O13.3 Trends in PrEP awareness and uptake among Gay, Bisexual and other Men who have Sex with Men (GBM) in Canada

Background Availability and public funding of pre-exposure prophylaxis (PrEP) varies by jurisdiction in Canada. We conducted a multi-site prospective-longitudinal study to assess trends and correlates of PrEP awareness and use among gay, bisexual and other men who have sex with men (GBM) in Vancouver, Toronto and Montreal. Methods Sexually-active GBM, aged ≥16 years, were recruited through respondent-driven sampling (RDS) from February 2017 with follow-up data collected to March 2020. Participants completed a Computer-Assisted Self-Interview to assess PrEP awareness and use. Analyses were limited to HIV-negative GBM. We used generalized estimating equations accounting for two levels of clustering (RDS recruitment chain; participant) to evaluate temporal trends (monthly prevalence) of awareness and past six-month usage of PrEP. Multivariable models were built using backward selection to minimize QIC to identify correlates for two outcomes 1) PrEP awareness, and 2) PrEP use. Results We recruited 2008 HIV-negative GBM (N=622 from Vancouver, N=418 from Toronto, and N=968 from Montreal). Awareness of PrEP increased significantly in all three sites: Montreal, 81.2% during the first 6-month period to 91.4% during the last 6-month period (p Conclusions PrEP awareness was very high among GBM in all three cities. Uptake was highest in Vancouver where full public funding and active health promotion began in 2018 for those clinically eligible. Health policy and public health intervention can remove key barriers to PrEP implementation.