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

Abstract

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.