Canadian Results From the European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017)
Date
2019
Authors
Brogan, Nicola
Paquette, Dana M.
Lachowsky, Nathan J.
Blais, Martin
Brennan, David J.
Hart, Trevor A.
Adam, Barry
Journal Title
Journal ISSN
Volume Title
Publisher
Canada Communicable Disease Report
Abstract
Background: In 2017, the international European Men-who-have-sex-with-men Internet Survey
(EMIS-2017) collected data from 50 countries, including Canada for the first time.
Objective: To provide an overview of the Canadian EMIS-2017 data to describe the
sexually transmitted and other bloodborne infection (STBBI) related needs of gay, bisexual and
other men who have sex with men (gbMSM).
Methods: The EMIS-2017 questionnaire was an updated version of EMIS-2010. It included
self-reported sociodemographic data, experience of discrimination, mental health and
substance use, knowledge of preexposure prophylaxis (PrEP) for HIV, sexual practices and
history of STBBI testing and diagnosis. Analysis was largely descriptive.
Results: Of the 6,059 respondents from Canada, 5,165 participants met the inclusion criteria
for this analysis. The majority of participants were born in Canada (79.3%); and over half of
the respondents (56.7%) were under the age of 39. In terms of discrimination related to their
attraction to other men, participants reported high levels of intimidation (31.9%), verbal abuse
(22.1%) and physical violence (1.5%) in the previous year. Regarding mental health, 23.9% had
a moderate to severe depression/anxiety score. Almost two-thirds (64.1%) indicated substance
use and one-fifth (21.5%) reported chemsex (or the use of stimulant drugs to make sex more
intense or last longer). Only 8.4% of participants reported use of PrEP for HIV; however, 51.7%
reported being likely to use PrEP if it was available and affordable. Sexual practices, such as
condom use, varied by PrEP use with 91.3% of men using PrEP reporting condomless anal
intercourse (CAI) compared with 71.5% of men not on PrEP. In terms of STBBI testing, 1.5%
reported being diagnosed with hepatitis C and 9.0% reported an HIV diagnosis. Of those with
an HIV diagnosis, most were on treatment (99.1%) and had an undetectable viral load (96.7%).
Conclusion: gbMSM in Canada experienced stigma, discrimination and mental health
problems; substance use was high as were high-risk sexual practices, such as CAI, among some
groups of men. There was a gap between the proportion of men who were interested in PrEP
and those who actually used it; and comprehensive STBBI testing was low.
These findings can inform public health action and provide a baseline to examine the impact of
current and new interventions.
Description
European Men-who-have-sex-with-men Internet Survey
(EMIS‑2017) was undertaken by Sigma Research at the London
School of Hygiene and Tropical Medicine in association with the
Robert Koch Institute in Berlin. The EMIS core team is made
up of F Hickson, D Reid, AJ Schmidt and P Weatherburn at the
London School of Hygiene and Tropical Medicine and U Marcus
and SB Schink at the Robert Koch Institute. We especially thank
AJ Schmidt for his continued and strong support of Canadian
participation in EMIS-2017.
We thank all of the men who took part in EMIS-2017 and our
nongovernmental organization (NGO) partners, particularly the
Health Initiative for Men, Rézo, the Gay Men’s Sexual Health
Alliance of Ontario and Canadian AIDS Treatment Information
Exchange (CATIE), who recruited participants through activities
on Facebook and/or other social media and by placing EMIS
banners on their websites. We thank all our partners for being
part of something huge. We also would like to thank C Archibald
for his advice prior to and throughout data collection and for his
review of the manuscript.
Keywords
HIV, sexually transmitted infections, sexual risk practices, gay bisexual and other men who have sex with men, gbMSM, preexposure prophylaxis, postexposure prophylaxis
Citation
Brogan, N., Paquette, D. M., Lachowsky, N. J., Blais, M., Brennan, D. J., Hart, T. A., & Adam, B. (2019). “Canadian Results From the European Men-Who-Have-Sex- With-Men Internet Survey (EMIS-2017).” Canada Communicable Disease Report, 45(11), 271-282. https://doi.org/10.14745/ccdr.v45i11a01