Men in Vancouver at higher risk of contracting HIV and sexually transmitted diseases (STIs) are being recruited to participate in a study that aims to identify ways to prevent the spread of these diseases.
Called Engage, the five-year study is the largest of its kind in Canada and is collecting information about the spread of HIV and STIs in the gay, bi, queer and other men who have sex with men (gbMSM) communities in Vancouver, Montreal and Toronto. Findings will be used for disease prevention initiatives and could inform future health care policies.
“One of the challenges is that HIV treatment has made HIV a much less frightening illness” today, compared to 20 years ago, when a diagnosis was often seen as a death sentence, said study co-principal investigator Dr. David Moore. This, along with issues around mental health and substance use, could be leading to more liberal sexual behaviour among gbMSM, Moore said, and is something that Engage will examine.
To complete the Vancouver arm of the study, which launched within the past month, researchers are partnering with local community organizations, such as the Health Initiative for Men, Positive Living BC and YouthCO. A community engagement committee has also been formed that includes representatives from Engage and men from various gbMSM communities, such as trans men and men from different cultural backgrounds.
While gbMSM account for over 57 percent of new HIV diagnoses, according to a 2014 study by the BC Centre for Disease Control, the causes and behaviours behind the statistics are complex.
“Engage is trying to give us a better understanding of why we have not seen decreases in gbMSM that we’ve seen in other populations,” said Jody Jollimore, principal knowledge user with Engage and director of policy and provincial engagement with the Community Based Research Centre for Gay Men’s Health in Vancouver.
“This study enables us to increase our ability to get a handle on what the situation is.”
Something that Jollimore said has been identified as a way to save lives is pre-exposure prophylaxis or PrEP, a prescription medication taken by people at high risk of contracting HIV to prevent them from becoming infected with the disease. At a cost of $1,000 per month – the medication is not publically funded in BC – it is also something many individuals cannot afford.
“We’re hoping that the Engage study will give us even more evidence to make the case for why PrEP should be publically funded,” along with other interventions and outreach initiatives, said Jollimore.
Representatives from the Engage study in Vancouver have already recruited eight out of 30 men from the gbMSM communities to participate. Each participant receives six “recruitment coupons” to give to six friends, sex partners or acquaintances, and men must receive a coupon to participate.
Participants fill out a questionnaire about attitudes towards HIV, treatment options, services they may or may not have access to, sexual behaviour and their general health, such as their mental state, and if they suffer from chronic diseases. Tests for HIV and other STIs, such as syphilis, Hepatitis C and chlamydia, are also administered.
“I think what all of us involved in this study would like to see is a way to use information from this research to inform effective health programming to reduce the burden of HIV for gbMSM,” said Moore, who is also a public health physician who sees patients with HIV. “I think that’s a very feasible process; we just have to make it happen.”