Grant: Team Grant: Boys' and Men's Health - LOI

Half of new human immunodeficiency virus (HIV) infections in Canada occur among gay, bisexual, and other men who have sex with men (MSM). Over the past ten years, there have been important developments in HIV treatment and prevention. For example, the use of antiretroviral medication therapies (ART) has been recognized as having the potential to act as a preventative measure at both the individual and the population level. In 2010, the government of British Columbia introduced a large scale program to "seek and treat" people living with HIV that involved prescribing ART to treat individuals and prevent the spread of the virus. This policy of "treatment as prevention" has not been implemented to the same degree in Ontario and Quebec. Canada has therefore begun a natural experiment on the effectiveness of this approach. We have created a national team to collaborate on HIV prevention among MSM in Canada in order to understand the effects of cross-provincial differences in the number of new cases of HIV and to address critical knowledge gaps in HIV prevention. Our team has 3 overlapping goals: (1) To develop the first ever national mulitsite study of new cases of HIV/sexually transmitted infection (STI) among MSM; (2) To build research capacity for HIV prevention research for MSM across Canada; and (3) Using an active, bidirectional Knowledge Translation approach, design and test HIV prevention programs for community and public health settings. Our cohort study objectives are: (1) To examine sexual behaviour and recreational drug use among MSM over a period of three years follow-up and to monitor changes in these behaviours as access to ART expands; and (2) To examine the effects of biomedical and sociohavioural HIV prevention programs on the number of new cases of HIV and STIs.