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Acknowledgements

HIV infection in a cohort of men who have sex with men (MSM) in Montreal: Update to February 2001. Robert S, Remis, Michel Alary, Joanne Otis, Benoit Mâsse, Eric Demers, Jean Vincelette, BrunoTurmel, René Lavoie, Roger LeClerc, Raymond Parent and the Omega Study Group

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Acknowledgements

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  1. HIV infection in a cohort of men who have sex with men (MSM) in Montreal: Update to February 2001 Robert S, Remis, Michel Alary, Joanne Otis, Benoit Mâsse, Eric Demers, Jean Vincelette, BrunoTurmel, René Lavoie, Roger LeClerc, Raymond Parent and the Omega Study Group Department of Public Health Sciences, University of TorontoGroup de recherche épidémiologique, CHUQDépartement de sexologie, Université du Québec à MontréalDépartement de microbiologie, Pavillon St Luc-CHUMDépartement de santé publique, Montréal-CentreSéro-Zéro, COCQ-sida Canadian Association of HIV/AIDS ResearchTenth Annual Scientific ConferenceToronto, Ontario, May 31-June 3, 2001

  2. Acknowledgements • Physicians who helped to recruit subjects • Gay and HIV-related community organizations • Omega Cohort Study Group • Staff, volunteers and Steering Committee members • funding agencies who supported the study including: • National Health Research and Development Program • Centre québécois de coordination du sida • Fonds de la recherche en santé du Québec • The men who contribute their time and energy by participating in the study

  3. Background • MSM in Montreal seriously affected by the HIV epidemic since it began • The OMEGA Study is a cohort of 2,000 seronegative gay men whom we intend to follow to better understand HIV transmission in Montreal • First participant recruited in October 1996

  4. Study objectives • Estimate HIV incidence and identify risk factors associated with seroconversion among men having sex with other men (MSM) in Montreal, in particular among those less than 30 years of age • Monitor and characterize changes in sexual behaviour over time • Facilitate transfer of knowledge to community groups involved in HIV prevention

  5. Recruitment and follow-up • MSM HIV negative or unknown serostatus • Recruit from clinical and community sites • Follow-up every 6 months • Subjects lost to follow-up replaced • Recruit marginalized MSM and MSM from ethnic minorities

  6. Data and specimen collection • A questionnaire, self-administered and interviewer-administered, on: • Demographic factors • Sexual behaviours during lifetime andprevious 6 months • Psychosocial data • Subjects tested for HIV and syphilis

  7. Characteristics of participants (n=1,588) Age • <20 5% • 20-29 41% • 30-39 32% • 40-49 15% • 50+ 6% Education • None 7% • High school 23% • CEGEP 23% • University 46%

  8. Characteristics of participants (n=1,588) Residence • Montreal Island 88% • Elsewhere 12% Place of birth • Quebec 71% • Canada, elsewhere 12% • Other country 17% Language • French only 78% • English only 12% • Both 9% • Other 1%

  9. Factors associated with HIV infection at baseline

  10. Factors associated with HIV infection at baseline

  11. Factors associated with HIV infection at baseline

  12. Factors associated with HIV infection at baseline

  13. Incidence density among subjects with 2 or more visits (n=1,247)

  14. HIV incidence by age and year

  15. HIV incidence (per 100 py) by rank of follow-up visit and year

  16. Factors associated with HIV seroconversion

  17. Factors associated with HIV seroconversion

  18. Behaviours (previous 6 months) associated with HIV seroconversion, multivariate model Entered in model but not statistically significant:Age, injection drug use, gave money or drugs for sex, and insertive anal sex with other than HIV-negative regular partner

  19. UR oral sex with selected partners among those with and without anal receptive sex with other than HIV-negative partner

  20. Interpretation • Data on behaviours self-reported and not independently validated • Subjects not necessarily representative of gay men in Montreal • Selective attrition may introduce bias • Multivariate model preliminary;Further analyses are ongoing

  21. Conclusions • HIV incidence in a cohort of Montreal MSM not increasing • Trends in incidence different in younger and older MSM • Young age at first homosexual experience associated with infection at baseline and new infection (univariate) • The following appear independently associated with seroconversion: • Unprotected receptive anal sex other than with HIV-negative regular partner • Drug use • Unprotected receptive oral sex with high-risk partners

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