community Consultation

Engage directly with target
high-risk populations

Including members of 2SLGBTQ+ communities (with a focus on trans women), newcomers, Indigenous communities, African, Caribbean and Black (ACB) communities, sex workers, and people who use drugs, to gain deeper insight into their attitudes, perceptions, needs and barriers related to HIV prevention, testing, treatment and care.

Uncover
critical gaps

In awareness and knowledge among these groups regarding HIV prevention and care, to inform more effective outreach, supports and services.

Strengthen understanding of
patient–provider relationships

Including trust, comfort, communication barriers and perceived stigma, to help healthcare professionals better serve and understand these communities.

Inform future public
awareness campaigns

Ensure that messages, channels and messengers reflect the lived realities of those that would be the targets of these campaigns and resonate in ways that motivate action and support.


Project Phases

1

Grounding

An in-depth literature review, sharing of existing knowledge and evidence, and the use of our proprietary research roadmap. Aswell, a interest holder mapping exercise to identify key partners, knowledge holders and potential gaps in engagement.

2

Pre-consultation

A Series of interviews with subject-matter experts, including representatives from organizations serving each of the target populations. These conversations helped us understand how to best reach, engage and meaningfully connect with underserved groups who are living with, or at higher risk of, HIV infection. They also illuminated common misperceptions and informed both our recruitment approach and discussion guides.

3

Physician & Nurse Survey

Fielded a survey with physicians and nurses to inform OHTN’s outreach strategy to healthcare professionals. The survey explored providers’ experience with HIV patients, and their attitudes, awareness and perceived barriers related to HIV prevention, testing and treatment; particularly for underserved populations.

4

Engagement with Target Populations

We then conducted an online consultation with members of the target groups to better understand their individual attitudes, views, needs and barriers related to HIV prevention and care. Discussions covered sexual health more broadly, understanding of HIV, perceptions of risk and responsibility, and experiences of support.

5

Action

Triangulated findings across all data sources: literature, expert interviews, healthcare provider survey and community consultations which then was synthesized into key themes and implications. We delivered final insights, analysis and reporting with clear, actionable recommendations for communications, outreach and provider supports.


Our Approach

Engaging Communities Directly

At its core, this work required reaching higher-risk groups to talk about a sensitive and often uncomfortable topic. Before any direct engagement, we grounded our work in existing research and identified gaps in understanding how best to conduct research with higher-risk populations.

Recognizing that many individuals in these groups may be hesitant to participate due to stigma, research fatigue or distrust of institutions, we built engagement plans centered on trust, clarity and accessibility.

We spoke with community leaders and service providers who work directly with these populations to ground our approach in lived reality. These conversations not only informed our recruitment strategies and how we framed discussions and crafted questions for community members but also provided an “on-the-ground yet macro” understanding of the broader systemic challenges these communities face; context that was essential for interpreting what we heard through the consultations.

Using an Anti-Oppressive Framework

Intersectional and anti-oppressive research practices were essential to ensure that every part of the consultation – from recruitment and facilitation through to analysis – was as equitable and respectful as possible.

This approach allowed us to capture more accurate and representative insights from underserved communities, acknowledging the layered and intersectional impacts of racism, homophobia, transphobia, colonialism, stigma and other structural barriers.


Application of Insights

Pre-consultation interviews shed light on common assumptions made about target groups and highlighted the need for messaging that addresses knowledge gaps while reflecting cultural and contextual nuances.

The healthcare provider survey illustrated Ontario providers’ experience with HIV patients, as well as their awareness, comfort and barriers in testing and treating HIV and discussing sexual health with underserved groups.

Findings from the community consultations centered around sexual health more broadly, understanding of HIV (including risk, responsibility, and action), and the nature of relationships with healthcare providers – particularly comfort, trust and barriers to effective communication.

Based on this, we provided recommendations to:

Close gaps in awareness, identifying where messaging should focus and what misconceptions must be addressed.

Support patient–doctor relationships by surfacing and addressing assumptions and hesitancies on both sides.

Communicate more effectively with target groups, including where they are most likely to see campaigns, how to make content relatable, and how to acknowledge and validate specific fears and experiences.


Performance

The findings and insights that Environics Research identified foundationally inform our communications efforts at OHTN. For example, for World AIDS Day 2025, we produced a video focused on how HIV service providers work to meet the needs of newcomers specifically. Without this work, we would not have been in the position to know which needs were most important to address in the context of this video.

Lorna Freeman – The Ontario HIV Treatment Network


About The Client

The Ontario HIV Treatment Network is a non-profit network funded by AIDS and Hepatitis C programs at the Ontario Ministry of Health. Their mission is to improve the health and lives of people living with and at risk of HIV by using data and evidence to drive change.

The OHTN works to influence decision-making at all levels—personal, clinical, organizational and policy—by working collaboratively with their partners to gather and analyze data, conduct targeted high-impact research and support the use of the best available data and research evidence.

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Vijay Wadhawan

Senior VP – Health & Wellness

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Maysa Husseini

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