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We used baseline data from Engage, a cohort of GBM recruited by respondent-driven sampling, to examine patterns of combination HIV prevention use among Montreal GBM since PrEP became available. Latent class analysis, stratified by HIV status, was used to categorize GBM by self-reported use of biomedical and behavioural prevention strategies. Correlates of resulting classes were identified using multinomial logistic regression. Among HIV-negative\/unknown GBM (n\u2009=\u2009968), we identified four classes:\n                    <jats:italic>low use of prevention<\/jats:italic>\n                    (32%),\n                    <jats:italic>condoms<\/jats:italic>\n                    (40%),\n                    <jats:italic>seroadaptive behaviour<\/jats:italic>\n                    (21%), and\n                    <jats:italic>biomedical<\/jats:italic>\n                    (including PrEP; 7%). Those using prevention (\n                    <jats:italic>condoms<\/jats:italic>\n                    ,\n                    <jats:italic>seroadaptive behaviour<\/jats:italic>\n                    , and\n                    <jats:italic>biomedical<\/jats:italic>\n                    ) had a higher number of anal sex partners and were more likely to report a recent sexually transmitted infection diagnosis\n                    <jats:italic>.<\/jats:italic>\n                    GBM using biomedical prevention also had a higher level of formal education. Among GBM living with HIV (n\u2009=\u2009200), we identified three classes:\n                    <jats:italic>mainly antiretroviral treatment (ART) with viral suppression<\/jats:italic>\n                    (53%),\n                    <jats:italic>ART with viral suppression and condoms<\/jats:italic>\n                    (19%), and\n                    <jats:italic>ART with viral suppression and seroadaptive behaviour<\/jats:italic>\n                    (18%). Again, the number of anal sex partners was higher among those using condoms and seroadaptive behaviours. Our findings show antiretroviral-based prevention, either alone or in combination with other strategies, is clearly a component of the HIV prevention landscape for GBM in Montreal. Nevertheless, PrEP uptake remains low, and there is a need to promote its availability more widely.\n                  <\/jats:p>","DOI":"10.1007\/s10461-020-02965-4","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T06:05:31Z","timestamp":1594274731000},"page":"269-283","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Combination HIV Prevention Strategies Among Montreal Gay, Bisexual, and Other Men Who Have Sex with Men in the PrEP Era: A Latent Class Analysis"],"prefix":"10.1007","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-3068","authenticated-orcid":false,"given":"Carla M.","family":"Doyle","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu","family":"Maheu-Giroux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharmistha","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herak","family":"Apelian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Messier-Peet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Otis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Grace","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor A.","family":"Hart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan J.","family":"Lachowsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7041-1556","authenticated-orcid":false,"given":"Joseph","family":"Cox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the Engage Study Team","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,9]]},"reference":[{"issue":"12","key":"2965_CR1","doi-asserted-by":"publisher","first-page":"304","DOI":"10.14745\/ccdr.v45i12a01","volume":"45","author":"N Haddad","year":"2019","unstructured":"Haddad N, Robert A, Weeks A, Popovic N, Siu W, Archibald C. 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JC has investigator-sponsored research grants from Gilead Sciences Canada, Merck Canada and ViiV Healthcare. He has also received financial support for conference travel and advisory work for Gilead Sciences Canada, Merck Canada and ViiV Healthcare. NJL has an investigator-sponsored research grant from Gilead Sciences Canada. All research grants and consulting are outside of the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethics approval for the Engage Study in Montreal was obtained from the Research Institute of the McGill University Health Centre. Ethics approval for the Engage Study co-authors outside of Montreal was obtained from Ryerson University, the University of Windsor, St. Michael\u2019s Hospital, the University of Toronto, the University of British Columbia, Simon Fraser University, and the University of Victoria.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"Informed consent was obtained from all individual participants included in the study. The age of consent to participate in a research study in all Canadian provinces, excluding Quebec, is 16 [\n                      \n                      ]. Within the province of Quebec, the age of consent to participate is 18 [\n                      \n                      ]. Following guidelines provided by <i>the Society for Adolescent Medicine<\/i> [\n                      \n                      ], Engage did not seek parental consent of those aged 16\u201318 in Montreal. Those aged 14 and older can legally consent to STBBI screening in Quebec without parental consent [\n                      \n                      ], and responding to the Engage questionnaire would be of minimal risk to GBM aged 16\u201318. On the other hand, as a study of sexual health among sexually active GBM, requiring parental consent could compromise the privacy, and possibly safety, of young GBM. Therefore, the potential harms of seeking parental consent to participate in the Engage study for GBM aged 16\u201318 outweighed the harms of not obtaining parental consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}}]}}