Background Awareness, availability, and public funding of pre-exposure prophylaxis (PrEP) has increased substantially since it was approved by Health Canada in 2016 but policies and guidelines vary by province. Given the dynamic nature of PrEP policy and promotion, we sought to determine awareness and use of PrEP among gay, bisexual, and other men who have sex with men (gbMSM) in Vancouver, Toronto, and Montreal.
Methods Beginning in 02/2017, sexually-active gbMSM ≥16 years and living in Vancouver, Toronto, or Montreal were recruited into a cohort study using respondent-driven sampling (RDS). Data are included up to 08/2018. At study visits every 6 months (Vancouver) or 12 months (Toronto, Montreal), participants completed a computer-assisted self-interview which included questions on PrEP awareness and use in the past 6 months (P6M). We used RDS-adjusted, general estimating equations accounting for two levels of clustering (RDS recruitment chain; participant) to evaluate temporal trends (monthly prevalence) of awareness and P6M usage of PrEP among HIV-negative participants.
Results 1619 HIV-negative gbMSM completed 2074 study visits (1205 Montreal, 285 Toronto, 584 Vancouver). Over the course of the study, PrEP awareness significantly increased among gbMSM in Montreal from 62.6% during the first 6-month period to 84.8% during the last 6-month period (OR:1.07, 95%CI:1.02–1.12, per month); awareness remained consistent in Toronto (89.8%–96.0%, ns) and Vancouver (84.5%–95.0%, ns). Use of PrEP increased significantly in all three sites: Montreal, 10.5% during the first 6-month period to 30.9% during the last 6-month period (OR:1.06, 95%CI:1.02–1.11); Toronto, 12.5% to 23.3% (OR:1.15, 95%CI:1.02–1.30); Vancouver, 11.4% to 35.2% (OR:1.16, 95%CI:1.06–1.27).
Conclusion Awareness of PrEP appears to be ≥85% among HIV-negative gbMSM across all three cities. Even though provincial policy and programs differ greatly in availability and cost of PrEP, use of PrEP increased in all sites during the course of the study.
Disclosure No significant relationships.
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