Perceptions and deflections: associations between attitudes towards people with hepatitis C and testing for hepatitis C among Australian gay and bisexual men

Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 268 ◽  
Author(s):  
Loren Brener ◽  
Jeanne Ellard ◽  
Dean Murphy ◽  
Denton Callander
Keyword(s):  
Hepatitis C ◽  
Online Survey ◽  
Sexual Transmission ◽  
Gay And Bisexual Men ◽  
Sexual Practices ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Health Seeking ◽  
And Bisexual ◽  
Hcv Testing

Background Research indicates that the incidence of hepatitis C (HCV) among HIV-positive men who have sex with men (MSM) is increasing. Although injecting drug use remains the predominant means of transmission of HCV in the developed world, there is evidence of sexual transmission of HCV among MSM. Stigma associated with HCV has been shown to negatively impact HCV testing and health-seeking behaviour. There is little research that addresses attitudes towards HCV testing among this population. Methods: The current exploratory study focussed on HCV knowledge, HCV testing, sexual practices, perceptions of HCV risk and attitudes towards people with HCV among Australian MSM. The sample consisted of 590 men who completed an online survey. Results: The findings suggest that attitudinal factors related to HCV were associated with HCV testing behaviour. The more negatively respondents felt about people with HCV, the less likely they were to have ever had an HCV test. Behavioural risk factors related to sexual practices (i.e. is condom use and sexual risk activities) were not associated with HCV testing. Testing for HCV was associated with HIV-positive status, more knowledge about HCV and a greater likelihood of ever having injected drugs. Conclusions: The attitudes of MSM towards those who inject drugs are negative, mirroring that of society more generally. Furthermore, these attitudes, coupled with a lack of knowledge of the risk of sexual transmission of HCV among gay men, especially those who are HIV-positive, may act to prevent routine HCV testing among some MSM at potential risk of acquiring HCV.

Hepatitis C risk factors, attitudes and knowledge among HIV-positive, HIV-negative and HIV-untested gay and bisexual men in Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 411 ◽  
Author(s):  
Loren Brener ◽  
Dean A. Murphy ◽  
Elena J. Cama ◽  
Jeanne Ellard
Keyword(s):  
Risk Factors ◽  
Sexual Transmission ◽  
Gay And Bisexual Men ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Hcv Transmission ◽  
Risk Practices ◽  
And Bisexual ◽  
Hcv Testing ◽  
Hiv Negative

Background There are increasing reports of sexual transmission of hepatitis C virus (HCV) among HIV-positive men who have sex with men (MSM). Still unclear is the level of HCV knowledge and the risk factors specific to HCV transmission among this population. This study compared HCV knowledge and risk practices among HIV-positive, HIV-negative and HIV-untested gay and bisexual men in Australia. Methods: Participants (n = 534) completed an online survey assessing sexual risk practices, HCV knowledge, perceived risk of acquiring HCV and perceptions of people with HCV and who inject drugs. Results: HIV-positive participants were older, reported greater engagement in sexual risk and injecting drug practices, felt they were at greater risk of acquiring HCV, were less likely to socially and sexually exclude people with HCV and had more positive attitudes towards people who inject drugs and people with HCV compared with HIV-negative and HIV-untested participants. HIV-untested participants were younger, reported fewer HCV-related serosorting practices and were more likely to socially and sexually exclude people with HCV than the other groups. Conclusions: Findings suggest that HCV education and prevention for gay men may be most effective if tailored according to HIV status. For HIV-positive men, health promotion could focus on specific sexual practices and biological factors linked to HCV transmission, regular HCV testing and better strategies for disclosure of HCV serostatus. For HIV-negative and HIV-untested men, there should be a more general focus on awareness, changing attitudes towards HCV testing and increasing general knowledge around HCV, including evidence of sexual transmission.

scholarly journals Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms

2021 ◽  
Author(s):  
Trevor A. Hart ◽  
Natalie Stratton ◽  
Todd A. Coleman ◽  
Holly A. Wilson ◽  
Scott H. Simpson ◽  
...  
Keyword(s):  
Sexual Transmission ◽  
Psychosocial Outcomes ◽  
Gay And Bisexual Men ◽  
Sexual Compulsivity ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Anal Sex ◽  
Counseling Intervention ◽  
And Bisexual ◽  
Sex With Men

Background Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. Method HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. Results There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. Conclusions The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. Trial Registration ClinicalTrials.gov NCT02546271

Awareness and knowledge of HIV pre-exposure prophylaxis among Australian gay and bisexual men: results of a national, online survey

Sexual Health ◽  
2016 ◽  
Vol 13 (4) ◽  
pp. 359 ◽  
Author(s):  
Martin Holt ◽  
Toby Lea ◽  
Susan Kippax ◽  
Johann Kolstee ◽  
Jeanne Ellard ◽  
...  
Keyword(s):  
Online Survey ◽  
Gay And Bisexual Men ◽  
Capital City ◽  
Hiv Positive ◽  
Post Exposure Prophylaxis ◽  
Bisexual Men ◽  
Post Exposure ◽  
And Bisexual ◽  
Exposure Prophylaxis ◽  
University Degree

Background Expanded access to HIV pre-exposure prophylaxis (PrEP) is being actively debated in Australia. Awareness and knowledge of this HIV-prevention method have not been assessed in detail in the primary affected population, gay and bisexual men. Methods: Awareness and knowledge of PrEP were assessed among Australian gay and bisexual men, who were asked to complete a national, anonymous, online survey in 2015. Associations with PrEP awareness were identified with multivariate logistic regression and associations with PrEP knowledge were identified using multivariate linear regression. Results: Among 1251 participants, 954 (77%) were aware of PrEP. The most common sources of information were gay community media, Australian websites and friends. Awareness of PrEP was independently associated with older age, living in a capital city, having a university degree, being tested for HIV, being HIV-positive, having condomless anal intercourse with regular male partners, and ever having taken post-exposure prophylaxis. Men in monogamous relationships were less likely to be aware of PrEP. Among men who were aware of PrEP, the mean PrEP knowledge score was 6.8 out of 13. Relatively few participants knew that taking PrEP involved regular clinical monitoring and that in Australia PrEP was only recommended for people at risk of HIV. Better knowledge was independently associated with living in a capital city, having a university degree, being in full-time employment, being HIV-positive, and ever having taken post-exposure prophylaxis or PrEP. Conclusions: To assist in appropriate PrEP uptake, we recommend educating gay and bisexual men about current Australian prescribing guidelines and how PrEP is accessed in Australia.

scholarly journals Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 28 ◽  
Author(s):  
Fengyi Jin ◽  
Gail V. Matthews ◽  
Andrew E. Grulich
Keyword(s):  
Systematic Review ◽  
Sexual Transmission ◽  
Case Series ◽  
Gay And Bisexual Men ◽  
Injecting Drug Use ◽  
Hiv Positive ◽  
Bisexual Men ◽  
And Bisexual ◽  
Hiv Negative ◽  
Hiv Positive Men

A systematic review was performed on the evidence of sexual transmission of hepatitis C virus (HCV) in gay and bisexual men (GBM). Studies conducted in industrialised countries and published in English from 2000 to 2015 with data on HCV in GBM were included. Pooled estimates of prevalence and incidence of HCV infection were stratified by study settings and participants’ HIV status using random effect models. Case-series reports were summarised descriptively. Of the 38 cross-sectional studies, the pooled HCV prevalence was substantially higher in HIV-positive men (8.3%, 95% CI: 6.7–9.9) than in HIV-negative men (1.5%, 95% CI 0.8–2.1), and higher in those who reported injecting drug use (34.8%, 95% CI 26.9–42.7) than in those who did not (3.5%, 95% CI 2.4–4.5). Of the 16 longitudinal studies, the pooled HCV incidence was markedly higher in clinic-based (7.0 per 1000 person-years, 95% CI 4.6–9.5) than in community-based (1.4 per 1000 person-years, 95% CI 0.7–2.1) studies, and in HIV-positive men (6.4 per 1000 person-years, 95% CI 4.6–8.1) than in HIV-negative men (0.4 per 1000 person-years, 95% CI 0–0.9). Since the early 2000s, 15 case-series reports increasingly pointed to the importance of sexual transmission of HCV in mainly HIV-positive men. Injecting drug use remained the major transmission route of HCV in GBM. Receptive condomless intercourse and concurrent ulcerative sexually transmissible infections are likely drivers that facilitated HCV sexual transmission in HIV-positive men. HCV incidence remains very low in HIV-negative GBM.

scholarly journals Can Australia Reach the World Health Organization Hepatitis C Elimination Goal by 2025 Among Human Immunodeficiency Virus–positive Gay and Bisexual Men?

2019 ◽  
Vol 70 (1) ◽  
pp. 106-113 ◽  
Author(s):  
David C Boettiger ◽  
Luisa Salazar-Vizcaya ◽  
Gregory J Dore ◽  
Richard T Gray ◽  
Matthew G Law ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C ◽  
Gay And Bisexual Men ◽  
World Health ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Immunodeficiency Virus ◽  
The World ◽  
Hcv Transmission ◽  
And Bisexual

Abstract Background Human immunodeficiency virus (HIV)–positive gay and bisexual men (GBM) in Australia are well engaged in care. The World Health Organization’s (WHO) hepatitis C virus (HCV) elimination target of an 80% reduction in incidence by 2030 may be reachable ahead of time in this population. Methods We predicted the effect of treatment and behavioral changes on HCV incidence among HIV-positive GBM up to 2025 using a HCV transmission model parameterized with Australian data. We assessed the impact of changes in behavior that facilitate HCV transmission in the context of different rates of direct-acting antiviral (DAA) use. Results HCV incidence in our model increased from 0.7 per 100 person-years in 2000 to 2.5 per 100 person-years in 2016 and had the same trajectory as previously reported clinical data. If the proportion of eligible (HCV RNA positive) patients using DAAs stays at 65% per year between 2016 and 2025, with high-risk sexual behavior and injecting drug use remaining at current levels, HCV incidence would drop to 0.4 per 100 person-years (85% decline from 2016). In the same treatment scenario but with substantial increases in risk behavior, HCV incidence would drop to 0.6 per 100 person-years (76% decline). If the proportion of eligible patients using DAAs dropped from 65% per year in 2016 to 20% per year in 2025 and risk behavior did not change, HCV incidence would drop to 0.7 per 100 person-years (70% reduction). Conclusions Reaching the WHO HCV elimination target by 2025 among HIV-positive GBM in Australia is achievable.

scholarly journals Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms

2021 ◽  
Author(s):  
Trevor A. Hart ◽  
Natalie Stratton ◽  
Todd A. Coleman ◽  
Holly A. Wilson ◽  
Scott H. Simpson ◽  
...  
Keyword(s):  
Sexual Transmission ◽  
Psychosocial Outcomes ◽  
Gay And Bisexual Men ◽  
Sexual Compulsivity ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Anal Sex ◽  
Counseling Intervention ◽  
And Bisexual ◽  
Sex With Men

Background Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. Method HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. Results There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. Conclusions The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. Trial Registration ClinicalTrials.gov NCT02546271

scholarly journals Sexual behaviours associated with incident high-risk anal human papillomavirus among gay and bisexual men

2021 ◽  
pp. sextrans-2020-054851
Author(s):  
Ian K J Wong ◽  
Isobel Mary Poynten ◽  
Alyssa Cornall ◽  
David J Templeton ◽  
Monica Molano ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Anal Cancer ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Sexual Practices ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Sexual Behaviours ◽  
And Bisexual

ObjectiveHigh-risk human papillomavirus (HRHPV) causes anal cancer, which disproportionately affects gay and bisexual men (GBM). We examined sexual behaviours associated with incident anal HRHPV in an observational cohort study of GBM in Sydney, Australia.MethodsGBM aged 35 years and above were enrolled in the Study of the Prevention of Anal Cancer. Detailed information on sexual practices in the last 6 months, including receptive anal intercourse (RAI) and non-intercourse receptive anal practices, was collected. Anal human papillomavirus (HPV) testing was performed at the baseline and three annual follow-up visits. Risk factors for incident HRHPV were determined by Cox regression using the Wei-Lin-Weissfeld method.ResultsBetween 2010 and 2015, 617 men were recruited and 525 who had valid HPV results at baseline and at least one follow-up visit were included in the analysis. The median age was 49 years (IQR 43–56) and 188 (35.8%) were HIV-positive. On univariable analysis, incident anal HRHPV was associated with being HIV-positive (p<0.001), having a higher number of recent RAI partners regardless of condom use (p<0.001 for both), preference for the receptive position during anal intercourse (p=0.014) and other non-intercourse receptive anal sexual practices, including rimming, fingering and receptive use of sex toys (p<0.05 for all). In multivariable analyses, being HIV-positive (HR 1.46, 95% CI 1.09 to 1.85, p=0.009) and reporting condom-protected RAI with a higher number of sexual partners (p<0.001) remained significantly associated with incident HRHPV. When stratified by recent RAI, non-intercourse receptive anal practices were not associated with incident HRHPV in men who reported no recent RAI.ConclusionGBM living with HIV and those who reported RAI were at increased of incident anal HRHPV. Given the substantial risk of anal cancer and the difficulty in mitigating the risk of acquiring anal HRHPV, HPV vaccination should be considered among sexually active older GBM.Trial registration numberANZCTR365383.

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