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Do rates of unprotected anal intercourse among HIV-positive MSM present a risk for hepatitis C transmission?
  1. Ron Stall1,
  2. Chongyi Wei1,
  3. H Fisher Raymond2,
  4. Willi McFarland2,3
  1. 1Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  2. 2HIV Epidemiology, San Francisco Department of Public Health, San Francisco, California, USA
  3. 3Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
  1. Correspondence to Ron Stall, University of Pittsburgh, 208 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261, USA; rstall{at}


Objectives To compare the rates of unprotected anal intercourse (UAI) among men who have sex with men (MSM) in HIV-seropositive sexual relationships with that among men in HIV-seronegative and serodiscordant relationships in the context of an emerging hepatitis C virus (HCV) epidemic among HIV-positive MSM.

Methods Time-location sampling was used to obtain a cross-sectional sample of MSM who attended public venues in San Francisco between November 2007 and October 2008 (N=1199). Behavioural measures of sexual risk-taking at the level of the sexual dyad were administered to the sample.

Results Men in HIV-positive/positive sexual relationships are significantly more likely to have UAI and combine sex and drugs than men in negative/negative sexual relationships.

Conclusions If it is possible to spread HCV infection between HIV-positive men via UAI, very high levels of behavioural risk among positive MSM should exist to facilitate HCV transmission. Identifying the precise behavioural risk factors for HCV among HIV-positive MSM has become an important public health priority.

  • Men who have sex with men
  • HCV
  • behavioural risk
  • gay men
  • hepatitis C
  • sexual behaviour

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  • Funding This study was funded by a grant from the National Institute of Mental Health (grant number: R01MH077509).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of California, San Francisco, Committee on Human Research and the University of Pittsburgh Institutional Review Board.

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