Canada's Engage study to examine sexual health of Vancouver, Toronto, and Montreal's queer men

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      So you've just had a great sexual experience with a guy and as you're getting dressed, he hands you a voucher. It turns out it's not a store voucher for a product or service but...an invitation to participate in a sexual-health study?

      While this may seem unusual at first, it's something that may happen to you in the near future.

      It's part of a significant undertaking and collaboration by Canadian researchers and organizations called Engage, and it's one of the first such studies to be simultaneously held in Vancouver, Toronto, and Montreal. The study is being funded by the Canadian Institutes for Health Research (CIHR), the Ontario HIV Treatment Network (OHTN), and the Canadian Foundation for AIDS Research (CANFAR).

      Nathan Lachowsky, an investigator for the Vancouver team, chatted with the Georgia Straight about Engage on a call from Auckland, New Zealand, where he's doing research.

      Engage investigator Nathan Lachowksy

      Lachowsky explained that this study builds upon a study started by the Momentum Health Study in Vancouver.

      The ongoing Momentum study, which will examine HIV prevalence among 700 participating men who have sex with men (MSM), began in 2011 and will wrap up in about a year or two.

      The new Engage study, Lachowsky explained, will provide the opportunity to conduct parallel cross-sectional studies in Canada's three biggest cities to examine HIV and sexual health similarities and differences between them. He said they will look at how knowledge and options for prevention, testing, and treatment are changing. In particular, they're hoping to observe how pre-exposure prophylaxis (PrEP) differs between cities as PrEP public programs vary from city to city.

      "There are differences in the way that health services are provided and their accessibility across these three cities and three provinces," he said. "So we're interested in looking at the difference in awareness of treatment as prevention and uptake of knowledge of treatment as prevention."

      In order to participate, interested MSM must either receive (as previously mentioned) a voucher from someone already in the study or they can contact the study's Vancouver office (604-558-2017) to inquire about eligibility as an initial participant.

      Lachowsky said they are employing what's called respondent-driven sampling for recruiting participants.

      In other words, the researchers start by selecting a few initial men from those interested in participating. Those men are then given vouchers to pass on to their contacts. Those participants then receive vouchers to give to their contacts, and so on, in subsequent waves.

      "The real benefit of doing this work is that it helps us through a statistical process get better estimates for what is really going on in the community," Lachowsky said. "If we just recruit the people we know and reach through our traditional advertising and community outreach, that's just a certain portion of the community and by leveraging the social and sexual networks of guys in these communities…we end up reaching guys who we would never have reached before."

      Although Lachowsky said that they will make adjustments in estimates to account for differences in social-network sizes (such as MSM who may be socially isolated, in closed social networks, or may be closeted), he pointed out that the goal isn't to reach every single person but to "get a representative sample of who's out there".

      He also pointed out that they are ensuring they start with diverse participants, across various ages, HIV statuses, sexual identities (and being trans-inclusive), and ethnicities.

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      Participant involvement consists of a two-hour study visit at the Vancouver office, during which researchers will provide an overview of study. That will be followed by an hour-long computer survey about sexual behaviour, attitude towards HIV, community connections, mental health, substance use, and social support. (The questionnaire will available in either English or French.)

      After that, participants will take part in a clinical component, in which they will be tested for sexually transmitted diseases to help the researchers estimate how prevalent HIV and STIs (such as syphilis, hepatitis C, gonorrhea, and chlamydia) are.

      As a bonus, participants have a chance to win up to $140 cash, $250 Apple store gift cards, or $2,000 Flight Centre travel vouchers. Lachowsky said they're raising awareness about the study so that Vancouver men aren't caught off guard if someone suddenly hands them a voucher.

      To learn more about the study, visit the Engage website in either English or French.

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