Joseph Cox
Biographic Data
| ID | 3581817 |
|---|---|
| NAME | Joseph Cox |
| GIVEN NAMES | Joseph |
| FAMILY NAME | Cox |
| SIGNATURE | COX J |
| AFFILIATIONS | McGill University Health Centre |
| ORCID | 0000-0002-7041-1556 |
| VERIFIED | Yes |
| TOTAL WORKS | 70 |
| TOTAL CITATIONS | 41 |
| AUTHOR COUNT | 70 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2006 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Disentangling Between- and Within-Person Effects of HIV PrEP and Treatment Attitudes on Condom Use and Bacterial STIs Among Sexual Minority Men
Substance Use and Incidence of Psychosis Diagnoses Among Gay, Bisexual, and Other Men Who Have Sex with Men Compared with Males from the General Population
BACKGROUND: Gay, bisexual, and other men who have sex with men (GBM) report higher use of psychoactive substances, which may contribute to many adverse outcomes. METHOD: We examined the incidence of psychosis and associated substance use among GBM compared with males from the general male population. We analyzed data from 798 sexually active GBM from two cohort studies based in Vancouver, Canada, linking their survey data to administrative health…
Evaluating primary health care utilization among lesbian, gay, and bisexual individuals in Canada with a view to inform more equitable health measures
Canada is advancing several reforms to strengthen primary health care. Although lesbian, gay, and bisexual (LGB) individuals experience a higher burden of some health conditions, they remain largely absent from these reforms, partly because of limited data. We assessed differences in primary care utilization between LGB and heterosexual individuals to address this gap. We used data from 91,172 heterosexual and 2,550 LGB participants in the 2015–2…
Community-Led Responses to Mpox Among Gay, Bisexual, and Queer Men in Canada
Since 2022, a global mpox outbreak in non-endemic countries, including Canada, has spread rapidly, mainly affecting gay, bisexual, and queer men (GBQM). With mpox primarily transmitted through sexual and close physical contact, concerns emerged over the replication of early responses to HIV/AIDS, which was initially labeled as a “gay disease,” perpetuating ongoing negative stereotypes and discrimination against GBQM. To prevent potential social a…
A cost-effectiveness analysis of a multidisciplinary model of care on hepatitis C care among people released from provincial prison in Quebec, Canada
Our multidisciplinary model of care increased the proportion of HCV RNA+ people released from prison who subsequently achieved SVR, at an additional cost of C$25,653 per additional patient. This is only C$5,653 more than the estimated cost of direct-acting antivirals, providing an economic rationale for broader implementation
Estimating the percentage and number of people with indications for HIV pre-exposure prophylaxis (PrEP) within two key populations, Canada, 2021
In Canada, the estimated number of people with PrEP indications among GBMSM and PWID far exceeded documented levels of use. Uptake of PrEP was lower among PWID compared to GBMSM. Efforts to improve PrEP access and uptake could help reduce HIV transmission in Canada
Disparities in healthcare, STI testing, and PrEP access among newcomer sexual minority men in Canada's three largest urban centers
Gay, bisexual, and other men who have sex with men (GBM) are more likely to be diagnosed with HIV and other sexually transmitted infections (STIs) compared with the general population. Although newcomers generally experience a health advantage in Canada compared with non‐immigrants and more established immigrants (i.e., healthy immigrant effect), they also experience disparities in access to healthcare services. These disparities, in turn, may le…
Effect of depressive symptoms on health services utilization in the HIV and hepatitis C co-infected population in Canada
Depression is common among people living with HCV and HIV, which contributes to health services utilization (HSU). It is unknown whether successful HCV treatment affects this. We examined depressive symptoms and HSU in people co-infected with HIV-HCV and their association with sustained virologic response (SVR) during the direct-acting antiviral era. We predicted depressive symptoms by a random forest classifier in the Canadian Co-infection Cohor…
Identifying Syndemic Factors and Their Effect on HIV Sexual Risk Behavior Among Gay, Bisexual and Other Men Who Have Sex with Men in Vancouver, Montreal and Toronto
We set out to identify syndemic factors associated with HIV sexual risk behavior among HIV-negative gay, bisexual and other men who have sex with men (GBM), and examine associations between syndemic factors and HIV sexual risk behaviors using models of co-occurring epidemics. We used baseline data from 1571 sexually active GBM from the Engage Cohort study, recruited using respondent-driven sampling in Montreal, Toronto, and Vancouver. We explored…
Factors influencing the acceptability of hepatitis C screening among people with experience of incarceration in Quebec, Canada
The TDF was useful in identifying factors associated with the acceptability of HCV screening among PWEI. Future interventions should seek to leverage peer networks, integrate point-of-care HCV testing, and provide whole-of-sector education and wrap-around services to better support PWEI and contribute to broader efforts to eliminate HCV among incarcerated populations
A pre-post study of the impact of a multidisciplinary model of care on linkage to hepatitis C care following release from prison
A multidisciplinary model of care increased linkage to HCV care among untreated individuals released from prison. Future interventions should support similar models, leveraging social support networks to maximize continuity of care
Improving access to test results for participants in bio-behavioural surveys of people who inject drugs
Impact of the Covid-19 pandemic on hepatitis C virus screening in provincial prisons in Montreal, Quebec, Canada
Background: Little is known about the impact of the COVID-19 pandemic on hepatitis C (HCV) screening efforts in carceral settings. We explored the impact of the pandemic on HCV screening in two of Quebec's largest provincial prisons. Methods: Retrospective data of HCV-related laboratory tests between July 2018 and February 2022 at l'Établissement de détention de Montréal (EDM) and l'Établissement de détention de Rivière-des-Prairies (EDRDP) were …
Attitudes of Gay, Bisexual, and Other Men Who Have Sex with Men (GBM) toward Their Use of Amphetamine-Type Stimulants and Relation to Reducing Use in Three Canadian Cities
BACKGROUND: We explored attitudes of gay, bisexual, and other men who have sex with men (GBM) toward their amphetamine-use and associations with reduced use over time. METHODS: We recruited sexually-active GBM aged 16+ years in Montreal, Toronto, and Vancouver, Canada, from 02-2017 to 08-2019, with follow-up visits every 6-12 months until November 2020. Among participants who reported past-six-month (P6M) amphetamine-use at enrollment, we used lo…
Minority Stress, Psychological Distress, Sexual Compulsivity, and Avoidance-Based Motivations Associated with Methamphetamine Use Among Sexual Minority Men Living with HIV
Objective Sexual minority men (SMM) living with HIV report significantly greater methamphetamine use compared with heterosexual and HIV-negative peers. Greater use may be related to stressors (e.g., HIV-related stigma) faced by SMM living with HIV and subsequent psychological and behavioral sequelae. We tested an integrated theoretical model comprised of pathways between stigma, discrimination, childhood sexual abuse, psychological distress, sexu…
Different classes of crystal methamphetamine use are associated with psychological and sexually transmitted infection outcomes among gay, bisexual, and other men who have sex with men
Interventions, Barriers, and Facilitators to Address the Sexual Problems of Gay, Bisexual and Other Men Who Have Sex with Men Living with HIV
HIV Treatment Optimism Moderates the Relationship between Sexual Risk Behavior and HIV Risk Perception among Urban HIV-negative Gay, Bisexual, and Other Men who have Sex With Men
Perceived patient navigator services and characteristics to address barriers to linkage to hepatitis C care among people released from provincial prison in Quebec, Canada
Interventions that seek to improve linkage to HCV care for people following release from prison should address many levels (individual, interpersonal, and policy) of the SEM. While people experience several competing priorities post-release, having an empathetic and consistent patient navigator, regardless of their lived experiences of HCV and/or incarceration, may improve linkage to HCV care post-release
Earlier First Anal Sex Predicts Engagement in Chemsex Among Men Who Have Sex with Men in the United Kingdom
Chemsex, a form of sexualized drug use, is prevalent among men who have sex with men (MSM) in the United Kingdom (UK), contributing to public health concerns like increased HIV transmission and overdose risk. This study explored the link between early first anal sex and chemsex engagement among MSM, a connection that has been underexplored in the UK. Analyzing data from 10,702 UK-based MSM from the European MSM Internet Survey (EMIS-2017), we use…
It's not as good as the face-to-face contact
The COVID-19 pandemic led to the widespread adoption of virtual care-the use of communication technologies to receive health care at home. We explored the differential impacts of the rapid transition to virtual care during the COVID-19 pandemic on health-care access and delivery for gay, bisexual and queer men (GBQM), a population that disproportionately experiences sexual and mental health disparities in Canada. Adopting a sociomaterial theoreti…
Unpacking racism during Covid-19
Racism remains a pernicious threat to the well-being of GBQM of colour. CRT highlights the importance of assessing how sexualized and gendered discourses about race shape the experiences of GBQM of colour navigating multiple epidemics like COVID-19 and HIV. These pervasive discourses unevenly affect racial and sexual minorities across multiple epidemics, and negatively impact health outcomes for these populations
Examining the secondary impacts of the Covid-19 pandemic on syndemic production and PrEP use among gay, bisexual and other men who have sex with men (GBM) in Vancouver, Canada
There were increasing PrEP interruptions since March 2020. However, those most at risk for HIV were less likely to have interruptions. Additional mental health services and targeted follow-up for PrEP continuation may help to mitigate the impacts of the COVID-19 pandemic on GBM
Examining Associations Between Resilience and PrEP Use Among HIV-negative GBM in Toronto, Montreal and Vancouver
It’s different for heterosexuals”
Critical scholarship has illustrated how COVID-19 public health policies can enact racism, classism, and cis-heteronormativity, perpetuating harms among vulnerable communities. We sought to examine the accounts of gay, bisexual, and queer men (GBQM) in Canada on how normative ideologies played out in COVID-19 directives and what impacts these orders had on their lives. Two rounds of semi-structured interviews with GBQM in Montreal (n = 30), Toron…
Include Them and They Will Tell You
Encouraging youth voice, visibility, and active participation in adolescent-related research is strongly advocated in the literature. In this article, we describe how participatory approaches informed by arts-based methods (e.g., reflective writing, dramatization) were used with adolescents to enhance the research process in an exploratory study designed to develop and evaluate prevention resources for sexual risk-taking behaviors.Youth aged 15 t…
You’re Gay, It’s Just What Happens”
Our grounded theory analysis derives from in-depth interviews conducted with 24 gay, bisexual, queer, and other men who have sex with men (GBM) living in Toronto, Canada, to understand their experiences of sexual coercion. Participants drew on discourse from the #MeToo movement to reconsider the ethics of past sexual experiences. The idea that gay or queer sex is inherently risky and unique from heterosexual relations made negotiating sexual safe…
Minority stressors and connectedness among urban gay, bisexual, and queer men
It's not as good as the face-to-face contact
The COVID-19 pandemic led to the widespread adoption of virtual care-the use of communication technologies to receive health care at home. We explored the differential impacts of the rapid transition to virtual care during the COVID-19 pandemic on health-care access and delivery for gay, bisexual and queer men (GBQM), a population that disproportionately experiences sexual and mental health disparities in Canada. Adopting a sociomaterial theoreti…
Social Network-Related Risk Factors for Bloodborne Virus Infections Among Injection Drug Users Receiving Syringes through Secondary Exchange
I was just doing what a normal gay man would do, right
Drawing on 24 interviews conducted with gay, bisexual, queer and other men who have sex with men (GBM) living in Toronto, Canada, we examined how they are making sense of the relationship between their mental health and substance use. We draw from the literature on the biopolitics of substance use to document how GBM self-regulate and use alcohol and other drugs (AODC) as technologies of the self. Despite cultural understandings of substance use …
Prevalence of HIV and sexually transmitted and blood-borne infections, and related preventive and risk behaviours, among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vanc…
The three largest cities of Canada differed in HIV prevalence, STBBI testing and PrEP use among GBM. Our findings also suggest the need for scale-up of both PrEP and STI testing among GBM in Canada
It's in Me to Give
Blood donation policies governing men who have sex with men have shifted significantly over time in Canada-from an initial lifetime ban in the wake of the AIDS crisis to successive phases of time-based deferment requiring periods of sexual abstinence (5 years to 1 year to 3 months). We interviewed 39 HIV-negative gay, bisexual, queer, and other sexual minority men (GBM) in Vancouver, Toronto, and Montreal to understand their willingness to donate…
Low perceived benefits and self-efficacy are associated with hepatitis C virus (HCV) infection-related risk among injection drug users
Characterizing the Drug-injecting Networks of Cocaine and Heroin Injectors in Montreal
Characterizing the Drug-injecting Networks of Cocaine and Heroin Injectors in Montreal
The importance of social networks in their association to drug equipment sharing among injection drug users
Aim To examine the scientific evidence regarding the association between characteristics of social networks of injection drug users (IDUs) and the sharing of drug injection equipment. Methods A search was performed on MEDLINE, EMBASE, BIOSIS, Current Contents, PsycINFO databases and other sources to identify published studies on social networks of IDUs. Papers were selected based on their examination of social network factors in relation to the s…
Minimal uptake of sterile drug preparation equipment in a predominantly cocaine injecting population
Hepatitis C meanings and preventive strategies among street-involved young injection drug users in Montréal
Social Network-Related Risk Factors for Bloodborne Virus Infections Among Injection Drug Users Receiving Syringes through Secondary Exchange
Low perceived benefits and self-efficacy are associated with hepatitis C virus (HCV) infection-related risk among injection drug users
Correlates of Unprotected Anal Sex at Last Sexual Episode
Behavioural Risks for HIV Infection Among Quebec Residents of Haitian Origin
Asking to listen
In this three-phase exploratory study, we used participatory approaches with youth in a small Canadian province. Through iterative focus groups in school settings, we examined young men and women's perspectives regarding factors important to taking control of their sexual health behaviour. Youth aged 15–17 discussed sexual health through role-play, reflective writing, and drawing. This study provides a view into the gender and sexual scripts of m…
Include Them and They Will Tell You
Encouraging youth voice, visibility, and active participation in adolescent-related research is strongly advocated in the literature. In this article, we describe how participatory approaches informed by arts-based methods (e.g., reflective writing, dramatization) were used with adolescents to enhance the research process in an exploratory study designed to develop and evaluate prevention resources for sexual risk-taking behaviors.Youth aged 15 t…
Food insecurity and low CD4 count among HIV-infected people
Food Insecurity in HIV-Hepatitis C Virus Co-infected Individuals in Canada
While research has begun addressing food insecurity (FI) in HIV-positive populations, knowledge regarding FI among individuals living with HIV-hepatitis C virus (HCV) co-infection is limited. This exploratory study examines sociodemographic, socioeconomic, behavioral, and clinical factors associated with FI in a cohort of HIV-HCV co-infected individuals in Canada. We analyzed longitudinal data from the Food Security and HIV-HCV Co-infection Study…
Beyond Condoms
Gay, bisexual, and other men who have sex with men (MSM) have adapted their sexual practices over the course of the HIV/AIDS epidemic based on available data and knowledge about HIV. This study sought to identify and compare patterns in condom use among gay, bisexual, and other MSM who were tested for HIV at a community-based testing site in Montreal, Canada. Results showed that while study participants use condoms to a certain extent with HIV-po…
Injection Drug Use, Unemployment, and Severe Food Insecurity Among HIV-HCV Co-Infected Individuals
Impact of Food Insecurity on Depressive Symptoms Among HIV–HCV Co-infected People
Association between depressive symptoms, CD4 count and HIV viral suppression among HIV-HCV co-infected people
Depressive symptoms are associated with poor HIV viral control and immune recovery among people living with HIV. However, no prior studies assessed this association exclusively among people co-infected with HIV-hepatitis C virus (HCV). While people with HIV only and those with HIV-HCV co-infection share many characteristics, co-infected people may become more susceptible to the effects of depressive symptoms on health outcomes. We assessed this a…
Injection drug use, food insecurity, and HIV-HCV co-infection
Injection drug use (IDU) and food insecurity (FI) are highly prevalent among individuals living with HIV-hepatitis C virus (HCV) co-infection. We quantified the association between IDU and FI among co-infected individuals using biannual data from the Canadian Co-infection Cohort (N = 608, 2012-2015). IDU (in the past six months) and IDU frequency (non-weekly/weekly in the past month) were self-reported. FI (in the past six months) and FI severity…
Interventions to increase testing, linkage to care and treatment of hepatitis C virus (HCV) infection among people in prisons
Delayed linkage to HIV care among asylum seekers in Quebec, Canada
While the majority of newly diagnosed asylum seekers were late presenters, only 45% were linked to care within 30 days. Once linked, care and viral suppression were rapid. Delays in screening and linkage to care present increased risk for onward transmission, and in the context of 21% baseline resistance, consideration of point-of-care testing and immediate referral at IME screening should be made
Variation in hepatitis C virus treatment uptake between Canadian centres in the era of direct-acting antivirals
A Structural Equation Model of the Effect of Masculinity and Avoidant Coping on Gay and Bisexual Men’s Sexual Risk-Taking
The Mediating Role of Depressive Symptoms in the Association Between Food Insecurity and HIV Related Health Outcomes Among HIV–HCV Co-Infected People
High-Risk Sexual Behavior, Binge Drinking and Use of Stimulants are Key Experiences on the Pathway to High Perceived HIV Risk Among Men Who Have Sex with Men in Brazil
Combination HIV Prevention Strategies Among Montreal Gay, Bisexual, and Other Men Who Have Sex with Men in the PrEP Era
Pre-exposure prophylaxis (PrEP) became publicly available in Quebec for gay, bisexual and other men who have sex with men (GBM) in 2013. We used baseline data from Engage, a cohort of GBM recruited by respondent-driven sampling, to examine patterns of combination HIV prevention use among Montreal GBM since PrEP became available. Latent class analysis, stratified by HIV status, was used to categorize GBM by self-reported use of biomedical and beha…
Real-World Eligibility for HIV Pre-exposure Prophylaxis Among People Who Inject Drugs
Medicine (58 works) · HIV/AIDS Research and Interventions (39 works) · Psychology (38 works) · HIV, Drug Use, Sexual Risk (36 works) · Human immunodeficiency virus (HIV (31 works) · Public health (26 works) · Internal Medicine (24 works) · Psychiatry (24 works) · Demography (23 works) · Environmental health (23 works)