Open Collections

Duailibe, Felipe

University of British Columbia

Introduction: We aimed to (1) estimate the size of the gay, bisexual, and other men who have sex with men population (GBM) in Canada, (2) identify syndemic factors associated with HIV sexual risk behaviour among HIV-negative GBM by creating a network of associations, and (3) apply syndemic theory to examine how factors influence HIV sexual risk behaviour in models of co-occurring epidemics. Methods: In study 1 we used two cycles of Canadian Community Health Survey data (2015-2016 and 2019) to estimate the size of the GBM population in Canada’s four most populous provinces and compare the sociodemographic composition of GBM and non-GBM. In study 2 we used baseline data (2017-2019) from sexually active self-reported HIV-negative GBM in Engage study sites of Montreal, Toronto and Vancouver to estimate HIV sexual risk behaviour. We explored pairwise associations between potential syndemic factors, sociodemographic characteristics and HIV sexual risk behaviour using Somers’ D statistics. We reduced the number of syndemic factors using a variable reduction method. We built logistic regression models for the mediation and product terms analyses. Results: In study 1 estimates of the GBM population were 4.0% in 2015-2016 in Alberta, Ontario, British Columbia and Quebec and 4.9% in British Columbia and Ontario in 2019. In study 2, syndemic factors associated with HIV sexual risk behaviour included childhood sexual abuse (CSA), intimate partner violence (IPV), transactional sex, polysubstance use, and sexual compulsivity. We estimated a statistically significant direct effect for CSA (c' = 0.09, 95% CI 0.01 – 0.17) and total effect of CSA (c = 0.14, 95% CI 0.06 – 0.21) on HIV sexual risk behaviour. The estimated increase in adjusted odds of HIV sexual risk behaviour was 14.0 (95% CI 5.6 – 35.2) for CSA and transactional sex combined, compared to the absence of these factors. Conclusions: In study 1 we observed sexual orientation discordance and an increase in the GBM population comparing CCHS cycles. In study 2 we found a significant multiplicative interaction between CSA and transactional sex associated with HIV risk behaviour. IPV, transactional sex, sexual compulsivity and polysubstance use mediated the effect of CSA on HIV sexual risk behaviour.

Text

2024-08-19

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/88964

Experimental Medicine

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/