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Epidemiological Trends Among New Seropositive Patients at Clinique Medicale L’Actuel, Montreal, 2016 – 2020

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Abstract

Background. Understanding the composition of the population most vulnerable to contracting HIV is essential to elaborate appropriate interventions to reduce the incidence of this communicable disease. This research project was conducted in collaboration with L’Actuel, a large medical center in Montreal offering testing and treatment of sexually transmitted and blood borne infections (STBBIs) and aimed to characterize the patients under its care who received a new diagnosis of HIV within the last five years. 

Methods. Demographic characteristics and clinical information were gathered for 230 patients who were diagnosed HIV-positive at L’Actuel between 2016 and 2020 and analyzed to describe changes in epidemiological trends. A subset of these patients was invited for a semi-structured interview to discuss the impact of HIV on their outlook on life and sexual practices. 

Results. HIV is still predominantly affecting men who represent 89.1% (205/230) of the study cohort. Among HIV-positive men, 83.4% (171/205) identify as gay or bisexual. However, 48.3% (111/230) of the new HIV-positive patients over the last five years were born outside of Canada, indicating that immigration has an important impact on the profile of patients seen at L’Actuel. There is a larger proportion of women and heterosexual men among patients having migrated to Canada than among Canadian-born patients. Patients interviewed say that HIV does not have a significant negative impact on their everyday lives as effective antiretroviral treatment (ART) is available in Canada, but that stigmatization of HIV-positive people persists in the context of intimate encounters. They recognize the usage of condoms and of pre-exposure prophylaxis (PrEP) as effective safer sex strategies to prevent the transmission of HIV and affirm that accessibility to HIV- screening needs to be improved. 

Conclusion. While gay, bisexual, and other men who have sex with men (gbMSM) remains the group associated with the highest number of new HIV diagnosis, immigration also has a significant impact on the profile of patients seen at L’Actuel. Future interventions to reduce HIV transmission should take into consideration the additional challenges to linkage to care experienced by HIV-positive patients who have immigrated to Canada. 

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