This is a story of working together collaboratively, and as reflexive colleagues, to answer the research question: Do men, women and transgender individuals in Canada experience the same number of combination antiretroviral therapy (cART) treatment changes? It was a long and winding journey, with bumps along the way, as together we developed a meaningful approach to using data from the Canadian HIV Observational Cohort (CANOC). Reciprocal learning and continued growth were at the heart of this project. Claudette first asked the question based on personal experiences and conversations with peers and the team worked collaboratively and flexibly to address her research objectives and conduct the analysis. Claudette, an Indigenous Elder, would offer a blessing and land acknowledgement to start us off in a good way for our regular check ins and meetings. A total of 10,555 people living with HIV in CANOC were included in the study (8,728 men, 1,771 women and 56 transgender) from five provinces in Canada. Women and transgender individuals experienced a higher crude number of cART regimen changes (1.95 and 2.09 mean changes, respectively) compared to men (1.63 mean changes). Women and transgender individuals also had a higher rate of change (0.26 and 0.27 mean changes/person year (PY) follow up, respectively) compared to men (0.22 mean changes/PY follow up). The risk of experiencing a cART change was significantly higher for women (adjusted incidence rate ratio (aIRR) 1.21 (95% confidence interval (CI) 1.16-1.25) and transgender individuals (aIRR 1.23 (95%CI 1.03-1.48), compared to men after adjusting for significant variables. This is our story of combining living experience of HIV with traditional epidemiological methods. ​