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Evaluation of hepatitis C testing in men who have sex with men, and associated risk behaviours, in Manchester, UK
  1. G Ireland1,
  2. S Higgins2,
  3. B Goorney3,
  4. C Ward4,
  5. S Ahmad5,
  6. C Stewart3,
  7. R Simmons1,
  8. S Lattimore1,
  9. V Lee4
  1. 1 National Infection Service, Public Health England, London, UK
  2. 2 Pennine Acute Hospitals NHS Trust, Manchester, UK
  3. 3 Salford Royal NHS Foundation Trust, Manchester, UK
  4. 4 Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  5. 5 University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
  1. Correspondence to G Ireland, National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK; Georgina.ireland{at}phe.gov.uk

Abstract

Objective To determine the prevalence of newly diagnosed hepatitis C virus (HCV) and associated risk behaviours among men who have sex with men (MSM) in Manchester.

Method A survey among MSM attending four genitourinary medicine clinics in Manchester was carried out over 9 months in 2013. Participants were asked about recent sexual behaviour, recreational drug use and HIV status. All men were offered an HCV test.

Results Overall, 2030 MSM completed a questionnaire and accepted an HCV test. Of whom, 0.9% (18) were newly diagnosed with HCV, including 1.8% (13/735) of HIV-positive MSM, 0.7% (3/440) of MSM of unknown HIV status and 0.2% (2/855) of HIV-negative MSM. HCV positivity was significantly associated with HIV status (p<0.001). When compared with HIV-negative MSM, HIV-positive MSM had higher rates of sharing snorting drug equipment, injecting drugs/‘slamming’ and using recreational drugs (all p<0.05) but lower rates of five or more sexual partners and insertive unprotected anal intercourse (p<0.05). MSM newly diagnosed with HCV had significantly higher prevalence of unprotected sex, sex with someone HCV positive, fisting, group sex, ever injecting drugs/‘slamming’ and recreational drug use (p<0.002).

Conclusions In this survey, HIV-positive MSM had significantly different drug use behaviour which may explain the higher HCV burden. However, HCV was also associated with HIV-negative MSM engaging in high-risk sexual practices. All MSM attending sexual health clinics must have a risk assessment and HCV screening should be offered based on the risk. Further studies are warranted to explore the interplay between HCV and HIV risk associated with drug use versus sexual practices.

  • HEPATITIS C
  • HIV
  • TESTING
  • MEN

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Footnotes

  • Handling editor Jackie A Cassell

  • Contributors SH, BG, CW, SA, CS and VL collected the data, which was sent to GI and SL at Public Health England. GI undertook the analysis and had access to the complete dataset, RS, SL and VL supervised GI. GI drafted the paper and all authors provided critical input to the manuscript and approved all revisions.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data is held by Public Health England (PHE) in London. The data holds personal information which means that it cannot be freely available in a public repository, but readers may contact Georgina Ireland (georgina.ireland@phe.gov.uk) at PHE to make a data request.