Grant: Project Grant

Half of new HIV cases continue to be among gay, bisexual, and other men who have sex with men (MSM) in Canada, and MSM are also disproportionately burdened by other sexually transmitted infections (STIs), such as syphilis and Hepatitis C Virus. Simultaneously, new medications used to prevent HIV are rapidly changing the context of HIV prevention. Uptake of HIV prevention technologies varies across Canada because of differing provincial policies that affect availability of and access to HIV and STI testing, treatment, and prevention. We hypothesize that as new prevention technologies are deployed, there will be differential effects across sites in terms of: (1) uptake of antiretroviral medication as treatment for HIV-positive MSM, and of pre-exposure prophylaxis as prevention for HIV-negative MSM; (2) risk compensation through decreased use of condoms for anal sex; and (3) increased STI incidence. This multisite study will follow MSM who are at high risk for STIs in Vancouver, Toronto, and Montreal semi-annually for 4 years. Recruitment of the sample and baseline data collection will already be completed from the cross-sectional study funded by our CIHR Team Grant. HIV and STI testing will be performed at each time point by study nurses. Participants will complete self-report questionnaires, which will collect data on mental health, access to services, social and community-level variables, and safer sex strategies aside from condom use, in addition to event-level data on recent sexual activity and other variables relevant to HIV prevention, all of which have not been studied using comparable measures across sites. This will be the first ever national, multisite, longitudinal study in this high-risk population. By expanding the work of our CIHR Team Grant into a cohort study, the research team will be better equipped to inform public health policy and develop evidence-based HIV and other STI prevention interventions for MSM in Canada and beyond.