[Physical activity, sleep, and substance use in adults reporting a borderline personality disorder in France and Canada: An online study]. / Activité physique, sommeil et consommation de substances chez les adultes déclarant un trouble de personnalité limite en France et au Canada : une étude en ligne.

Introduction Borderline personality disorder (BPD) is associated with many unhealthy behaviors. Psychoactive substance (alcohol and drugs) use is present in 78% of adults with BPD. Moreover, a poor sleep seems linked to the clinical profile of adults with BPD. Finally, some physical comorbid disorders like obesity, cardiovascular diseases, and diabetes are linked to physical inactivity and sedentary behaviors. However, to this day no study analyzed these behaviors in French-speaking individuals with BPD. Objectives This study's goal is to document health behaviors in adults with BPD in Canada and in France. Method This cross-sectional study consists of an online survey on the LimeSurvey platform including validated questionnaires distributed in France and Canada. To measure physical activity, we used the "Global Physical Activity Questionnaire." Insomnia was measured with the "Insomnia Severity Index." Substance use was measured with the "Alcohol, Smoking and Substance Involvement Test." Descriptive statistics (N,% and mean) are used to describe previously mentioned health behaviors. Five regression models have been realized to find the main associated variables (age, perceived social status, education level, household income, body mass index, emotional regulation difficulties, BPD symptoms, depression level, previous suicide attempts and psychotropic medication use) to health behaviors. Results A total of 167 participants (92 Canadians, 75 French; 146 women, 21 men) filled out the online survey. In this sample, 38% of Canadians and 28% of French reported doing less than 150 minutes of physical activity weekly. Insomnia affected 42% of Canadians and 49% of French. Tobacco use disorder affected 50% of Canadians and 60% of French. Alcohol use disorder affected 36% of Canadians and 53% of French. Cannabis use disorder affected 36% of Canadians and 38% of French. All tested variables were linked to physical activity (R² = 0.09). Insomnia was only linked with BPD symptoms (R² = 0.24). Tobacco use disorder was linked to social status and alcohol use disorder (R² = 0.13). Alcohol use disorder was linked to social status, body mass index, tobacco use disorder, and depression (R² = 0.16). Finally, cannabis use disorder was linked to age, body mass index, tobacco use disorder, depression, and past suicide attempts (R² = 0.26). Conclusion These results are essential to design health prevention interventions in French-speaking adults with BPD in Canada and in France. They help identify the main factors associated with these health behaviors.

Pre-exposure Prophylaxis Uptake Among Men Who Have Sex With Men Who Used nPEP: A Longitudinal Analysis of Attendees at a Large Sexual Health Clinic in Montréal (Canada).

BACKGROUND: Reducing HIV transmission using pre-exposure prophylaxis (PrEP) requires focussing on individuals at high acquisition risk, such as men who have sex with men with a history of nonoccupational post-exposure prophylaxis (nPEP). This study aims to characterize longitudinal trends in PrEP uptake and its determinants among nPEP users in Montréal. METHODS: Eligible attendees at Clinique médicale l'Actuel were recruited prospectively starting in October 2000 (nPEP) and January 2013 (PrEP). Linking these cohorts, we characterized the nPEP-to-PrEP cascade, examined the determinants of PrEP uptake after nPEP consultation using a Cox proportional-hazard model, and assessed whether PrEP persistence differed by nPEP history using Kaplan-Meier curves. RESULTS: As of August 2019, 31% of 2682 nPEP cohort participants had 2 or more nPEP consultations. Subsequent PrEP consultations occurred among 36% of nPEP users, of which 17% sought nPEP again afterward. Among 2718 PrEP cohort participants, 46% reported previous nPEP use. Among nPEP users, those aged 25-49 years [hazard ratio (HR) = 1.3, 95% confidence interval (CI): 1.1 to 1.7], with more nPEP episodes (HR = 1.4, 95% CI: 1.3 to 1.5), who reported chemsex (HR = 1.3, 95% CI: 1.1 to 1.7), with a sexually transmitted infection history (HR = 1.5; 95% CI: 1.3 to 1.7), and who returned for their first nPEP follow-up visit (HR = 3.4, 95% CI: 2.7 to 4.2) had higher rates of PrEP linkage. There was no difference in PrEP persistence between nPEP-to-PrEP and PrEP only participants. CONCLUSION: Over one-third of nPEP users were subsequently prescribed PrEP. However, the large proportion of men who repeatedly use nPEP calls for more efficient PrEP-linkage services and, among those who use PrEP, improved persistence should be encouraged.