TAKING ACTION TO DISRUPT THE HIV-STBBI STATUS QUO

Required Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:

Optional Information

• In which Regional Health Authority (RHA) do you live?

  • Winnipeg RHA
  • Southern RHA
  • Interlake RHA
  • Prairie Mountain RHA
  • Northern RHA
  • Other

• Which of the following categories best describes your role?

  • Person with lived experience
  • Researcher/evaluator/academic
  • Front-line service provider
  • Policy/decision maker
  • Consultant
  • Student
  • Other

• Organization
• City

• Which of the following settings best describes where you live?

  • Large urban
  • Small city or town
  • Rural
  • Remote

• How many MB HIV-STBBI Collective Impact Network symposiums have you attended in the past?

  • This is my first event!
  • 1
  • 2
  • 3
  • 5-10
  • More than 10!

• Which of the following best describes your role with the CINetwork?

  • Stewardship Advisory Team
  • Backbone Support Team
  • General CINetwork

• How long have you been involved with the CINetwork?

  • 5+ years
  • 3-4 years
  • 1-2 years
  • Under 1 year

• Do you identify with any of the following categories?

  • Indigenous
  • Women
  • LGBQT2S+
  • African Caribbean Black (ACB)
  • BIPOC (other than Indigenous and ACB)
  • None of the above