Publications by authors named "David M Moore"

Introduction: Access to and engagement with primary healthcare can be difficult for marginalized low-income populations residing in inner cities in high-income countries. We designed a study to examine retention in primary care among clients of a novel interdisciplinary primary care clinic in the Downtown Eastside of Vancouver, Canada who did not previously have access to care.

Methods: Beginning in June 2021, clients of the Hope to Health clinic were offered enrolment in a cohort study which involved a baseline and follow-up surveys every six months, and linking their data to information from the clinic's electronic medical records.

View Article and Find Full Text PDF
Article Synopsis
  • The study examined the prevalence and factors associated with intimate partner violence (IPV) among gay, bisexual, and other men who have sex with men (GBM) in Canada from 2017 to 2022, revealing high rates of both IPV experience (31%) and perpetration (17%) among participants.
  • Data from 1455 GBM showed that during follow-up, IPV experience (6%) was more common than perpetration (4%), and certain factors like prior IPV experience and substance use significantly increased the risk of both experiencing and perpetrating IPV.
  • Despite the COVID-19 pandemic, rates of IPV remained stable over time, indicating a need for targeted interventions that address underlying determinants such as marginalization and substance use
View Article and Find Full Text PDF

Introduction: The COVID-19 pandemic has changed healthcare service delivery. We examined the overall impact of COVID-19 on people living with HIV in British Columbia (BC), Canada, with a special focus on the potential impact of COVID-19 on antiretroviral treatment interruptions (TIs).

Methods: Purposive sampling was used to enrol people living with HIV aged ≥19 years across BC into the STOP HIV/AIDS Program Evaluation study between January 2016 and September 2018.

View Article and Find Full Text PDF

Background: Men who have sex with men (MSM) in British Columbia (BC) are disproportionately affected by infectious syphilis and HIV. In this study, we developed a co-interaction model and evaluated the impact and effectiveness of possible interventions among different MSM subgroups on the syphilis epidemic.

Methods: We designed a deterministic compartmental model, which stratified MSM by HIV status and HIV pre-exposure prophylaxis (HIV-PrEP) usage into (1) HIV-negative/unaware MSM (HIV-PrEP not recommended, not on HIV-PrEP), (2) HIV-negative/unaware MSM with HIV-PrEP recommended (not on HIV-PrEP), (3) HIV-negative/unaware MSM actively on HIV-PrEP, and (4) MSM diagnosed with HIV.

View Article and Find Full Text PDF

Aims: To cope with homonegativity-generated stress, gay, bisexual and other men who have sex with men (GBM) use more mental health services (MHS) compared with heterosexual men. Most previous research on MHS among GBM uses data from largely white HIV-negative samples. Using an intersectionality-based approach, we evaluated the concomitant impact of racialization and HIV stigma on MHS use among GBM, through the mediating role of perceived discrimination (PD).

View Article and Find Full Text PDF
Article Synopsis
  • The study examines how both distal (external) and proximal (internal) stressors affect alcohol use among gay, bisexual, and other men who have sex with men (GBM), considering the impact of anxiety and depression as mediators.
  • Researchers analyzed data from 2,449 GBM across major Canadian cities, using advanced statistical methods to identify relationships between stressors, mental health, and alcohol consumption.
  • The findings indicate that while distal stress leads to increased proximal stress and mental health issues, the direct effects on alcohol use are more complex, with anxiety and depression playing differing roles in alcohol consumption and problems.
View Article and Find Full Text PDF
Article Synopsis
  • Positive attitudes towards HIV treatment among gay, bisexual, and other men who have sex with men (GBM) may lead to riskier sexual behaviors that increase the chances of bacterial STIs.
  • A study involving 2449 GBM discovered a direct link between favorable HIV treatment attitudes and higher rates of current STI diagnoses, particularly through pathways of having more male anal sex partners and engaging in condomless anal sex.
  • The findings stress the need for healthcare providers to educate GBM about the risks attached to these attitudes in order to improve sexual health counseling, testing, and prevention strategies.
View Article and Find Full Text PDF

Background: Minority stress from racism and heterosexism may uniquely interact to impact the mental health of racialized sexual minorities. We examined variations in anxiety and depressive symptoms by reported by ethno-racial identity among gay, bisexual, and other men who have sex with men (gbMSM) in Vancouver, Canada.

Methods: We recruited gbMSM aged ≥ 16 years from February 2012 to February 2015 using respondent-driven sampling (RDS).

View Article and Find Full Text PDF

Background: Social support has previously been found to be associated with improved health outcomes of individuals managing chronic illnesses, including amongst people living with HIV (PLWH). For women and people who use injection drugs who continue to experience treatment disparities in comparison to other PLWH, social support may have potential in facilitating better treatment engagement and retention. In this analysis, we examined determinants of social support as measured by the Medical Outcomes Study - Social Support Survey (MOS-SSS) scale, and quantified the relationship between MOS-SSS and HIV treatment interruptions (TIs) among PLWH in British Columbia, Canada.

View Article and Find Full Text PDF
Article Synopsis
  • - HIV pre-exposure prophylaxis (PrEP) has been available in Québec since 2013, and a study evaluated its impact on HIV transmission among men who have sex with men (MSM) in Montreal from 2013 to 2021, using a mathematical model to analyze data.
  • - The results indicated that while annual HIV incidence decreased from 0.4 to 0.2 per 100 person-years during this period, PrEP coverage was initially very low but increased to 10% of HIV-negative MSM by 2020, leading to an estimated 20% reduction in HIV infections attributed to PrEP from 2015 to 2021.
  • - The study suggested that targeting PrEP to
View Article and Find Full Text PDF

Background: The secondary impacts of the COVID-19 pandemic may disproportionately affect gay, bisexual, and other men who have sex with men (GBM), particularly related to HIV prevention and treatment outcomes. We applied syndemic theory to examine PrEP disruptions during the during the height of the COVID-19 pandemic in Vancouver, Canada.

Methods: Sexually-active GBM, aged 16 + years, were enrolled through respondent-driven sampling (RDS) from February 2017 to August 2019.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the attitudes of gay, bisexual, and other men who have sex with men (GBM) towards amphetamine use and factors influencing the reduction of such use over time in Canadian cities.
  • A total of 2,449 participants were recruited, with a significant percentage reporting past six-month amphetamine use, but only a small fraction felt they needed substantial help to reduce it.
  • The research found that those who perceived their amphetamine use as problematic were less likely to successfully reduce their consumption, highlighting the need for tailored interventions for individuals struggling with substance use perceptions.
View Article and Find Full Text PDF

Depressive symptoms among people living with HIV (PLWH) are associated with poorer overall health outcomes. We characterized depressive symptoms and improvements in symptomology among PLWH (≥ 19 years old) in British Columbia (BC), Canada. We also examined associations between depressive symptomology and antiretroviral therapy (ART) treatment interruptions.

View Article and Find Full Text PDF

Objective: Epidemics impact individuals unevenly across race, gender, and sexuality. In addition to being more vulnerable to COVID-19 infection, evidence suggests racialized gender and sexual minorities experienced disproportionate levels of discrimination and stigma during the COVID-19 epidemic. Drawing on Critical Race Theory (CRT), we examined the experiences of gay, bisexual, queer, and other men who have sex with men (GBQM) of colour facing discrimination during COVID-19.

View Article and Find Full Text PDF

Background: The Engage Study is a longitudinal biobehavioral cohort study of gay, bisexual and other men who have sex with men (GBM) in Toronto, Montreal, and Vancouver. Baseline data (2,449 participants) were collected from February 2017 - August 2019 using respondent-driven sampling (RDS). Recruitment in Montreal required fewer seeds, had a much shorter recruitment period, and recruited the largest sample.

View Article and Find Full Text PDF

Mobile phone-based engagement approaches provide potential platforms for improving access to primary healthcare (PHC) services for underserved populations. We held two focus groups (February 2020) with residents ( = 25) from a low-income urban neighbourhood (downtown Vancouver, Canada), to assess recent healthcare experiences and elicit interest in mobile phone-based healthcare engagement for underserved residents. Note-based analysis, guided by interpretative description, was used to explore emerging themes.

View Article and Find Full Text PDF

This study identified patterns of sexualized substance use among gay, bisexual, and other men who have sex with men (gbMSM) and examined associated risk factors for sexually transmitted and blood borne infections (STBBI). Data were from a longitudinal cohort recruited using respondent-driven sampling between Feb-2017 and Feb-2019. Participants reported on events with up to five of their most recent sexual partners.

View Article and Find Full Text PDF

In 2018, the pre-exposure prophylaxis (PrEP) program was initiated in British Columbia (BC), Canada, providing PrEP at no cost to qualifying residents. This observational study discussed the steps to develop key evidence-based monitoring indicators and their calculation using real-time data. The indicators were conceptualized, developed, assessed and approved by the Technical Monitoring Committee of representatives from five health authority regions in BC, the BC Ministry of Health, the BC Centre for Disease Control, and the BC Centre for Excellence in HIV/AIDS.

View Article and Find Full Text PDF

This study evaluated the association between resilience and PrEP use among a population-based sample of Canadian gay, bisexual, and other men who have sex with men (GBM). Sexually active GBM aged ≥ 16 years old were recruited via respondent-driven sampling (RDS) in Toronto, Montreal, and Vancouver from 02/2017 to 07/2019. We conducted a pooled cross-sectional analysis of HIV-negative/unknown GBM who met clinical eligibility for PrEP.

View Article and Find Full Text PDF

Background: Depression and anxiety are commonly experienced among gay, bisexual and other men-who-have-sex-with-men (gbMSM). We explored factors associated with improvements in mental health symptoms among gbMSM with abnormal depression and anxiety scores over a period of four years, in Vancouver, Canada.

Methods: Sexually active gbMSM ≥16 years of age were recruited using respondent-driven sampling from February 2012 to February 2015.

View Article and Find Full Text PDF

Background: Self-report of human papillomavirus (HPV) vaccination has ~80-90% sensitivity and ~75-85% specificity. We measured the effect of nondifferential exposure misclassification associated with self-reported vaccination on vaccine effectiveness (VE) estimates.

Methods: Between 2017-2019, we recruited sexually active gay, bisexual, and other men who have sex with men aged 16-30 years in Canada.

View Article and Find Full Text PDF

Background: Real-world evidence of human papillomavirus (HPV) vaccine effectiveness (VE) against longitudinal outcomes is lacking among gay, bisexual, and other men who have sex with men (GBM). We compared 12-month incidence and persistence of anal HPV infection between vaccinated and unvaccinated GBM.

Methods: We recruited GBM aged 16-30 years in Montreal, Toronto, and Vancouver, Canada, from 2017 to 2019.

View Article and Find Full Text PDF