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Trends in HIV incidence in the Omega cohort of men who have sex with men (MSM) in Montreal: October 1996 - February 2002.

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  1. Trends in HIV incidence in the Omega cohort of men who have sex with men (MSM) in Montreal: October 1996 - February 2002 Robert S, Remis, Michel Alary, Joanne Otis, Benoit Mâsse, Eric Demers, Clemon George, Jean Vincelette, BrunoTurmel, René Lavoie, Roger LeClerc, Raymond Parent and the Omega Study Group Department of Public Health Sciences, University of TorontoUnité de recherche en santé des populations (URESP), 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 Research11th Annual Scientific ConferenceWinnipeg, Manitoba, April 25-28, 2002

  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: • Canadian Institutes for Health Research • 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 • The OMEGA Study is a cohort of 2,000 seronegative gay men whom we are following to better understand HIV transmission in Montreal • First participant was recruited in October 1996

  4. Study objectives • Estimate HIV incidence and identify risk factors associated with seroconversion among 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, syphilis and HBV

  7. Characteristics of participants (n=1,787) Age • <20 5% • 20-29 42% • 30-39 32% • 40-49 15% • 50+ 6% Education • None 7% • High school 23% • CEGEP 23% • University 46%

  8. Characteristics of participants (n=1,787) Residence • Montreal Island 88% • Elsewhere 12% Place of birth • Quebec 71% • Canada, elsewhere 12% • Other country 17% Language • French only 79% • English only 12% • Both 8% • Other 1%

  9. Factors associated with HIV infection at baseline

  10. Factors associated with HIV infection at baseline

  11. n HIV+ p-value Injected drugs Never Rarely Sometimes Fairly often Very often 1,573 32 58 26 60 1.1% 0.0% 10.3% 3.9% 11.7% <0.0001 Factors associated with HIV infection at baseline

  12. Factors associated with HIV infection at baseline

  13. Incidence density among subjects with two or more visits (n=1,436)

  14. HIV incidence by age group and year

  15. Limitations • Data on behaviours self-reported and not independently validated • Subjects not necessarily representative of gay men in Montreal • Selective attrition may introduce bias

  16. Conclusions • HIV prevalence at baseline related to age, education, injection of drugs and age at first homosexual sex • Overall, HIV incidence in a cohort of Montreal MSM has been relatively low and stable • However, increase observed in 2001-02 compared to 2000 may be real, especially in light of increasing risky sexual behaviour • Trends in HIV incidence are different in younger and older MSM

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