Grant: Catalyst Grant: HIV/AIDS CBR Program - General Stream

In Canada, rates of bacterial sexually transmitted infections (STIs) - specifically syphilis, gonorrhea and chlamydia - among HIV-positive and -negative men who have sex with men (MSM) have increased substantially over the past decade. The majority of cases occur in Toronto. Left untreated, syphilis may progress to serious outcomes such as neurosyphilis. Certain strains of chlamydia may cause Lymophgranuloma venereum (LGV) leading to painful inflammation and bleeding in the rectum. Furthermore, the prevalence of antibiotic-resistant strains of gonorrhea is on the rise. On the other hand, STI testing and treatment could reduce chances of further disease and the spread of these STIs. Unfortunately, testing remains below recommended guidelines among MSM in Toronto. New approaches to healthcare delivery are needed so more men will undergo testing for bacterial STIs and test more often. We are a team representing community-service, care-delivery, and research organizations experienced in promoting, providing, and evaluating sexual health promotion including STI testing to MSM. Working collaboratively with community members, we wish to determine which bacterial STI testing interventions should be implemented and evaluated among MSM in Toronto. We will do this by exploring and combining current knowledge on reasons men may or may not get tested for bacterial STIs, existing testing programs and practices and new testing interventions to be considered. We will then form an Expert Panel of MSM community members, knowledge users, and researchers to determine the intervention(s) with the greatest potential for our setting. This will lay the groundwork for its evaluation through a future grant proposal. Our project will lead to community-directed, informed decision making around STI testing in urban settings that may guide other cities experiencing similar increases in bacterial STIs.