Publications

Digital health records that collapse sex and gender into a single binary field cause real harm. When systems cannot carry the information clinicians need for affirming communication, patients face misgendering, deadnaming, and being outed, leading to disrespectful encounters, inappropriate care, and avoidance of health services altogether. This case study introduces the HL7 International Gender Harmony Model, a standard designed to support the design, implementation, and use of digital health information systems that enable affirming clinical interactions. Applying the model to a recently published account of one Canadian patient's experience, the authors show how such harms could be addressed through nursing informatics.

HPV vaccines became publicly funded for younger gay, bisexual, and other men who have sex with men in most Canadian provinces in 2015 and 2016. To gauge oral infection levels afterwards, this study recruited sexually active men in Montreal, Toronto, and Vancouver between 2017 and 2019 through respondent-driven sampling; those aged 16 to 30 self-collected oral rinse samples for testing. Among 838 valid specimens, about 37 percent of participants reported at least one vaccine dose. Oral HPV prevalence was low overall, at 2.6 percent for any type and 1.2 percent for high-risk types. The results provide a baseline for tracking vaccination's future impact.

Do men who take more sexual risk actually perceive themselves as at risk of HIV? Baseline data from the Canadian Engage Cohort Study, which recruited sexually active gay, bisexual and other men who have sex with men through respondent-driven sampling, addressed this among 1,961 HIV-negative participants. Higher-risk condomless anal sex with casual partners was associated with substantially greater odds of perceiving personal HIV risk. Optimism or skepticism about HIV treatment shifted that relationship: among men reporting higher-risk sex, greater treatment optimism corresponded with higher perceived risk. The authors emphasize promoting accurate awareness of advances in HIV prevention and treatment.

Intimate partner violence among gay, bisexual and other men who have sex with men has rarely been tracked over time. Using the Engage Cohort Study, which recruited participants in Montreal, Toronto and Vancouver through respondent-driven sampling, researchers examined physical or sexual violence both experienced and perpetrated between 2017 and 2022. Among 1,455 partnered men with follow-up, roughly a third reported lifetime experience of such violence, and experience during follow-up was more common than perpetration. Prior violence, lower education and substance use were linked to higher risk. Rates stayed stable over time, including during COVID-19 restrictions, pointing interventions toward underlying marginalization.

Recognition of Two-Spirit, lesbian, gay, bisexual, transgender, queer and other sexual and gender minority (2S/LGBTQ+) health equity is growing, yet the harder work remains undone. This commentary, closing a themed issue, argues that research, policy and practice still rarely engage the structural drivers behind poor health in these populations, and that intersectionality shapes how those drivers land on different communities. The authors point to persistent gaps in interventions that tackle those root causes rather than individual behaviour. They stress the urgency of doing so as structural threats to 2S/LGBTQ+ well-being intensify in Canada and other geopolitical contexts.