Since the very beginnings of HIV-AIDS, patients have continued to demand to be part of the solution. Patients were demanding that they receive the experimental drugs because they figured it was that or certain death at that time. Of course today things have changed. The treatments are less toxic. We are even reaching an injectable medication every two months (Cabotegravir in its new Apretude formula) or even twice a year (Lenacapavir/Sunleca). But now, we have to carry out research, we have to recruit patients to improve all these treatments and, possibly, even succeed in stemming new contaminations through PrEP. This is what the L’Actuel Medical Clinic is proposing, which is calling on patients to be part of research cohorts to advance science.
These studies are in fact essential to the development of new drugs and prevention treatments such as injectable PrEP (medications before sexual intercourse) which will soon be available.
To find out more, we met with the very energetic Sam Kajjo, PhD, the Academic and Clinical Research Coordinator at Clinique Médicale l’Actuel.
With Sam Kajjo, a total of seven people work within the academic and clinical research team. “It’s a very dynamic team, very dedicated to research,” says Sam Kajjo, who has been its coordinator for six months now. For me, it’s about helping people in my community who are suffering due to HIV. Growing up in Syria, it was not allowed to live who you were, you had to hide your sexual orientation all the time, if you told your parents who you were, it was over, period. I hid who I was until I arrived in Canada 12 years ago, where I finally came out. But here, I have the opportunity to work with a superb team. It is for me an honor to meet Drs Réjean Thomas [le président fondateur de la clinique] and Jason Szabo [le directeur de recherche]they are mentors for me. They have so much experience and expertise in medicine related to HIV-AIDS, but also the whole social, human and research side. And how we can better help the community. I learn a lot with them. They are an almost inexhaustible source of advice for me.”
“We have 12 clinical research projects underway here and others will begin in 2025. Don’t be afraid, everything is perfectly anonymous. All a patient needs to do is mention it to their doctor when they meet them during an appointment. Everything is processed anonymously in our database,” explains Sam Kajjo, who studied biology and chemistry at the University of Ottawa, then did his master’s and doctorate at McGill University on the subject of RNA. “with the aim of doing research and being able to help people in the community suffering from HIV”.
Several studies focus on injectable treatments, as mentioned above. “These long-term treatments are intended to provide the person with more immunity and make them less resistant and more adherent,” continues Sam Jakko. We are also targeting individuals who practice ”chemsex” here, these injectables can be simpler for them because it is every two months and they no longer have to think about it.
Speaking of “chemsex” (sexual relations with crystal meth consumption, among other things), this study called “Cheers” particularly wants to help this population. “If people participate in ‘chemsex,’ it’s important to reach them and involve them in this study to get psychosocial help,” says Sam Jakko. Here we can easily forget one or more doses of medication, this study aims to be able to protect this population and the community in general to avoid contamination. Posters will be published to this effect. We are looking for 50 people for this survey and 15 have already come forward in one month.
“Québec Blood Donation” is a long-term study conducted in collaboration with Sainte-Justine Hospital. It began in 2020. In 2022, Héma-Québec, the organization that manages blood donations in the province, lifted the ban on homosexual men donating blood. Héma-Québec thus followed the general trend in Canadian provinces and was the last to do so. However, there is a catch: “If someone is on PrEP, Héma-Québec can assume here that this person is sexually active and therefore could be a carrier of STBBIs (infections transmitted by sex and blood), continues Sam Kajjo, whose doctoral studies focus on RNA stability and research for an HIV vaccine. It’s not very clear in Héma-Québec’s criteria, but it can refuse a donation from a man who is on PrEP, for example.”
What we are trying to prove with this study is that homosexual men are no more carriers of STBBIs than other types of populations. “This is a study which aims to reduce these criteria because we want to prove that these men, in fact, are more protected than others because they are on PrEP, precisely. It’s not hidden, but it’s not very well known here either.” If you are on PrEP you would have to stop the last dose and wait a period of four months before being able to donate blood. On the other hand, if it is an injectable medication, you must allow a period of two years after the last injection (for example if you are on Lenacapavir/Sunleca twice a year). If a person has to stop PrEP, they can infect themselves and others. “But they [Héma-Québec] had decided on this rule without really doing any serious studies on this subject, which is why we are participating in this study with Sainte-Justine Hospital to collect scientific data. So far, 300 people are in this research at the Clinic, the objective is to reach 600,” underlines Sam Kajjo.
Migrant populations can have access to PrEP via the PSHARSAH (men who have sex with men) and NOVA studies which will be carried out in 2025. “A migrant arriving in Canada sees that it is an open and liberated country. sexually, especially if he has suffered discrimination, he may have sexual relations, he may not think about protecting himself adequately and he may become infected, continued Sam Kajjo. This MSM study is important because it aims to raise awareness of PrEP among migrants so that they can better protect themselves.”
By broadcasting videos in several languages, migrants talk about their experiences with PrEP and how they can protect themselves with medication. These videos will be available during 2025 and will encourage migrants to register for PrEP. This is the NOVA study. “We want to reach 200 to 300 patients. This is why we are appealing to other clinics that have migrant clients among their patients. This is not just about the Clinique l’Actuel, but rather about picking up migrants where they are. The same goes for several other studies because this can benefit the entire LGBTQ+ community,” argues Sam Kajjo.
Other academic research focuses on STBBIs and is ongoing or will be conducted in 2025.
“The goal of all these studies is to improve the quality of life of HIV-positive people, to reduce HIV-related stigma so that these people can have a normal life, be with a spouse who will be protected, also [puisque l’autre conjoint sera indétectable et donc intransmissible] or that this man is on PrEP and, again, will be protected and will protect others,” insists Sam Kajjo.
This is why the database of the Clinique Médicale l’Actuel is very important. It collects all data collected from consenting patients, anonymously, once again, for the clinic to use this data for research purposes. We thus collect figures on the different aspects of intersectionality between HIV and other diseases or others. “For example, how many people are both HIV positive and living with hepatitis C, or how many are also diabetic, or have heart disease or high blood pressure, or use drugs, etc.? Everything is collected anonymously, but it is important data that allows us to advance science, treatments, help for patients, etc.,” the research coordinator continues here.
Info: L’Actuel Medical Clinic, 1001, boul. From Maisonneuve Est, Montreal, 11e floor, office 1130. T. 514-524-1001 or Cliniculelacteur.com
