Brogan N, Paquette D M, Lachowsky N J, Blais M, Brennan D J, Hart T A, Adam B
Public Health Agency of Canada, Ottawa, ON.
University of Victoria, Victoria, BC.
Can Commun Dis Rep. 2019 Nov 7;45(11):271-282. doi: 10.14745/ccdr.v45i11a01.
In 2017, the international European Men-who-have-sex-with-men Internet Survey (EMIS-2017) collected data from 50 countries, including Canada for the first time.
To provide an overview of the Canadian EMIS-2017 data to describe the sexually transmitted and other bloodborne infection (STBBI) related needs of gay, bisexual and other men who have sex with men (gbMSM).
The EMIS-2017 questionnaire was an updated version of EMIS-2010. It included self-reported sociodemographic data, experience of discrimination, mental health and substance use, knowledge of preexposure prophylaxis (PrEP) for HIV, sexual practices and history of STBBI testing and diagnosis. Analysis was largely descriptive.
Of the 6,059 respondents from Canada, 5,165 participants met the inclusion criteria for this analysis. The majority of participants were born in Canada (79.3%); and over half of the respondents (56.7%) were under the age of 39. In terms of discrimination related to their attraction to other men, participants reported high levels of intimidation (31.9%), verbal abuse (22.1%) and physical violence (1.5%) in the previous year. Regarding mental health, 23.9% had a moderate to severe depression/anxiety score. Almost two-thirds (64.1%) indicated substance use and one-fifth (21.5%) reported chemsex (or the use of stimulant drugs to make sex more intense or last longer). Only 8.4% of participants reported use of PrEP for HIV; however, 51.7% reported being likely to use PrEP if it was available and affordable. Sexual practices, such as condom use, varied by PrEP use with 91.3% of men using PrEP reporting condomless anal intercourse (CAI) compared with 71.5% of men not on PrEP. In terms of STBBI testing, 1.5% reported being diagnosed with hepatitis C and 9.0% reported an HIV diagnosis. Of those with an HIV diagnosis, most were on treatment (99.1%) and had an undetectable viral load (96.7%).
gbMSM in Canada experienced stigma, discrimination and mental health problems; substance use was high as were high-risk sexual practices, such as CAI, among some groups of men. There was a gap between the proportion of men who were interested in PrEP and those who actually used it; and comprehensive STBBI testing was low.These findings can inform public health action and provide a baseline to examine the impact of current and new interventions.
2017年，国际男男性行为者互联网调查（EMIS - 2017）首次从包括加拿大在内的50个国家收集数据。
概述加拿大EMIS - 2017数据，以描述男同性恋、双性恋和其他与男性发生性行为的男性（gbMSM）与性传播及其他血源感染（STBBI）相关的需求。
EMIS - 2017问卷是EMIS - 2010的更新版本。它包括自我报告的社会人口统计学数据、歧视经历、心理健康和物质使用情况、HIV暴露前预防（PrEP）知识、性行为以及STBBI检测和诊断史。分析主要是描述性的。
在来自加拿大的6059名受访者中，5165名参与者符合本分析的纳入标准。大多数参与者出生在加拿大（79.3%）；超过一半的受访者（56.7%）年龄在39岁以下。在与他们对其他男性的吸引力相关的歧视方面，参与者报告在前一年遭受高水平的恐吓（31.9%）、言语虐待（22.1%）和身体暴力（1.5%）。关于心理健康，23.9%的人有中度至重度抑郁/焦虑评分。近三分之二（64.1%）的人表示有物质使用情况，五分之一（21.5%）的人报告有化学性行为（或使用兴奋剂药物使性行为更激烈或持续时间更长）。只有8.4%的参与者报告使用HIV的PrEP；然而，51.7%的参与者报告如果PrEP可得且价格合理，他们可能会使用。性行为，如使用避孕套的情况，因PrEP使用情况而异，使用PrEP的男性中有91.3%报告有无保护肛交（CAI），而未使用PrEP的男性中这一比例为71.5%。在STBBI检测方面，1.5%的人报告被诊断为丙型肝炎，9.0%的人报告有HIV诊断。在那些被诊断为HIV的人中，大多数正在接受治疗（99.1%）且病毒载量不可检测（96.7%）。
加拿大的gbMSM经历了耻辱、歧视和心理健康问题；物质使用情况普遍，一些男性群体中的高风险性行为，如CAI，也很常见。对PrEP感兴趣的男性比例与实际使用PrEP的男性比例之间存在差距；全面的STBBI检测率较低。这些发现可为公共卫生行动提供参考，并提供一个基线来评估当前和新干预措施的影响。
