Grant: Project Grant

New HIV diagnoses are 71 times higher among gay, bisexual and other men who have sex with men (GBM) than other men in Canada. Since 2010, BC has adopted Treatment as Prevention (TasP) as a policy to increase HIV testing and treatment in order to reduce HIV transmission. However, new diagnoses among GBM in BC remain stable with an increase among young GBM. HIV pre-exposure prophylaxis (PrEP), a new prevention tool, was approved for use in Canada earlier this year although uptake in BC remains limited. We wish to examine the differential impact of PrEP and TasP on HIV and sexually transmitted infection (STI) prevention and transmission among younger (<30 years) versus older (30+ years) GBM in Metro Vancouver with 3 study aims: 1) To measure significant HIV risk behaviour over time that considers use of TasP and PrEP; 2) To determine cumulative STI incidence and the affect of PrEP and TasP; and 3) To understand attitudes about HIV, challenges with HIV prevention and treatment, and changes in sexual negotiation and practices. We will conduct a 3-year mixed method study to collect and triangulate rich data sources. To address Aim 1 and 2, we will enrol 700 GBM (including 250 young GBM) into a prospective bio-behavioural cohort study. Participants will be followed every six months to complete computer assisted self-interview questionnaires and provide biological specimens for HIV and other STI testing. To address Aim 3, we will conduct in-depth qualitative interviews with 50 GBM who were recently diagnosed with HIV, are currently using PrEP, or who report significant HIV risk with no TasP or PrEP use. Situated within the world-renowned BC Centre for Excellence in HIV/AIDS, our experienced research team includes public health and service organization leaders. This research will inform population-specific, age-relevant public health policy, programming, and interventions to reduce the burden of HIV and STIs for GBM, especially young GBM.