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Sang JM, Wong J, Ryan V, Cumming E, Wang L, Cui Z, Bacani N, Haag D, Lachowsky NJ, Cox J, Grace D, Otterstatter M, Morshed M, Edward J, Grennan T, Arkles J, Brownrigg B, Hogg RS, Moore DM. Examining the impacts of a syphilis awareness campaign among gay, bisexual, and other men who have sex with men (gbMSM) in British Columbia, Canada. Can J Public Health 2023; 114:295-307. [PMID: 36156198 PMCID: PMC10036687 DOI: 10.17269/s41997-022-00690-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Syphilis rates have increased in BC and disproportionately affect gay, bisexual, and other men who have sex with men (gbMSM). A social marketing campaign (Syphistory) ran from January to September 2017 with the primary goal of increasing syphilis knowledge and a secondary goal of increasing syphilis screening among gbMSM in BC. METHODS We used pre- and post-campaign surveys to assess changes in syphilis knowledge from a convenience sample of clients attending STI clinics using one-sided t-tests. We used online Piwik metrics to examine the campaign reach, and provincial testing data to examine trends in syphilis screening. We used data from the Engage Study to examine factors associated with campaign awareness and associations with syphilis testing. RESULTS Of the 2155 visitors to the Syphistory website with known geography, 79.4% were from BC. Moreover, STI clinic participants who saw the campaign demonstrated a greater knowledge of syphilis (9.7/12, 80.8%) than those who did not see the campaign (mean 8.9/12, 74%) (p < 0.001). Provincial syphilis testing rates were 8764 and 9749 in the 12 months before and after the campaign; however, we did not find an overall trend in testing before versus after the campaign (p = 0.147). Among Engage participants, 12.7% reported seeing the campaign and we found an association between campaign exposure and recent syphilis testing (aOR = 2.73; 95% CI = 1.51, 4.93). CONCLUSION gbMSM who saw the campaign were more likely to report being tested for syphilis in the previous 6 months. STI clinic attendees who reported seeing the campaign also had higher syphilis knowledge compared to those who did not.
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Affiliation(s)
- Jordan M Sang
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
| | - Jason Wong
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - Venessa Ryan
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Emma Cumming
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Lu Wang
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Zishan Cui
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Nicanor Bacani
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Devon Haag
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- University of Victoria, Victoria, BC, Canada
| | - Joseph Cox
- McGill University, Montreal, QC, Canada
- Direction régionale de santé publique - Montréal, Montréal, QC, Canada
| | | | - Michael Otterstatter
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - Muhammad Morshed
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - Joshua Edward
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Troy Grennan
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | | | | | - Robert S Hogg
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Simon Fraser University, Burnaby, BC, Canada
| | - David M Moore
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
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2
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Sang JM, Cui Z, Wang L, Bacani N, Lachowsky NJ, Lal A, Card KG, Roth EA, Montaner JSG, Howard T, Hogg RS, Moore DM. Treatment interruptions and community connectedness among gbMSM living with HIV in Metro Vancouver, Canada. AIDS Care 2023; 35:139-147. [PMID: 36345611 DOI: 10.1080/09540121.2022.2142927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
HIV treatment interruptions are a major public health concern that demonstrate a lack of engagement in care and is detrimental to the health of people living with HIV. Community connectedness have demonstrated a protective effect for psychosocial health but are not well understood for HIV treatment outcomes. We explored associations between community connectedness and treatment interruptions among gay, bisexual and other men who have sex with men (gbMSM) living with HIV in Vancouver, British Columbia. We analyzed survey data from the Momentum Health Study and identified treatment interruptions through data linkages with the provincial HIV Drug Treatment Program as episodes lasting more than 60 days beyond an expected antiretroviral therapy refill date from February 2012 to July 2019. We built a mixed-effects logistic regression model, adjusting for confounders. Of 213 gbMSM living with HIV, 54 experienced treatment interruption (25.4%) over a median five-year follow-up. Multivariable results found the number gbMSM who spoken to in the past month (aOR = 0.995; 95% CI = 0.991, 1.000 (per 100-unit increase)) and attending a gay community meeting more than once per month (aOR = 0.32; 95% CI = 0.11, 0.89) were associated with lower odds of treatment interruptions. These results highlight the importance of social connections in facilitating effective HIV care.
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Affiliation(s)
- Jordan M Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nathan J Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Kiffer G Card
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Terry Howard
- Momentum Health Study Community Advisory Board, Vancouver, Canada
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, Canada
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3
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Armstrong HL, Gitelman J, Cui Z, Bacani N, Sereda P, Lachowsky NJ, Card KG, Sang JM, Raymond HF, Montaner J, Hall D, Howard T, Hull M, Hogg RS, Roth EA, Moore DM. Virological suppression among gay, bisexual, and other men who have sex with men living with HIV in Vancouver, Canada: A longitudinal cohort study from 2012-2017. PLoS One 2022; 17:e0276596. [PMID: 36269767 PMCID: PMC9586352 DOI: 10.1371/journal.pone.0276596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 10/11/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION In 2010, British Columbia (BC) implemented HIV Treatment as Prevention (TasP) as policy. We examined trends in virologic suppression and determinants of significant viremia among a prospective biobehavioural cohort of men who have sex with men (gbMSM) in Vancouver from 2012-2017. METHODS Respondent-driven sampling was used to recruit sexually active gbMSM (≥16 years) who completed biannual study visits with a computer-assisted self-interview and clinical CD4 and viral load (VL) testing. We linked participant data with the BC HIV Drug Treatment Program to obtain antiretroviral dispensing and VL data. We conducted a trend analysis of VL suppression using univariable generalized estimating equation (GEE) multi-level modelling and multivariable GEE to identify factors associated with episodes of VL ≥200 copies/mL. RESULTS Of 774 participants, 223 were living with HIV at baseline and 16 were diagnosed during follow-up (n = 239). We observed a significant trend towards reduced levels of unsuppressed VL (>200 copies/mL) from 22% (07/2012-12/2012) to 12% (07/2016-12/2016) (OR:0.87; 95%CI:0.83-0.91 for each 6-month period). Among those with at least one follow-up visit, (n = 178, median follow-up = 3.2 years, median age = 46.9 years), younger age (aOR:0.97; 95%CI:0.94-0.99, per year), ecstasy use (aOR:1.69; 95%CI:1.13-2.53), crystal methamphetamine use (aOR:1.71; 95%CI:1.18-2.48), seeking sex via websites (aOR:1.46; 95%CI:1.01-2.12), and lower HIV treatment optimism (aOR:0.94; 95%CI:0.90-0.97) were associated with episodes of elevated viremia. CONCLUSIONS During a period when TasP policy was actively promoted, we observed a significant trend towards reduced levels of unsuppressed VL. Continued efforts should promote HIV treatment optimism and engagement, especially among younger gbMSM and those who use ecstasy and crystal methamphetamine.
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Affiliation(s)
- Heather L. Armstrong
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Psychology, University of Southampton, Southampton, United Kingdom
- * E-mail:
| | | | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nathan J. Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Kiffer G. Card
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Jordan M. Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Henry F. Raymond
- School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| | - Julio Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - David Hall
- Immunodeficiency Clinic, St. Paul’s Hospital, Vancouver, Canada
| | - Terry Howard
- Momentum Health Study, Community Advisory Board, Vancouver, Canada
| | - Mark Hull
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Robert S. Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Eric A. Roth
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Anthropology, University of Victoria, Victoria, Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Thompson KA, Blank G, Toy J, Moore DM, Lachowsky N, Bacani N, Zhang W, Sereda P, Lima VD, Barrios R, Montaner JSG, Hull MW. Prevalence and incidence of hepatitis C infection amongst men who have sex with men in a population-based pre-exposure prophylaxis program in British Columbia, Canada. Liver Int 2022; 42:1528-1535. [PMID: 35274805 DOI: 10.1111/liv.15237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/18/2021] [Accepted: 08/27/2021] [Indexed: 02/13/2023]
Abstract
BACKGROUND Men who have sex with men (MSM) are at risk for sexually-transmitted hepatitis C (HCV). Evidence for HCV infection in the context of pre-exposure prophylaxis (PrEP) use in North America is limited. We sought to characterize baseline HCV prevalence and incidence in MSM receiving PrEP in British Columbia (BC), Canada. METHODS We followed individuals in the BC PrEP program from January 2018 to August 2019. We evaluated baseline prevalence and incident seroconversions (newly positive HCV antibody). A multivariable logistic regression model was performed in MSM for factors associated with HCV prevalence at enrollment, including reported prior sexually transmitted infection (STI), HIV Incidence Risk Index for MSM score, PrEP use because of a partner living with HIV, and location of residence. RESULTS The median age of the cohort was 33 years, 98.3% male, with 3058 person years (PY) of follow-up. Baseline HCV prevalence was 0.82% (31/3907 MSM enrollees) and HCV incidence (n = 3) was 0.15 per 100 PY (95% confidence interval [CI] 0.03-0.45). In multivariable analysis, initiating PrEP because of a partner living with HIV (adjusted odds ratio [aOR] 5.02; 95% CI 1.87-13.47) and prior STI (aOR 2.34; 95% CI 1.04-5.24) were associated with positive HCV status. CONCLUSIONS Baseline HCV prevalence and incidence was low amongst MSM in a population-based PrEP program in BC, Canada. HCV was associated with bridging from populations living with HIV and evidence of a reported prior STI as a PrEP indicator condition amongst MSM. PrEP initiation may be an opportunity for linkage to HCV screening and treatment.
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Affiliation(s)
- Kyle A Thompson
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Gabriel Blank
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Junine Toy
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - David M Moore
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan Lachowsky
- Faculty of Human & Social Development, School of Public Health & Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Nicanor Bacani
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Wendy Zhang
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Paul Sereda
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Viviane D Lima
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rolando Barrios
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Julio S G Montaner
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark W Hull
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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5
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McClean AR, Trigg J, Ye M, McLinden T, Kooij KW, Bacani N, Hui C, Sereda P, Burchell AN, Walmsley SL, Kelly D, Machouf N, Montaner JSG, Loutfy M, Hogg RS. Neighbourhood-level material deprivation and response to combination antiretroviral therapy in the Canadian Observational Cohort (CANOC): a longitudinal cohort study. CMAJ Open 2022; 10:E183-E189. [PMID: 35292476 PMCID: PMC8929426 DOI: 10.9778/cmajo.20200249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Socioeconomic status has been associated with higher viral loads and lower CD4 cell counts among people living with HIV. The objective of this study was to evaluate the relation between neighbourhood-level material deprivation and immunologic and virologic response to combination antiretroviral therapy (ART) among people living with HIV in Canada. METHODS The Canadian Observational Cohort (CANOC) is a longitudinal cohort of people living with HIV, containing data from 2000-2016 from 5 Canadian provinces. We defined response to combination ART as positive if the CD4 cell count increased by 50 cells/mm3 (0.05 cells × 109/L) or more (CD4+) and viral load decreased to 50 copies/mL or less (VL+) within 6 months of treatment initiation. We further categorized response to therapy as concordant positive (CD4+/VL+), concordant negative (CD4-/VL-) or discordant (CD4+/VL- or CD4-/VL+). We used adjusted multinomial logistic regression to quantify the relation between neighbourhood-level material deprivation and immunologic and virologic response. RESULTS This study included 8274 people living with HIV, of which 1754 (21.2%) lived in the most materially deprived neighbourhoods. Most individuals (62.2%) showed a concordant positive response to combination ART. After adjustment, living in the most materially deprived neighbourhoods was associated with a CD4-/VL+ discordant response (adjusted odds ratio [OR] 1.31, 95% confidence interval [CI] 1.06-1.62) and a concordant negative response (adjusted OR 1.45, 95% CI 1.13-1.86), using a concordant positive response as the reference. No other deprivation quartile was independently associated with a particular response. INTERPRETATION People living with HIV from the most materially deprived neighbourhoods had increased odds of poor immunologic or virologic response to combination ART. These results motivate further study of the specific socioeconomic factors that potentially affect response to combination ART among people living with HIV in Canada.
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Affiliation(s)
- Alison R McClean
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont.
| | - Jason Trigg
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Monica Ye
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Taylor McLinden
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Katherine W Kooij
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Christian Hui
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Ann N Burchell
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Sharon L Walmsley
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Deborah Kelly
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Nimâ Machouf
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Mona Loutfy
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS (McClean, Trigg, Ye, McLinden, Kooij, Bacani, Sereda, Montaner, Hogg); Faculty of Medicine (McClean, Montaner), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Kooij, Hogg), Simon Fraser University, Burnaby, BC; Faculty of Arts (Hui), Ryerson University, Toronto Ont.; Canadian Institutes of Health Research Canadian HIV Trials Network (Hui, Walmsley), Vancouver, BC; Department of Family and Community Medicine (Burchell), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Burchell), Faculty of Health Sciences, University of Toronto; University Health Network (Walmsley), Toronto, Ont.; Faculty of Medicine and School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Clinique de Médecine Urbaine du Quartier Latin (Machouf), Montréal, Que.; Division of Infectious Disease (Loutfy), Department of Medicine, University of Toronto; Women's College Hospital (Loutfy), Toronto, Ont
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Thompson KA, Blank G, Toy J, Moore DM, Lachowsky N, Bacani N, Zhang W, Sereda P, Lima VD, Barrios R, Montaner JSG, Hull MW. Chronic Hepatitis B Infection Among Preexposure Prophylaxis Users Enrolled in a Population-Based Program in British Columbia, Canada. Open Forum Infect Dis 2021; 8:ofab492. [PMID: 34805433 PMCID: PMC8598915 DOI: 10.1093/ofid/ofab492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/04/2021] [Indexed: 12/17/2022] Open
Abstract
Initiation of human immunodeficiency virus preexposure prophylaxis (PrEP) medications will also treat hepatitis B infection (HBV). The prevalence of chronic HBV was 0.86% (n=41/4760) among enrollees in a provincial PrEP program in British Columbia, Canada. Overall, 46.3% lacked follow-up HBV DNA monitoring, underscoring the need for HBV-related education for PrEP prescribers.
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Affiliation(s)
- Kyle A Thompson
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Gabriel Blank
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Junine Toy
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - David M Moore
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan Lachowsky
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - Nicanor Bacani
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Wendy Zhang
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Paul Sereda
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Viviane D Lima
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rolando Barrios
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Julio S G Montaner
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark W Hull
- BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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7
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Khatra J, Sang JM, Wang C, Bacani N, Lachowsky NJ, Grennan T, Burchell AN, Lal A, Roth E, Hogg R, Card K, Moore D. Longitudinal uptake of the human papillomavirus vaccine among gay, bisexual and other men who have sex with men in British Columbia, Canada 2012-2019. Sex Transm Infect 2021; 98:302-306. [PMID: 34400578 DOI: 10.1136/sextrans-2020-054871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/08/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES In 2015, a publicly funded human papillomavirus (HPV) vaccination programme was implemented for gay, bisexual and other men who have sex with men (gbMSM) up to age 26 years in British Columbia, Canada. We assessed trends and correlates of HPV vaccine uptake from 2012 to 2019 in a cohort of gbMSM in Vancouver. METHODS We recruited sexually active gbMSM aged ≥16 years using respondent-driven sampling from February 2012 to February 2015 and followed them until July 2019. We evaluated self-reported HPV vaccine trends using mixed-effects logistic regression and identified factors associated with uptake using multivariable mixed-effects Poisson regression. RESULTS A total of 719 participants were recruited and completed the baseline visit, of whom 549 were unvaccinated with at least one follow-up visit. The median age was 33 years and 23% were living with HIV. HPV vaccination increased from 4% in 2012 to 28% in 2019 (p<0.001) among gbMSM >26 years, and from 9% in 2012 to 20% in 2017 (p<0.001) among gbMSM ≤26 years. Vaccination uptake increased after September 2015, following vaccination policy expansion (adjusted rate ratio (aRR)=1.82, 95% CI 1.06 to 3.12). In multivariable models, increased vaccination was associated with age ≤26 years vs ≥45 years (aRR=3.90; 95% CI 1.75 to 8.70), age 27-44 vs ≥45 years (aRR=2.86; 95% CI 1.46 to 5.62), involvement in gay community sports teams (aRR=2.31; 95% CI 1.15 to 4.64) and other groups (aRR=1.71; 95% CI 1.04 to 2.79), awareness of HIV-postexposure prophylaxis (aRR=5.50; 95% CI 1.31 to 23.09), recent sexually transmitted infection testing (aRR=2.72; 95% CI 1.60 to 4.60) and recent sex-work (aRR=2.59; 95% CI 1.08 to 6.19). CONCLUSIONS Although we observed increases in HPV vaccination uptake from 2012, by 2019 HPV vaccination still remained below 30% among gbMSM in Vancouver, BC. Additional interventions are needed to increase vaccine uptake.
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Affiliation(s)
- Jatinder Khatra
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan Mitchell Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Clara Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Nathan John Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Troy Grennan
- Department of Infectious Diseases, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Ann Natalie Burchell
- Department of Family and Community Medicine and MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Eric Roth
- Department of Anthropology, University of Victoria, Victoria, British Columbia, Canada
| | - Robert Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kiffer Card
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - David Moore
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
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8
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McClean AR, Kooij KW, Trigg J, Ye M, Sereda P, McLinden T, Bacani N, Aran N, Thomas R, Wong A, Klein MB, Hull M, Cooper C, Salters K, Hogg RS. Tobacco smoking and HIV-related immunologic and virologic response among individuals of the Canadian HIV Observational Cohort (CANOC). AIDS Care 2021; 34:982-991. [PMID: 34074181 DOI: 10.1080/09540121.2021.1929813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We assessed the relationship between tobacco smoking and immunologic and virologic response among people living with HIV (PLWH) initiating combination antiretroviral therapy (cART) in the Canadian HIV Observational Cohort (CANOC). Positive immunologic and virologic response, respectively, were defined as ≥50 cells/mm3 CD4 count increase (CD4+) and viral suppression ≤50 copies/mL (VL+) within 6 months of cART initiation. Using multinomial regression, we examined the relationship between smoking, immunologic, and virologic response category. Model A adjusted for birth sex, baseline age, enrolling province, and era of cohort entry; models B and C further adjusted for neighbourhood level material deprivation and history of injection drug use (IDU), respectively. Among 4267 individuals (32.7%) with smoking status data, concordant positive (CD4+/VL+) response was achieved by 64.2% never, 66.9% former, and 59.4% current smokers. In the unadjusted analysis, current smoking was significantly associated with concordant negative response (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.40-2.45). Similarly, models A and B showed an increased odds of concordant negative response in current smokers (adjusted OR [aOR] 1.78, 95% CI 1.32-2.39 and 1.74, 95% CI 1.29-2.34, respectively). The association between current smoking and concordant negative response was no longer significant in model C (aOR 1.18, 95%CI 0.85-1.65).
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Affiliation(s)
- Alison R McClean
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,University of British Columbia, Vancouver, Canada
| | - Katherine W Kooij
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Jason Trigg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Monica Ye
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Taylor McLinden
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Niloufar Aran
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | | | - Alexander Wong
- Department of Medicine, University of Saskatchewan, Regina, Canada
| | - Marina B Klein
- McGill University Health Centre, Montreal, Canada.,CIHR Canadian HIV Trials Network, Vancouver, Canada
| | - Mark Hull
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,University of British Columbia, Vancouver, Canada
| | | | - Kate Salters
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Simon Fraser University, Burnaby, Canada
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Simon Fraser University, Burnaby, Canada
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- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
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Cheng B, Sang JM, Cui Z, Bacani N, Armstrong HL, Zhu J, Elefante J, Olarewaju G, Card KG, Blackwell E, Lachowsky NJ, Hogg RS, Roth EA, Moore DM. Factors Associated with Cessation or Reduction of Methamphetamine Use among Gay, Bisexual, and Other Men Who Have Sex with Men (gbMSM) in Vancouver Canada. Subst Use Misuse 2020; 55:1692-1701. [PMID: 32406780 PMCID: PMC7527035 DOI: 10.1080/10826084.2020.1756854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Methamphetamine (MA) use among gay, bisexual, and other men who have sex with men (gbMSM) is a pervasive issue, associated with detrimental health outcomes. We identified factors associated with discontinuation or reduction in MA among a subset of gbMSM reporting frequent (at least weekly) use, with a specific focus on symptoms of anxiety and depression. Methods: We recruited sexually-active gbMSM aged ≥16 years in Vancouver, Canada into a prospective-cohort study using respondent-driven sampling. Participants completed study visits once every six months. We used generalized linear mixed models to identify factors associated with reductions in MA use following a visit where participants previously reported using MA at least weekly. Results: Of 584 cohort participants with at least one follow-up visit, 67 (11.5%) reported frequent MA use at baseline or in follow-up visits. Of these, 46 (68.7%) had at least one subsequent study visit where they transitioned to less frequent (monthly or less) or no MA use. In multivariable models, reduced MA use was less likely for those who spent >50% of social time with other gbMSM (aRR = 0.49, 95%CI:0.28-0.85), gave or received drugs in exchange for sex (aRR = 0.34, 95%CI:0.13-0.87), injected drugs (aRR = 0.35, 95%CI:0.18-0.68), or used gamma-hydroxybutyrate (GHB) (aRR = 0.41, 95%CI:0.21-0.78). Symptoms of anxiety or depression were not associated with reductions in MA use. Conclusions: Social connection and drug-related factors surrounding MA use were associated with reductions, but anxiety and depressive symptomatology were not. Incorporating socialization and polysubstance-related components with MA reduction may help in developing efficacious interventions toward reducing MA use for gbMSM.
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Affiliation(s)
- Brooke Cheng
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Jordan M Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | | | - Julia Zhu
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Julius Elefante
- St. Paul's Hospital, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Gbolahan Olarewaju
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kiffer G Card
- University of Victoria, Victoria, BC, Canada.,Canadian Institute for Substance Use Research, Victoria, BC, Canada
| | | | - Nathan J Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,University of Victoria, Victoria, BC, Canada.,Canadian Institute for Substance Use Research, Victoria, BC, Canada
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Simon Fraser University, Burnaby, BC, Canada
| | - Eric A Roth
- University of Victoria, Victoria, BC, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Card KG, Armstrong HL, Wang L, Bacani N, Moore DM, Roth EA, Hogg RS, Lachowsky NJ. Escape expectancies and sexualized substance use among gay, bisexual, and other men who have sex with men. AIDS Care 2019; 32:1489-1497. [PMID: 31851524 DOI: 10.1080/09540121.2019.1705961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
McKirnan's Cognitive Escape Theory (1996) is often characterized by the hypothesis that drugs are used during sex by gay, bisexual, and other men who have sex with men (gbMSM) to relieve internal cognitive conflict over safe-sex norms and sexual desire. We examined how McKirnan's Cognitive Escape Scale (CES) is related to other widely used constructs relevant to sexualized substance use with hopes of better situating the theory within the evolving landscape of HIV-prevention. Associations between CES and trait anxiety, depression, treatment optimism, sexual altruism, sexual sensation seeking, and self-perceived risk for HIV transmission/acquisition were tested. Mediation analyses tested whether associated psychological measures mediated the effect of CES on the proportion of events in which participants reported co-occurrent substance use and condomless anal sex. Results indicated that CES is associated with higher sexual sensation seeking, treatment optimism, trait anxiety, and perceived likelihood of HIV transmission/acquisition. Mediation analyses suggest that CES is related to but operates independently of treatment optimism, sensation seeking, and trait anxiety. Nevertheless, the intersection of HIV-related worries and substance use expectancies are clearly more nuanced than is widely reported is discussions on cognitive escape.
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Affiliation(s)
- Kiffer G Card
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, Canada.,Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Heather L Armstrong
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, Canada
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Nathan J Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, Canada.,Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
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11
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Hunt G, Wang L, Bacani N, Card K, Sereda P, Lachowsky N, Roth E, Hogg R, Moore D, Armstrong H. Generational differences in sexual behaviour and partnering among gay, bisexual, and other men who have sex with men. Can J Hum Sex 2019; 28:215-225. [PMID: 34305417 DOI: 10.3138/cjhs.2019-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Given that different generations of gay, bisexual, and other men who have sex with men (gbMSM) have been influenced by substantially different life course events and cultural contexts, we explored differences in sexual behaviour between millennials, Gen-Xers, and baby boomers. METHODS Sexually active gbMSM from Metro Vancouver, ≥16 years, were recruited using respondent-driven sampling between 2012-2015 and completed computer-assisted self-interviews every 6 months, up to 2017. To explore differences between generations (millennials born ≥1987, Gen-Xers born 1962-1986, baby boomers born <1962) we used multivariable logistic regression models using baseline, RDS-weighted data. We also examined 6-month trends, stratified by generation, in partner number, prevalence of high-risk sex, and relationship status using hierarchical mixed-effects models. RESULTS Among 774 gbMSM (190 millennials, 469 Gen-Xers, 115 baby boomers), median age of first anal sex with a male partner decreased from 20 (aQ1,aQ3:17,25) among baby boomers to 18 (aQ1,aQ3: 16,20) among millennials (x 2 (DF=2, N=764)=12.920, p=0.002). After controlling for relevant demographics, differences were observed for some sexual behaviours (i.e., anal sex positioning, giving oral sex, sex toys, masturbation, sexual app/website use, transactional sex) but not others (i.e., receiving oral sex, rimming, fisting, watersports, group sex). At baseline, millennials reported less high-risk sex than other generations but all trended toward less high-risk sex, fewer partners, and regular partnering over the course of the study. CONCLUSIONS While there was notable similarity across generations, millennial gbMSM reported earlier age at first anal intercourse and less high-risk sex. However, all generations trended towards less high-risk sex, fewer partners, and regular partnering over time.
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Affiliation(s)
- Giselle Hunt
- Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Kiffer Card
- School of Population Health and Social Policy, University of Victoria, Victoria, BC
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Nathan Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC.,School of Population Health and Social Policy, University of Victoria, Victoria, BC
| | - Eric Roth
- Department of Anthropology, University of Victoria, Victoria, BC
| | - Robert Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
| | - David Moore
- Faculty of Medicine, University of British Columbia, Vancouver, BC.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Heather Armstrong
- Faculty of Medicine, University of British Columbia, Vancouver, BC.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
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12
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Closson K, Chown S, Armstrong HL, Wang L, Bacani N, Ho D, Jollimore J, Olarewaju G, Moore DM, Roth EA, Hogg RS, Lachowsky NJ. HIV leadership programming attendance is associated with PrEP and PEP awareness among young, gay, bisexual, and other men who have sex with men in Vancouver, Canada. BMC Public Health 2019; 19:429. [PMID: 31014296 PMCID: PMC6480620 DOI: 10.1186/s12889-019-6744-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young gay, bisexual, and other men who have sex with men (YGBM) may have reduced engagement and knowledge of HIV care and biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and Treatment as Prevention (TasP), compared with adult GBM. We sought to understand differences in HIV prevention awareness, health care access, and service utilization between youth (16-29 years) and adult (≥30 year) GBM, as well as factors associated with attendance in HIV leadership programming among YGBM living in the publicly funded PrEP setting of Vancouver, Canada. METHODS Sexually-active GBM were recruited using respondent-driven sampling (RDS) from February 2012 to February 2015. Participants completed an in-person computer-assisted self-interview every 6 months, up to February 2017, with questions on sociodemographic factors, awareness of biomedical HIV prevention strategies, and an HIV treatment optimism-skepticism scale. Participants were asked if they had ever attended either of two HIV-leadership programs designed for YGBM. Both programs involve multiple GBM-led education and social networking sessions operated by community-based organizations in Vancouver. Multivariable Glimmix confounder models assessed differences between youth and adult GBM. Among younger men, bivariate analyses examined factors associated with HIV-leadership program attendance. RESULTS Of 698 GBM who enrolled in the longitudinal study, 36.8% were less than 30 years old at the first study visit. After controlling for gender identification, sexual orientation, HIV status, and income in the past 6 months, younger GBM (n = 257/698) had lower awareness of biomedical HIV prevention strategies and less HIV treatment optimism compared with older GBM (n = 441/698). Among younger GBM who attended HIV-leadership programs (n = 50), greater awareness of biomedical HIV prevention strategies and higher HIV treatment optimism were reported, compared with non-attendees. CONCLUSION Younger GBM, who are disproportionately affected by the HIV epidemic, are less aware of new prevention technologies than older GBM, but attending peer-based HIV-leadership programs ameliorates age-disparities in HIV-prevention knowledge and treatment optimism.
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Affiliation(s)
- Kalysha Closson
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Sarah Chown
- YouthCO HIV & Hep C Society, 205-568 Seymour St., Vancouver, BC V6B 3J5 Canada
| | - Heather L. Armstrong
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
| | - Darren Ho
- Community-Based Research Centre for Gay Men’s Health, 1007-808 Nelson St., Vancouver, BC V6Z 2H2 Canada
| | - Jody Jollimore
- Community-Based Research Centre for Gay Men’s Health, 1007-808 Nelson St., Vancouver, BC V6Z 2H2 Canada
| | - Gbolahan Olarewaju
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - Eric A. Roth
- Department of Anthropology, University of Victoria, Cornett Building B228, 3800 Finnerty Road, Victoria, BC V8P 5C2 Canada
| | - Robert S. Hogg
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Nathan J. Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- School of Public Health and Social Policy, University of Victoria, Human and Social Development Building B202, 3800 Finnerty Road, Victoria, BC V8P 5C2 Canada
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Chou FY, Armstrong HL, Wang L, Bacani N, Lachowsky NJ, Patterson TL, Walsh Z, Olarewaju G, Card KG, Roth EA, Hogg RS, Moore DM. A longitudinal analysis of cannabis use and mental health symptoms among gay, bisexual, and other men who have sex with men in Vancouver, Canada. J Affect Disord 2019; 247:125-133. [PMID: 30665075 PMCID: PMC6588188 DOI: 10.1016/j.jad.2019.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/03/2019] [Accepted: 01/13/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cannabis use, anxiety, and depression are common among gay, bisexual, and other men who have sex with men (gbMSM) and some report using cannabis to manage mental health symptoms. METHODS Sexually-active gbMSM aged ≥16 years were recruited into a longitudinal cohort through respondent-driven sampling and completed study visits every six months. Data on demographics, drug use, and anxiety and depression symptoms were collected via a self-administered computer-based survey. A study nurse determined previous mental health diagnoses and treatment. Using multivariable generalized linear mixed models, we examined factors associated with regular cannabis use (≥weekly in the previous 3 months) and, among individuals who reported anxiety or depression/bipolar diagnoses, factors associated with moderate/severe anxiety or depression symptoms. RESULTS Of 774 participants (551 HIV-negative, 223 HIV-seropositive), 250 (32.3%) reported regular cannabis use, 200 (26.4%) reported ever being diagnosed with anxiety, and 299 (39.3%) reported ever being diagnosed with depression or bipolar disorder at baseline. Regular cannabis use was positively associated with HIV-seropositivity (aOR = 2.23, 95%CI:1.40-3.54) and previous mental health diagnosis (aOR = 1.52, 95%CI: 1.00-2.31, p = 0.05). Among those previously diagnosed with anxiety or depression/bipolar disorder, regular cannabis use was not associated with moderate/severe anxiety (aOR = 1.16, 95%CI:0.69-1.94) or depression symptoms (aOR = 0.96, 95%CI:0.59-1.58), respectively. LIMITATIONS Because of observational study design, we are unable to determine absolute effect. CONCLUSIONS Regular cannabis use was more likely among HIV-positive gbMSM and those previously diagnosed with a mental health disorder. No association was found between regular cannabis use and severity of anxious or depressive symptoms among those diagnosed with these conditions.
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Affiliation(s)
- Frank Y Chou
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Queen's University, Kingston, Ontario, Canada
| | - Heather L Armstrong
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Lu Wang
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
| | - Nicanor Bacani
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; University of Victoria, Victoria, BC, Canada
| | | | - Zach Walsh
- Department of Psychology, University of British Columbia, Kelowna, BC, Canada
| | - Gbolahan Olarewaju
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
| | - Kiffer G Card
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; University of Victoria, Victoria, BC, Canada
| | - Eric A Roth
- University of Victoria, Victoria, BC, Canada
| | - Robert S Hogg
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Simon Fraser University, Burnaby, BC, Canada
| | - David M Moore
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Parent S, Barrios R, Nosyk B, Ye M, Bacani N, Panagiotoglou D, Montaner J, Ti L. Impact of Patient-Provider Attachment on Hospital Readmissions Among People Living With HIV: A Population-Based Study. J Acquir Immune Defic Syndr 2018; 79:551-558. [PMID: 30204719 PMCID: PMC6231958 DOI: 10.1097/qai.0000000000001857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Hospital readmission 30 days after discharge is associated with adverse health outcomes, and people living with HIV (PLWH) experience elevated rates of hospital readmission. Although continuity of care with a health care provider is associated with lower rates of 30-day readmission among the general population, little is known about this relationship among PLWH. The objective of this study is to examine whether engaging with the same provider, defined as patient-provider attachment, is associated with 30-day readmission for this population. SETTING Data were derived from the Seek and Treat for Optimal Prevention of HIV in British Columbia cohort. METHODS Using generalized estimating equation with a logit link function, we examined the association between patient-provider attachment and 30-day hospital readmission. We determined whether readmission was due to all cause or to a similar cause as the index admission. RESULTS Seven thousand thirteen PLWH were hospitalized during the study period. Nine hundred twenty-one (13.1%) were readmitted to hospital for all cause and 564 (8.0%) for the similar cause as the index admission. Patient-provider attachment was negatively associated with 30-day readmission for all causes (adjusted odds ratio = 0.85, confidence interval = 0.83 to 0.86). A second multivariable model indicated that patient-provider attachment was also negatively associated with 30-day readmission for a similar cause (adjusted odds ratio = 0.86, confidence interval = 0.84 to 0.88). CONCLUSIONS Our results indicate that a higher proportion of patient-provider attachment was negatively associated with 30-day hospital readmission among PLWH. Our study findings support the adoption of interventions that seek to build patient-provider relationships to optimize outcomes for PLWH and enhance health care sustainability.
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Affiliation(s)
- Stephanie Parent
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Bohdan Nosyk
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Monica Ye
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Dimitra Panagiotoglou
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Julio Montaner
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Lianping Ti
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada
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