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Intern. AIDS Soc."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Treatment as prevention strategies have been variously applied across provinces in Canada. We estimated HIV care cascade indicators and correlates of unsuppressed viral load (VL) among gay, bisexual and other men who have sex with men (GBM) recruited in Vancouver, Toronto and Montreal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sexually active GBM, aged \u226516\u00a0years, were recruited through respondent\u2010driven sampling (RDS) from February 2017 to August 2019. Participants completed a Computer\u2010Assisted Self\u2010Interview and tests for HIV and other sexually transmitted infections (STIs). We conducted bivariate analyses comparing RDS\u2010adjusted proportions across cities. We used multivariable logistic regression to examine factors associated with having a measured VL\u00a0\u2265\u00a0200\u00a0copies\/mL with data pooled from all three cities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We recruited 1179 participants in Montreal, 517 in Toronto and 753 in Vancouver. The RDS\u2010adjusted HIV prevalence was 14.2% (95% CI 11.1 to 17.2) in Montreal, 22.1% (95% CI 12.4 to 31.8) in Toronto and 20.4% (95% CI 14.5 to 26.3) in Vancouver (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Of participants with confirmed HIV infection, 3.3% were previously undiagnosed in Montreal, 3.2% undiagnosed in Toronto and 0.2% in Vancouver (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.154). In Montreal, 87.6% of GBM living with HIV were receiving antiretroviral therapy (ART) and 10.6% had an unsuppressed VL; in Toronto, 82.6% were receiving ART and 4.0% were unsuppressed; in Vancouver, 88.5% were receiving ART and 2.6 % were unsuppressed (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001 and 0.009 respectively). Multivariable modelling demonstrated that participants in Vancouver (adjusted odds ratio [AOR]=0.23; 95% CI 0.06 to 0.82), but not Toronto (AOR\u00a0=\u00a00.27; 95% CI 0.07 to 1.03), had lower odds of unsuppressed VL, compared to Montreal, as did older participants (AOR 0.93 per year; 95% CI 0.89 to 0.97), those at high\u2010risk for hazardous drinking (AOR\u00a0=\u00a00.19; 95% CI 0.05 to 0.70), those with a primary care provider (AOR\u00a0=\u00a00.11; 95% CI 0.02 to 0.57), and those ever diagnosed with other STIs (AOR\u00a0=\u00a00.12; 95% CI 0.04 to 0.32).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GBM living in Montreal, Toronto and Vancouver are highly engaged in HIV testing and treatment and all three cities have largely achieved the 90\u201090\u201090 targets for GBM. Nevertheless, we identified disparities which can be used to identify GBM who may require additional interventions, in particular younger men and those who are without a regular primary care provider.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.25699","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T06:08:15Z","timestamp":1619762895000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Characteristics of the HIV cascade of care and unsuppressed viral load among gay, bisexual and other men who have sex with men living with HIV across Canada\u2019s three largest cities"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1078-9247","authenticated-orcid":false,"given":"David M","family":"Moore","sequence":"first","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"},{"name":"University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zishan","family":"Cui","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayna","family":"Skakoon\u2010Sparling","sequence":"additional","affiliation":[{"name":"Ryerson University Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Sang","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Barath","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Lachowsky","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"},{"name":"University of Victoria Victoria BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Cox","sequence":"additional","affiliation":[{"name":"McGill University Montr\u00e9al QC Canada"},{"name":"Direction r\u00e9gionale de sant\u00e9 publique \u2010Montr\u00e9al CIUSSS Centre\u2010Sud\u2010de\u2010l'Ile\u2010de\u2010Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Lambert","sequence":"additional","affiliation":[{"name":"Direction r\u00e9gionale de sant\u00e9 publique \u2010Montr\u00e9al CIUSSS Centre\u2010Sud\u2010de\u2010l'Ile\u2010de\u2010Montr\u00e9al Montr\u00e9al QC Canada"},{"name":"Institut national de sant\u00e9 publique du Qu\u00e9bec Montr\u00e9al QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed W","family":"Noor","sequence":"additional","affiliation":[{"name":"Ryerson University Toronto ON Canada"},{"name":"School of Human Sciences Louisiana State University Shreveport Shreveport USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Grace","sequence":"additional","affiliation":[{"name":"University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody","family":"Jollimore","sequence":"additional","affiliation":[{"name":"Community Based Research Centre Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herak","family":"Apelian","sequence":"additional","affiliation":[{"name":"McGill University Montr\u00e9al QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Lal","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbie","family":"Parlette","sequence":"additional","affiliation":[{"name":"Ryerson University Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor A","family":"Hart","sequence":"additional","affiliation":[{"name":"Ryerson University Toronto ON Canada"},{"name":"University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v43i12a01"},{"key":"e_1_2_9_3_1","unstructured":"Public Health Agency of Canada.A PAN\u2010CANADIAN FRAMEWORK FOR ACTION: Reducing the Health Impact of Sexually Transmitted and Blood\u2010Borne Infections in Canada by 2030. 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