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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

Published in: Health & Medicine
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Mancount Sizes Up the Gaps*

  1. 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
  2. 2. A Multi-Agency Collaboration <ul><li>Study Team </li></ul><ul><li>BC Centre for Disease Control: Dr. Mark Gilbert (PI), Claudia Rank </li></ul><ul><li>BC Centre for Excellence in HIV/AIDS: Dr. Bob Hogg (PI), Eric Druyts, Arn Schilder Dr. David Moore, Steve Kanters, Warren Michelow </li></ul><ul><li>Community-Based Research Centre: Dr. Rick Marchand, Dr. Terry Trussler </li></ul><ul><li>Health Initiative for Men: Wayne Robert, Phillip Banks, Jim Sheasgreen </li></ul><ul><li>Vancouver Coastal Health: Dr. Réka Gustafson (PI), Michael Kwag, Miranda Compton, Meaghan Thumath, Chris Buchner, Stephanie Harvard, Johann Kolstee </li></ul><ul><li>Public Health Agency of Canada: Dana Paquette, Rhonda Kropp, Stephen Cule, Susanna Ogunnaike-Cooke, Maureen Perrin, Marissa Maguire, Liz Venditti, Gayatri Jayaraman, Dr. Chris Archibald, Dr. Tom Wong </li></ul><ul><li>University of British Columbia: Dr. Paul Gustafson </li></ul><ul><li>Survey Interviewers: </li></ul><ul><li>Jody Jollimore, Adam Graham, Dirceu Campos, Lukas Maitland, Olivier Ferlatte, Seamus Sullivan, Ray Sullivan, Blair Petty </li></ul><ul><li>HPV (Self-collection) Component </li></ul><ul><li>Dr. Chen Zhou, Dr. Dirk van Niekerk, Dr. Kathy Seballos, Jane Lo, Dr. Gina Ogilvie, Darlene Taylor, Wendy Mei, Dr. Alberto Severini, Dr. Natasha Press </li></ul><ul><li>Community Advisory Committee </li></ul><ul><li>Robert Hong (VCH), Paul Harris (BCCFE), Shimpei Chihara (ASIA), Elgin Lim (BCPWA), Richard O’Donnell (VCH), Chris Buchner (Qmunity), Robin Parry (Qmunity), Matthew Taylor (PEERS), Hywel Tuscano (YouthCO), Jesse Brown (YouthCO), Devon MacFarlane (VCH), Jody Jollimore (HIM) </li></ul>
  3. 3. What is ManCount? <ul><li>A sexual health survey for gay, bisexual, and other men who have sex with men in Vancouver </li></ul><ul><li>Vision : to collect relevant data to inform collective action to prevent the transmission of HIV and improve sexual health </li></ul><ul><li>Objectives : </li></ul><ul><ul><li>To measure the prevalence of HIV, Hepatitis C, syphilis </li></ul></ul><ul><ul><li>To track trends in testing and sexual behaviours </li></ul></ul>
  4. 4. M-Track Surveillance System Montreal Ottawa Toronto Winnipeg Victoria Vancouver
  5. 5. New positive HIV tests in MSM, BC
  6. 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. 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.
  8. 8. How ManCount worked <ul><li>Men approached at community venues (bars, events, businesses) in Vancouver </li></ul><ul><ul><li>Time-space sampling </li></ul></ul><ul><ul><li>August 2008 to February 2009 </li></ul></ul><ul><ul><li>Eligible if: 19 yrs +, self-identified as man who has ever had sex with a man, English language </li></ul></ul><ul><ul><li>1169 men completed a questionnaire </li></ul></ul><ul><ul><li>1139 men gave a dried blood spot specimen </li></ul></ul><ul><ul><li>Honorarium provided </li></ul></ul><ul><li>Subset of men asked to provide a self-collected rectal swab </li></ul>
  9. 9. Interpretation of findings <ul><li>Represents men who go to Vancouver’s gay venues </li></ul><ul><li>Results are estimates that probably vary from the “true” population results by a few percentage points </li></ul><ul><li>“ To provide reliable – though arguably </li></ul><ul><li>imperfect – indicators on the road </li></ul><ul><li>to a community response” </li></ul>
  10. 10. Section 1: Who Participated?
  11. 15. 87% lived in metro Vancouver
  12. 16. Section 2: HIV and other infections
  13. 17. HIV Prevalence
  14. 19. HIV treatment <ul><li>In the past 6 months, 71% of HIV positive men had taken anti-HIV medication </li></ul>
  15. 21. 13.6% of HIV negative men believed that they were somewhat to very likely to become HIV positive in their lifetime
  16. 22. Other blood test results <ul><li>Indicate current or past infection </li></ul><ul><li>More uncertainty with these findings </li></ul><ul><li>Hepatitis C antibodies </li></ul><ul><ul><li>4.9% positive 23% appear unaware </li></ul></ul><ul><li>Syphilis antibodies </li></ul><ul><ul><li>4.4% positive 31% appear unaware </li></ul></ul>
  17. 24. Self-collected rectal swabs <ul><li>HPV infection 62.3% </li></ul><ul><li>Anal dysplasia 42.3% </li></ul><ul><li>Chlamydia 5.4% </li></ul><ul><li>Gonorrhea 2.1% </li></ul>
  18. 25. Section 3: Testing Practices
  19. 29. Testing among unaware <ul><li>Half had tested for HIV at least once over the previous 2 years </li></ul><ul><li>(may be between screenings) </li></ul>
  20. 30. Section 4: Sexual Health and Behaviour
  21. 32. <ul><li>Pressure for unprotected sex 29% </li></ul>
  22. 34. Risk among unaware <ul><li>More likely to report unprotected sex </li></ul><ul><li>Majority reported using sero-sorting as a strategy </li></ul>
  23. 38. Other health issues <ul><li>Current smoker </li></ul><ul><li>Vaccinated against Hepatitis A, B </li></ul><ul><li>Disclosed had male sex partners to a health care provider </li></ul>38% 64-73% 79%
  24. 39. Implications
  25. 40. Implications: <ul><li>Critical, chronic, and not unique </li></ul><ul><li>Multiple drivers of HIV epidemic </li></ul><ul><li>Prevention is important to gay men, but strategies used may not always be effective </li></ul><ul><li>Testing is high but there are gaps </li></ul><ul><li>Opportunity to reverse trends in young men </li></ul>
  26. 41. What next? <ul><li>Need to strengthen our response to HIV prevention in gay men </li></ul><ul><li>Multiple strategies required </li></ul><ul><li>Beginning to plan collaboratively </li></ul>
  27. 42. Report of findings available at Questions? [email_address]