Maybe I'll start. In Canada, the short answer is that we don't yet know. Until quite recently, even among gbMSM, where globally there's a lot of community interest in PrEP, PrEP uptake in Canada has been very low. In most provinces, that was thought to be due to an absence of public funding for PrEP, but PrEP has actually been part of the provincial medicare program in Quebec since 2016. Even in Quebec, it seems like uptake there was not as great as might have been expected.
However, it does seem like that's changed recently. Researchers from Quebec have been presenting a lot of data on PrEP uptake and the acceptability of PrEP in Quebec. As I mentioned, in our studies of gay men in B.C. prior to public funding of PrEP, only about 2% of our participants reported using PrEP. Now we're seeing maybe 20% or 30% of participants using PrEP.
Public funding and increasing awareness over time are certainly fostering interest in PrEP, primarily among gbMSM. There's always a concern or perhaps an over-concern that this is going to adversely affect sexual behaviour and that we're going to see an increase in epidemics of other STIs. It's important to remember that PrEP is really targeted to individuals who are already at high risk of acquiring not just HIV but other STIs.
When we see very high rates of syphillis, gonorrhea and chlamydia diagnoses among PrEP users, that's really what we expect. That says we're actually targeting the people who really need this. It remains to be seen whether those rates will continue over time or whether we might in fact get better control of these other STIs, now that we're engaging these people at high risk of acquiring other STIs in regular medical care.
I think it's probably important to mention what we've heard, at least anecdotally, are the mental health benefits of being on PrEP. A lot of people report that their sex lives have improved now that they don't have to worry about catching HIV.
That's my take on it. We're interested in measuring many of these things over time but right now we don't have a lot of information about the real-world use of PrEP in Canada.