Engage-COVID-19: A mixed methods study of biomedical, behavioural, and psychosocial aspects of the COVID-19 pandemic among gay, bisexual, and other men who have sex with men in Canada [Added supplement: COVID-19 Variant Supplement]

Gay, bisexual, and other men who have sex with men (GBM) have historically experienced significant disparities in physical, mental, and sexual health, amplified by systemic marginalization and high barriers to healthcare. This context of inequity creates heightened vulnerabilities to COVID-19. Failure to respond to the health and wellness needs of GBM may have significant negative effects on COVID-19 outcomes and exacerbate existing health disparities. We propose the Engage-COVID-19 Study to rapidly respond to current and pressing knowledge gaps concerning the COVID-19 pandemic among GBM in Canada. This study will be embedded within the Engage Cohort Study, which is the only study with comparable biobehavioural data on HIV/STI prevalence and risk behaviours for GBM in Canada. To date, baseline data collection has been completed with 1842 GBM who are enrolled in the Engage Cohort Study (565 in Vancouver, 388 in Toronto, and 889 in Montreal). All of these participants will be invited to have SARS-CoV-2 antibody testing and complete an in-depth survey that will include COVID-specific quantitative questions. We anticipate recruiting a total sample of 1695-1768 participants. In addition, from this group we will recruit 90 GBM participants for qualitative interviews in Vancouver (30), Toronto (30), and Montreal (30) to assess the direct and indirect impacts of COVID-19 on Canadian GBM. These data are necessary both to understand COVID-19 risks, vulnerabilities, and prevention strategies, as well as the impacts of COVID-19 on health service access and different levels of HIV/STI risk across provinces. By making efficient use of available research infrastructure, our proposed study will ascertain the occurrence of COVID-19 by documenting SARS-CoV-2 immunity within both HIV-positive and -negative participants and produce rapid, high-quality evidence for preventing the direct and indirect effects of COVID-19 for this population across multiple jurisdictions.