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Awareness of chronic hepatitis B and C in men who have sex with men in Belgium: epidemiological survey and on-site screening
  1. Marie Coessens1,2,
  2. Jeoffrey Schouten1,3,
  3. Tom Holvoet1,3,
  4. Wim Verlinden1,2
  1. 1Department of Gastroenterology and Hepatology, Vitaz, Sint-Niklaas, Belgium
  2. 2Laboratory of Experimental Medicine and Pediatrics, University of Antwerp Faculty of Medicine and Health Sciences, Wilrijk, Belgium
  3. 3Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
  1. Correspondence to Dr Marie Coessens, Department of Gastroenterology and Hepatology, Vitaz, Sint-Niklaas, Belgium; marie.coessens{at}


Objectives To eliminate hepatitis B and C virus (HBV/HCV) as a public health threat by 2030, the WHO focuses on screening key populations, including men who have sex with men (MSM).

This study aims to assess HBV and HCV knowledge and awareness and HCV prevalence in MSM in Belgium.

Methods First, a questionnaire was designed to assess MSM's knowledge of HBV and HCV infection (disease process, vaccination, treatment and transmission routes). This questionnaire was conducted online, and by means of a tablet-based face-to-face questionnaire at the Antwerp and Belgian Pride. Second, HCV and HIV prevalence data were collected during outreach projects and office screening for sexually transmitted infections (STIs) organised by Sensoa and Exaequo, a Flemish and Walloon sexual health organisation.

Results 300 MSM completed the questionnaire (median age 36 years; 7.7% HIV+). Mean overall survey scores were low (HBV: 41.1%; HCV: 39.8%). Few participants identified all transmission routes correctly (HBV: 15%; HCV 1%).

The degree of education was significantly correlated with HBV knowledge and showed a trend towards correlation with HCV knowledge. HCV knowledge was significantly correlated with high-risk sexual behaviour.

The prevalence of HCV and HIV was 0.3% and 1.0%, respectively, in MSM attending commercial gay venues and 0% and 1.9% in MSM attending office STI screening.

Conclusions Knowledge of HBV and HCV infection in MSM is poor. More awareness campaigns are needed, focusing on frequent HCV risk factors (group sex, chemsex, receptive fisting, and sharing of anal toys and anal douching devices), especially targeting low-educated MSM. HBV vaccination of MSM requires continued attention.

The prevalence of HCV and HIV was remarkably low in commercial gay venues and may be higher in older MSM or in subcultures where risk factors coexist (eg, chemsex). The cost-effectiveness of internet-based approaches with subsequent at-home testing needs to be evaluated in the future.

  • Sexual and Gender Minorities
  • Sexual Behaviour

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  • Handling editor Miłosz Parczewski

  • Contributors WV designed the study and JS wrote the grant application. JS, TH and WV participated in collecting the data. MC was responsible for the data analysis and writing of the manuscript. JS, TH and WV reviewed the manuscript. WV is the principal investigator.

  • Funding This work was supported by Gilead Sciences and AbbVie (grant number 2017-491444).

  • Competing interests WV and JS have received research funding from Gilead Sciences and AbbVie. WV has been a speaker on lectures sponsored by Gilead Sciences and AbbVie. MC received a travel grant from Gilead Sciences.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.