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Abstract
Objective The hepatitis C virus (HCV) epidemic among gay, bisexual and other men who have sex with men (GBMSM) is associated with sexual and drug-related behaviours. To stem the tide of HCV infection in GBMSM, regular testing leading to early diagnosis and treatment as prevention is vital. This study aimed to evaluate the success of current HCV testing guidelines from the perspective of GBMSM in four Celtic nations.
Methods Subpopulation analysis of data from the 2020 cross-sectional online SMMASH3 (social media, men who have sex with men, sexual and holistic health) survey was undertaken to examine HCV testing experiences and sexual behaviours among sexually active GBMSM (n=1886) stratified across three groups: HIV-diagnosed GBMSM (n=124); HIV-negative GBMSM using pre-exposure prophylaxis (PrEP) (n=365); and HIV-negative/untested GBMSM not using PrEP (n=1397).
Results Sexual behaviours associated with HCV acquisition were reported by the majority of HIV-diagnosed (76.6%, n=95) and PrEP-using (93.2%, n=340) GBMSM. Reassuringly, recent testing for HCV in these groups was common, with 79.8% (n=99) and 80.5% (n=294) self-reporting HCV screening within the preceding year, respectively, mostly within sexual health settings. While 54.5% (n=762) of HIV-negative/untested GBMSM not using PrEP reported sexual behaviours associated with HCV, 52.0% had not been screened for HCV in the last year, despite almost half (48.0%, n=190) of unscreened men being in contact with sexual health services in the same period.
Conclusions Sexual behaviours associated with HCV acquisition among HIV-diagnosed and PrEP-using GBMSM are common but complemented by regular HCV testing within sexual health services. Current testing guidelines for these groups appear to be effective and generally well observed. However, behaviour-based HCV testing for HIV-negative/untested GBMSM not using PrEP appears less effective and may undermine efforts to achieve HCV elimination. Accordingly, we need to increase HCV testing for these men in clinical settings and explore ways to screen those who are not in touch with sexual health services.
- Hepatitis C
- Sexual and Gender Minorities
- Pre-Exposure Prophylaxis
- Serologic Tests
Data availability statement
Data are available upon reasonable request. Data are available on request from the last author via their ORCID identifier.
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Data availability statement
Data are available upon reasonable request. Data are available on request from the last author via their ORCID identifier.
Footnotes
Handling editor Anna Maria Geretti
Twitter @DrDaveWhiteley, @jamiefrankis
Contributors DW, JSF and SB conceptualised this article using data from the SMMASH3 study. DS and PV contributed to the original design of SMMASH3, led by JSF. DS and JSF collected the data. JSF, DW and SB performed this subpopulation analysis and interpreted the data. DW and JSF drafted the original manuscript, with all authors contributing to critical review and revision. JSF acts as guarantor.
Funding Funding for the SMMASH3 study was provided by NHS Lothian, NHS Greater Glasgow and Clyde, NHS Tayside, Waverley Care, HIV Scotland and Public Health Scotland (internal award number GCU/RIO/19-122). The subpopulation analysis presented in this paper received no additional funding.
Competing interests DW has received speaker’s honoraria from Gilead and Janssen and funding for attendance at conferences and educational meetings from Janssen, MSD and BMS.
Provenance and peer review Not commissioned; externally peer reviewed.
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