Findings from the Tracks survey on sexually transmitted and blood-borne infections and related factors among Two-Spirit people, gay, bisexual, trans and queer men and non-binary people (2S/GBTQ+) in Canada, 2024

Background: Population health data are scarce for sexual-and gender-diverse communities who are disproportionately affected by sexually transmitted and blood-borne infections (STBBI).The Tracks survey of Two-Spirit people, gay, bisexual, trans and queer men and non-binary people (2S/GBTQ+) collected data from 43 Pride and community events in 19 cities across Canada in summer 2024.Objective: To describe the self-reported prevalence of STBBI, including HIV, and associated factors among 2S/GBTQ+ people. Methods:The self-administered questionnaire collected information on sociodemographics, social determinants of health, sexual behaviours, substance use, use of STBBI prevention services, HIV pre-exposure prophylaxis (PrEP), care and treatment for HIV and experiences of discrimination and abuse.Descriptive analysis was performed.Results: Of the 4,880 participants, 52.2% described their sexual orientation as gay, 26.5% as queer and 24.1% as bisexual; 62.2% identified as a man and 22.4% as non-binary; 28.5% identified as trans; and median age was 30 years.Of participants aged 18 years or older, 63.3% experienced discrimination in the past 12 months and 45.5% had sex forced upon them in their lifetime.In the past 12 months, 5.6% of participants self-reported having been diagnosed with gonorrhea, 5.2% with chlamydia and 2.3% with syphilis; overall, 4.2% of participants selfreported living with HIV.Among participants who self-reported being HIV-negative, 17.5% were currently taking HIV PrEP.Conclusion: High levels of discrimination and abuse were found among study participants.While most participants were aware of HIV PrEP, fewer than one in four currently used it.Findings from this survey will help inform STBBI programs and policies.The intentional inclusion of diverse participants provides important information on populations who have been previously less engaged in STBBI research.