infection among gay, bisexual and other men who have sex with men in Montréal, Canada.

BACKGROUND

The bacteria has been identified as a causative agent of urethritis in men, especially in gay, bisexual and other men who have sex with men (gbMSM). Canadian clinic-based data have identified a high prevalence of and resistance to antibiotic treatments. This article estimates the prevalence of infections among Montréal gbMSM, explores correlates for infection and estimates the prevalence of mutations associated with antimicrobial resistance (AMR).

METHODS

Engage Cohort Study is a multi-site longitudinal study on sexually active gbMSM, aged 16 years and older, recruited via respondent-driven sampling in Montréal, Toronto and Vancouver. Participants completed a questionnaire on behaviour and were tested for sexually transmitted and blood-borne infections at each visit. For this sub-study, Montréal participants with a follow-up visit that occurred between November 2018 and November 2019 were included.

RESULTS

A total of 2,064 samples were provided by 716 participants. Prevalence of infection was 5.7% at rectal and/or urethral sites, 4.0% at rectal site and 2.2% at urethral site. Correlates for infection were younger age and reporting six or more sexual partners in the past six months. Prevalence of macrolide resistance associated mutations (MRAM), quinolone resistance associated mutations (QRAM) and either MRAM or QRAM, was 82%, 29% and 85%, respectively.

CONCLUSION

This first population-based study among gbMSM in Canada documents a high prevalence of urethral and rectal infection and high levels of AMR. Our results highlight the importance of access to testing and AMR detection when indicated.