Community mobilisation to optimize access to combination HIV prevention for MSM in Montreal: initial results from the MOBILISE! project

International audienceBackground: Using multiple prevention options and services together (“combination prevention”) could significantly reduce HIV infections among MSM, but a coordinated, synergistic strategy is needed to achieve this. MOBILISE ! is a community-based research project initiated in Montreal that aims to develop a strategy for optimizing access to combination prevention for MSM through participatory evaluation and community mobilization. Method: A coalition of 33 partners has collaborated to implement peer-led community discussions and an online survey to gather data on: 1) what MSM across Quebec know about combination prevention; 2) their experiences accessing health services in Montreal. Qualitative data from discussions were gathered using logbooks and analyzed thematically. Descriptive analyses of means and proportions were generated for quantitative data from survey responses. A deliberative process was used to leverage this data to identify priorities for action.Results: Between November 2015 and October 2016, 20 peer researchers were recruited to lead small-group discussions with a total of 83 MSM, and 394 respondents completed the survey. Over 70 participants attended a community forum to discuss key findings including: 1) barriers in access to PEP and PrEP; 2) discrepancies in attitudes and knowledge about serosorting and undetectable viral load depending on HIV status; 3) the need for better coordination between medical and non-medical care providers. MSM unaware of their HIV status were identified as a priority group that knows less about and makes less use of risk reduction strategies. Structural change within the health care system, capacity building, and psychosocial interventions were identified as potential solutions.Conclusion: Results from the forum will be used to develop a community consensus statement. The mobilization strategies used in Montreal are being adapted by partners in Toronto, Ottawa, and Vancouver and a framework is being developed to evaluate the impact of structural interventions on access to services and health outcomes