Characteristics of the sexual networks of gay, bisexual, and other men who have sex with men in Montréal, Toronto, and Vancouver: implications for the transmission and control of mpox in Canada
Bibliographic record
Abstract
Abstract Background The 2022-2023 global mpox outbreak disproportionately affected gay, bisexual, and other men who have sex with men (GBM). In Canada, >70% of cases thus far have been among GBM in Montréal, Toronto, and Vancouver. We examined how the distributions of sexual partners 1) varied by city and over time related to the COVID-19 pandemic and 2) were associated with mpox transmission. Methods The Engage Cohort Study (2017-2023) recruited GBM via respondent-driven sampling in Montréal, Toronto, and Vancouver (n=2,449). We compared numbers of sexual partners in the past 6 months across cities and three time periods: pre-COVID-19 pandemic (2017-2019), pandemic (2020-2021), and post-restrictions (2021-2023). We modeled the distribution of sexual partner numbers using Bayesian negative binomial regressions and post-stratification, adjusting for sampling design and attrition. We estimated the basic reproduction number ( R 0 ), secondary attack rate (SAR), and cumulative incidence proportion of mpox using the fitted distributions and case timeseries. Results The pre-COVID-19 pandemic distribution of sexual partner numbers was similar across cities: participants’ mean number of partners was 10.3 (95%CrI: 9.3-11.3) in Montréal, 12.8 (11.1-14.7) in Toronto, and 10.6 (9.41-11.9) in Vancouver. Partner numbers decreased during the pandemic in all cities. Post-restrictions, sexual activity increased but remained well below pre-pandemic levels. Based on reported cases and post-restrictions distributions, the estimated R 0 (2.4-2.6) and cumulative incidences (0.6-0.9%) were similar across cities. The estimated average SAR across cities was 79%. Conclusion GBM sexual activity after restrictions were lifted remained below pre-pandemic levels. Comparable sexual partner distributions across cities may explain similarities in mpox R 0 and cumulative incidence across cities. Public health authorities should consider the risk of mpox resurgence for future vaccination and surveillance strategies as sexual activity is expected to recover.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| 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".