Mancount Sizes Up the Gaps*
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From Summit 2010: Gay Men's Health Presented by Mark Gilbert, BC CDC & Terry Trussler, CBRC
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Mancount Sizes Up the Gaps*
- 1. ManCount Sizes Up the Gaps Dr. Mark Gilbert BC Centre for Disease Control Dr. Terry Trussler Community Based Research Centre Gay Men’s Health Summit - Nov 26, 2010
- 4. M-Track Surveillance System Montreal Ottawa Toronto Winnipeg Victoria Vancouver
- 5. New positive HIV tests in MSM, BC
- 6. Percent of new HIV infections, BC, 2008 Boulos et al. Estimates of HIV Prevalence and Incidence in Canada, 2005. CCDR 2006;32(15):165-174 Chris Archibald, PHAC, personal communication, November 2009.
- 7. People living with HIV, BC, 2008 Boulos et al. Estimates of HIV Prevalence and Incidence in Canada, 2005. CCDR 2006;32(15):165-174 Chris Archibald, PHAC, personal communication, November 2009.
- 10. Section 1: Who Participated?
- 15. 87% lived in metro Vancouver
- 16. Section 2: HIV and other infections
- 17. HIV Prevalence
- 21. 13.6% of HIV negative men believed that they were somewhat to very likely to become HIV positive in their lifetime
- 25. Section 3: Testing Practices
- 30. Section 4: Sexual Health and Behaviour
- 39. Implications
- 42. Report of findings available at www.mancount.ca Questions? [email_address]
Notes de l'éditeur
- ManCount gives us a snapshot of the current state of HIV in the gay and MSM community in Vancouver
- ManCount is the Vancouver Site of M-Track, a national second generation HIV surveillance system developed and coordinated by the Public Health Agency of Canada, in partnership with local government, NGO and research organizations
- Total, 11, 400 people estimated to be living with HIV in BC in 2008 MSM 42%, MSM-IDU 3%
- Gender identity: (more than one option possible) Man – 95.4% Woman – 0.5% Trans man (F to M) - 1.0% Trans woman (M to F) – 0.6% Intersexed - 0.1% Two-spirit – 3.6%
- Remainder from nearby cities, elsewhere in BC, Canada, and some from far away
- Similar prevalence to what has been measured in similar surveys in Montreal, Toronto, US Prevalence was 21% among residents of metro Vancouver
- Differences in the generational experience of HIV Positive in the sense that increased survival, excellence of medical care/HAART Ron Stall & lifetime trajectory Opportunity among younger gay men to halt transmission and to prevent seeing similar prevalences when older
- 14% of all HIV positive men were unaware Proportion and number of men unaware was greater in younger age groups: 43% were < 30 years old
- 33% very unlikely 36% unlikely Reflects reality? Reflects fatalism?
- Uncertainty – based on laboratory test (not validated as diagnostic test) and questions (as can be treated for these infections, and based on a combination of responses to other questions) Hepatitis C – most had a history of injection drug use; however, some did not suggesting role for sexual transmission of HCV. 62% of HCV +ve on DBS were HIV +ve.
- Any STBBI – gonorrhea, chlamydia, genital warts, syphilis, genital herpes Importance as STIs can be affect likelihood of HIV acquisition and transmission
- 239 specimens tested High but similar to other jurisdictions
- 68% had tested once for HIV in the past 2 years Young men: 77% had ever tested for HIV Typically as one might expect, ever testing for these infections was lower among < 30 years Testing in the past year had fewer differences by age, often lower at older ages
- 6.6% tested because of the “system”: being tested for STD, HCW recommended test, saw ad/poster/article about HIV
- For many HIV negative men who hadn’t tested due to perceived low risk – answers to other questions suggested this was true About 16% of HIV negative men reported not testing due to “negative consequences”: do not want to know, could not deal, affect relationships/career, discrimination, nothing can be done, reporting, impact on sex life) About 14% not testing because of the system (don’t have a doctor, couldn’t get appointment, don’t know where to go for testing)
- For those who had not been tested, reasons for not testing included: concern about their relationships, suspicion that they were already HIV-infected, not wanting to know, being unable to cope with the result
- Range of sexual behaviours and profiles; not sexually active, not having anal sex, one to multiple partners 58% reported condom use the last time they had sex Of men who were sexually active More common among HIV positive compared to HIV negative
- Pressure greater among HIV unaware men, also among men reporting UAI-US
- Likely indicates how became infected, and how may transmit infection One of the inconsistencies that contributes to transmission May be men who are acutely infected with HIV & higher viral loads
- Poppers, crystal meth and cocaine were associated with unprotected sex between unknown or different status partners Cocaine is higher and crystal meth lower compared to Sex Now survey data
- For men who had disclosed, median of 4 years after first had sex
- Multiple strategies – different for different age groups, acting on different drivers, positive and negative men, multiple levels