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Examining the secondary impacts of the COVID-19 pandemic on syndemic production and PrEP use among gay, bisexual and other men who have sex with men (GBM) in Vancouver, Canada.
Sang, Jordan M; Moore, David M; Wang, Lu; Chia, Jason; Toy, Junine; Montaner, Julio; Skakoon-Sparling, Shayna; Cox, Joseph; Lambert, Gilles; Grace, Daniel; Hart, Trevor A; Lal, Allan; Jollimore, Jody; Lachowsky, Nathan J.
Afiliação
  • Sang JM; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada. jordan.sang@bccsu.ubc.ca.
  • Moore DM; BC Centre on Substance Use, Vancouver, BC, Canada. jordan.sang@bccsu.ubc.ca.
  • Wang L; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
  • Chia J; University of British Columbia, Vancouver, Canada.
  • Toy J; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
  • Montaner J; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
  • Skakoon-Sparling S; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
  • Cox J; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
  • Lambert G; University of British Columbia, Vancouver, Canada.
  • Grace D; Toronto Metropolitan University (formerly Ryerson), Toronto, Canada.
  • Hart TA; Research Institute of the McGill University Health Center, Montreal, Canada.
  • Lal A; Direction régionale de santé publique -Montréal, CIUSSS Centre-Sud, Montreal, Canada.
  • Jollimore J; Direction régionale de santé publique -Montréal, CIUSSS Centre-Sud, Montreal, Canada.
  • Lachowsky NJ; Institut national de santé publique du Québec, Quebec City, Canada.
BMC Public Health ; 23(1): 2124, 2023 10 30.
Article em En | MEDLINE | ID: mdl-37904163
BACKGROUND: The secondary impacts of the COVID-19 pandemic may disproportionately affect gay, bisexual, and other men who have sex with men (GBM), particularly related to HIV prevention and treatment outcomes. We applied syndemic theory to examine PrEP disruptions during the during the height of the COVID-19 pandemic in Vancouver, Canada. METHODS: Sexually-active GBM, aged 16 + years, were enrolled through respondent-driven sampling (RDS) from February 2017 to August 2019. Participants completed a Computer-Assisted Self-Interview every six months and data were linked to the BC PrEP Program (program responsible for publicly funded PrEP in the province) to directly measure PrEP disruptions. The analysis period for this study was from March 2018-April 2021. We used univariable generalized linear mixed models to examine (1) six-month trends for syndemic conditions: the prevalence of moderate/severe depressive or anxiety symptoms, polysubstance use, harmful alcohol consumption, intimate partner violence, and (2) six-month trends for PrEP interruptions among HIV-negative/unknown GBM. We also applied 3-level mixed-effects logistic regression with RDS clustering to examine whether syndemic factors were associated with PrEP interruptions. RESULTS: Our study included 766 participants, with 593 participants who had at least one follow-up visit. The proportion of respondents with abnormal depressive symptoms increased over the study period (OR = 1.35; 95%CI = 1.17, 1.56), but we found decreased prevalence for polysubstance use (OR = 0.89; 95%CI = 0.82, 0.97) and binge drinking (OR = 0.74; 95%CI = 0.67, 0.81). We also found an increase in PrEP interruptions (OR = 2.33; 95%CI = 1.85, 2.94). GBM with moderate/severe depressive symptoms had higher odds (aOR = 4.80; 95%CI = 1.43, 16.16) of PrEP interruptions, while GBM with experiences of IPV had lower odds (aOR = 0.38; 95%CI = 0.15, 0.95) of PrEP interruptions. GBM who met clinical eligibility for PrEP had lower odds of experiencing PrEP interruptions (aOR = 0.25; 95%CI = 0.11, 0.60). CONCLUSION: There were increasing PrEP interruptions since March 2020. However, those most at risk for HIV were less likely to have interruptions. Additional mental health services and targeted follow-up for PrEP continuation may help to mitigate the impacts of the COVID-19 pandemic on GBM.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Profilaxia Pré-Exposição / Minorias Sexuais e de Gênero / COVID-19 Limite: Humans / Male País/Região como assunto: America do norte Idioma: En Revista: BMC Public Health Assunto da revista: SAUDE PUBLICA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Canadá País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Profilaxia Pré-Exposição / Minorias Sexuais e de Gênero / COVID-19 Limite: Humans / Male País/Região como assunto: America do norte Idioma: En Revista: BMC Public Health Assunto da revista: SAUDE PUBLICA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Canadá País de publicação: Reino Unido