Effectiveness of HIV prevention in Ontario, Canada: a multilevel comparison of bisexual men.

Abstract

We examined the effectiveness of community-level HIV prevention programming for men who have sex with men. We used multilevel methods to examine unprotected intercourse by bisexual men (n = 1016) with male and female partners in geographic regions with and without HIV prevention programming. Men living in geographic regions with HIV prevention programming had significantly less frequent unprotected homosexual intercourse with both casual and regular partners. In contrast, no differences were observed for unprotected heterosexual intercourse. This study provides evidence supporting the effectiveness of community-level HIV prevention programming and the need for its broader implementation. The study also demonstrates the suitability of multilevel methods for examining the effectiveness of community-level public health programs.