Pre-exposure prophylaxis (PrEP) became publicly available in Quebec for gay, bisexual and other men who have sex with men (GBM) in 2013. 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 = 968), we identified four classes: low use of prevention (32%), condoms (40%), seroadaptive behaviour (21%), and biomedical (including PrEP; 7%). Those using prevention (condoms, seroadaptive behaviour, and biomedical) had a higher number of anal sex partners and were more likely to report a recent sexually transmitted infection diagnosis. GBM using biomedical prevention also had a higher level of formal education. Among GBM living with HIV (n = 200), we identified three classes: mainly antiretroviral treatment (ART) with viral suppression (53%), ART with viral suppression and condoms (19%), and ART with viral suppression and seroadaptive behaviour (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.

魁北克于2013年在同性恋者，双性恋者和其他与男性发生性关系的男性（GBM）上公开了暴露前预防（PrEP）。自PrEP可用以来，在蒙特利尔GBM中结合使用HIV预防模式。通过艾滋病毒感染状况分层的潜在类别分析，通过自我报告的生物医学和行为预防策略的使用，对GBM进行分类。使用多项逻辑回归来确定所得类的相关性。在HIV阴性/未知的GBM（n = 968）中，我们确定了四类：预防使用率低（32％），避孕套（40％），自检行为（21％）和生物医学（包括PrEP； 7％）。使用预防措施（避孕套，自我适应行为和生物医学）的人肛交伴侣的数量较多，更有可能报告最近的性病感染诊断。使用生物医学预防的GBM也具有较高的正规教育水平。在患有HIV的GBM（n = 200）中，我们确定了三类：主要是病毒抑制的抗逆转录病毒治疗（ART）（53％），病毒抑制和避孕套的ART（19％），以及病毒抑制和自残行为的ART（18％）。同样，在使用避孕套和自残行为的人群中，肛交伴侣的数量更高。我们的研究结果表明，单独或与其他策略结合使用的基于抗逆转录病毒的预防显然是蒙特利尔GBM的HIV预防领域的组成部分。然而，PrEP摄取仍然很低，因此有必要更广泛地推广其可用性。