Grant: Cat. Gr.: STBBI Res.: Beyond HIV/AIDS/Hep. C- STBBI other than HIV/hep. C (gen.)

Bacterial sexually transmitted infections (STIs)-such as chlamydia, syphilis, and gonorrhea-are on the rise in Canada. These infections can have severe consequences for patients and treatment can be both time consuming and costly for Canada's healthcare system. Stemming the tide of increasing STIs is a federal priority and one new prevention tool is doxycycline medication ("doxy"). Doxy can be taken before or immediately after STI exposure and has recently been made available in Canada at no cost to gay, bisexual, and queer men (GBQM) who participate in group sex. Using doxy may be especially useful for preventing STIs in this context given that having group sex is common (as many as 1 in 4 GBQM in a recent Vancouver study) and STIs can be transmit in unique ways (e.g., if someone does not change condoms between partners). The aims of this project are to 1) understand how many GBQM who have group sex are currently using doxy, 2) whether doxy is helping to prevent STIs among these QBQM, and 3) learn how specifically GBQM are using doxy at group sex events. Our multidisciplinary team will address our first two aims through a questionnaire linked to bacterial STI test results. We will analyze how many GBQM in Vancouver, Toronto, and Montreal with group sex experience are using doxy, and whether this predicts fewer STI diagnoses. To address our third aim, we will conduct follow up interviews with 10 participants from each city (30 interviews total) to learn more about how doxy is (or is not) incorporated into group sex events. To develop our questions, we will work closely with a community advisory board of local GBQM in each city. Based on our results, we will create resources for GBQM who have group sex, for healthcare clinicians and workers serving GBQM, and for healthcare policy makers. We expect these resources to reduce bacterial STI transmission through better equipping healthcare providers and helping GBQM who have group sex make informed choices about doxy.