Prevalence of HIV and sexually transmitted and blood-borne infections, and related preventive and risk behaviours, among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver: results from the Engage Study

Abstract

Objectives The last Canadian biobehavioural surveillance study of HIV and other sexually transmitted and blood-borne infections (STBBI) among gay, bisexual and other men who have sex with men (GBM) was conducted in 2010. We designed a study to measure STBBI prevalence among GBM in metropolitan Montreal, Toronto and Vancouver and to document related preventive and risk behaviours. Methods The Engage Cohort Study used respondent-driven sampling (RDS) to recruit GBM who reported sex with another man in the past 6 months. At baseline, we examined recruitment characteristics of the samples, and the RDS-II-adjusted distributions of socio-demographics, laboratory-confirmed HIV and other STBBI prevalence, and related behaviours, with a focus on univariate differences among cities. Results A total of 2449 GBM were recruited from February 2017 to August 2019. HIV prevalence was lower in Montreal (14.2%) than in Toronto (22.2%) or Vancouver (20.4%). History of syphilis infection was similar across cities (14–16%). Vancouver had more HIV-negative/unknown participants who reported never being HIV tested (18.6%) than Toronto (12.9%) or Montreal (11.5%). Both Montreal (74.9%) and Vancouver (78.8%) had higher proportions of men who tested for another STBBI in the past 6 months than Toronto (67.4%). Vancouver had a higher proportion of men who used pre-exposure prophylaxis (PrEP) in the past 6 months (18.9%) than Toronto (11.1%) or Montreal (9.6%). Conclusion The three largest cities of Canada differed in HIV prevalence, STBBI testing and PrEP use among GBM. Our findings also suggest the need for scale-up of both PrEP and STI testing among GBM in Canada.

Social support and HIV prevention behaviors among urban HIV-negative gay, bisexual, and other men who have sex with men.

“…Participants were recruited to visit a study site in one of the three cities (Vancouver, Toronto, or Montreal) from February 1, 2017 to July 31, 2019 as part of a larger bio-behavioral study examining the role of biomedical prevention in the sexual health of GBM (Hart et al, 2020). Eligible participants self-identified as sexually active (reporting at least one male sex partner in the past six months) GBM who were aged 16 years or older at the time of recruitment.…”

“…Participants were recruited using respondent driven sampling (RDS), a method where participants are chain recruited through their own social networks, in order to attenuate the bias of convenience sampling and approximate probability sampling (Heckathorn, 2011). See (Hart et al, 2020) for additional information related to the RDS recruitment conducted for this study sample. At their study visit, participants provided written informed consent for study procedures and self-completed computer-assisted questionnaires in French or English.…”

“…Although optimal PrEP use reduces the risk of HIV acquisition via CAS by 86% (Sagaon-Teyssier et al, 2016), PrEP-protected CAS still presents risk for other STIs (e.g., CDC, 2018b). Further, a large number of men who meet clinical recommendations for PrEP do not report using it (Cox et al, 2020;Finlayson et al, 2019), which suggests that these men may be at elevated risk for both STI and HIV transmission when they engage in CAS without PrEP. Given the increased diagnoses of bacterial STIs and other STIs in GBM (e.g., CDC, 2018a;Haddad et al, 2018), CAS (with or without PrEP use) continues to have public health significance, especially in the context of sex partners other than a main partner.…”

Minority stressors and connectedness among urban gay, bisexual, and queer men.

“…Eligible participants self-identified as cisgender or transgender men who were 16+ years of age and reported having had sex with a male partner in the past 6 months. See Hart et al (2021) for additional information related to the RDS recruitment and data collection conducted for this study. RDS sampling was used to approximate probability sampling (Heckathorn, 2002).…”

“…Baseline data from participants from a larger study of sexual health outcomes among GBQM were used. These GBQM were recruited using respondent-driven sampling (RDS) (Heckathorn, 2011) in Canada’s three largest cities (Montreal, Toronto, and Vancouver; see Cox et al, 2021; Hart et al, 2021; Moore et al, 2021). Eligible participants self-identified as cisgender or transgender men who were 16+ years of age and reported having had sex with a male partner in the past 6 months.…”