HIV Community Viral Load and Factors Associated With Elevated Viremia Among a Community-Based Sample of Men Who Have Sex With Men in Vancouver, Canada

Abstract

Background We developed estimates of community viral load (VL) and risk factors for unsuppressed VL from a cross-sectional study of men who have sex with men (MSM) in Vancouver, Canada. Methods MSM were recruited from February 25, 2012 – February 28, 2014 using Respondent-Driven Sampling (RDS). Participants completed a computer assisted self-interview questionnaire and a nurse-administered point-of-care HIV test. For HIV positive participants, we conducted VL and CD4 cell counts. We used RDS-weighted analysis to obtain population estimates of key variables and multivariable logistic regression to examine factors associated with having a VL ≥200 copies/mL among HIV-positive participants. Results We recruited 719 participants, of whom 119 (16.6%) were seeds. Our estimate of the population HIV prevalence was 23.4% (95% CI 15.8 – 31.0%) after RDS-adjustments. We estimated that 18.6% (95% confidence interval [CI] 8.8 – 30.4%) of HIV-positive MSM in Vancouver had a VL ≥200 copies/mL. Having an unsuppressed VL was associated with non-Caucasian ethnicity (adjusted odds ratio [AOR]= 4.34; 95% CI 1.67 – 11.1); an annual income of <$15,000 CAD (AOR=6.43; 95%CI 2.08–19.9); using GHB in the previous six months (AOR=4.85; 95%CI 1.79–13.2); unprotected anal intercourse with a known HIV negative or unknown serostatus partner (AOR=3.13; 95%CI 1.10–8.90); and disclosing one’s HIV serostatus ≥50% of the time (AOR=7.04; 95%CI 1.01–49.1). Conclusion Despite a high prevalence of HIV, we estimated that a small proportion of HIV positive MSM have undiagnosed HIV and unsuppressed VL. Our results highlight the importance of continued work to address health inequities using a social determinants of health framework.

Gay Men’s Understanding and Education of New HIV Prevention Technologies in Vancouver, Canada

“…Participants were drawn from the larger Momentum Health Study, a longitudinal bio-behavioral prospective cohort study of 698 HIV-positive and HIV-negative gay men in Metro Vancouver, Canada (inclusion criteria: age ≥ 16, live in Metro Vancouver, identify as a man, have had sex with a man in the last six months, and able to answer a questionnaire in English) (Moore et al, 2016). The goal of the overarching Momentum Health Study is to evaluate shifts in gay men’s health, sexual behavior, and substance use in response to TasP scale-up.…”

Increasing HIV Treatment Optimism but No Changes in HIV Risk Behavior Among Men Who Have Sex With Men in Vancouver, Canada

“…Enrollment of HIV-negative participants concluded in February 2014, but we continued to enroll HIV-positive participants for an additional year. Seed participants were recruited through community contacts, mobile phone applications, and websites catering to Vancouver-based MSM [19] .…”

Changes in smoking status among a longitudinal cohort of gay, bisexual, and other men who have sex with men in Vancouver, Canada

“…Data were collected as part of the Momentum Health Study (Moore et al, 2016), a longitudinal cohort study of GBMSM in Vancouver, British Columbia. Eligibility criteria included being ≥16 years old, having had sex with a man in the past 6 months, identifying as male (including trans men), living in Metro Vancouver, and ability to complete the study in English.…”

“…Participants received a $50 honorarium per study visit and an additional $10 for each person they successfully recruited into the study. A detailed description of full study procedures is published elsewhere (Moore et al, 2016). …”

“…Since GBMSM are more likely to smoke and more likely to be living with HIV than the general population –estimated population prevalence of HIV among GBMSM in Vancouver is 23.4% (Moore et al, 2016) – understanding factors associated with changes in smoking status can assist local campaigns and programs to support cessation in this marginalized subpopulation. To address this need, we conducted longitudinal analyses to examine patterns of smoking cessation, initiation, reinitiation, and sustained abstinence in a cohort of Vancouver GBMSM.…”