P503 Trends in awareness and use of PrEP among HIV-negative men who have sex with men in vancouver, toronto, and montreal
Bibliographic record
Abstract
Background Awareness, availability, and public funding of pre-exposure prophylaxis (PrEP) has increased substantially since it was approved by Health Canada in 2016 but policies and guidelines vary by province. Given the dynamic nature of PrEP policy and promotion, we sought to determine awareness and use of PrEP among gay, bisexual, and other men who have sex with men (gbMSM) in Vancouver, Toronto, and Montreal. Methods Beginning in 02/2017, sexually-active gbMSM ≥16 years and living in Vancouver, Toronto, or Montreal were recruited into a cohort study using respondent-driven sampling (RDS). Data are included up to 08/2018. At study visits every 6 months (Vancouver) or 12 months (Toronto, Montreal), participants completed a computer-assisted self-interview which included questions on PrEP awareness and use in the past 6 months (P6M). We used RDS-adjusted, general estimating equations accounting for two levels of clustering (RDS recruitment chain; participant) to evaluate temporal trends (monthly prevalence) of awareness and P6M usage of PrEP among HIV-negative participants. Results 1619 HIV-negative gbMSM completed 2074 study visits (1205 Montreal, 285 Toronto, 584 Vancouver). Over the course of the study, PrEP awareness significantly increased among gbMSM in Montreal from 62.6% during the first 6-month period to 84.8% during the last 6-month period (OR:1.07, 95%CI:1.02–1.12, per month); awareness remained consistent in Toronto (89.8%–96.0%, ns) and Vancouver (84.5%–95.0%, ns). Use of PrEP increased significantly in all three sites: Montreal, 10.5% during the first 6-month period to 30.9% during the last 6-month period (OR:1.06, 95%CI:1.02–1.11); Toronto, 12.5% to 23.3% (OR:1.15, 95%CI:1.02–1.30); Vancouver, 11.4% to 35.2% (OR:1.16, 95%CI:1.06–1.27). Conclusion Awareness of PrEP appears to be ≥85% among HIV-negative gbMSM across all three cities. Even though provincial policy and programs differ greatly in availability and cost of PrEP, use of PrEP increased in all sites during the course of the study. Disclosure No significant relationships.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".