Grant: Planning Grants - Priority Announcement: HIV/AIDS

Men who have sex with men (MSM) continue to bear a major burden of HIV infections in Canada. Pre-exposure prophylaxis (PrEP) is a new approach to HIV prevention involving daily use of an HIV medication, and has been shown to reduce the risk of HIV in clinical trials. There are now urgent global calls for PrEP pilot or Demonstration projects that could study how best to deliver PrEP in the real world. However, in contrast to the United States, where PrEP has received formal FDA approval and where pilot projects are already underway, there has little effort to prepare for PrEP in Canada. We are thus planning a PrEP Demonstration Project for Toronto MSM that will study how best to implement this proven HIV prevention strategy in the Canadian context. Because there is a risk that PrEP users may be stigmatized (eg. as promiscuous or dangerous), with negative effects on PrEP uptake and adherence, we are also planning community-based efforts to address stigma and related issues in a pro-active fashion. This planning grant will address these issues through a careful, consultative process. Our interdisciplinary team will first conduct two brief scoping reviews about existing PrEP projects and related community efforts, to clarify how our work can best contribute to the global PrEP knowledge base. We will then host a two-day in-person meeting, including speakers from ongoing PrEP projects in other jurisdictions, to articulate the key operations research questions for our Demonstration Project, initiate a community-based anti-stigma effort, and develop substudy plans that will maximize the research output of our project. Working groups will mature these ideas into full substudy protocols, and we will synthesize our findings into a formal project proposal to be submitted to CIHR and other funding agencies. Ultimately, this work has the potential to translate recent research findings into tangible HIV prevention benefits for this important, vulnerable population.