Response to a sexual risk reduction intervention provided in combination with hepatitis C treatment by HIV/HCV co-infected men who have sex with men: a reflexive thematic analysis

Abstract

Background Hepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the program regarding sexual risk taking. Based on the participants’ input, we hoped to judge the intervention’s potential for scale-up. Methods Seventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention. We evaluated the responses via reflexive thematic analysis and applied the concept of sense-making. Results Giving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1. Avoid risks: get rid of hepatitis C for life. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes. 2. Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. 3. Accept risks; live with the risk of hepatitis C. These men perceived behavioral changes as much more difficult than “easy” medical treatment. They expected to either undergo repeated rounds of treatment or stay HCV re-infected. Conclusion These results illustrate the diversity of men’s responses and their decisions regarding sexual risk behavior after participating in a combination of antiviral treatment and a sexual risk reduction intervention. Two major aspects were identified: 1) Teachable moments, particularly at the time of diagnosis/treatment, could offer an opportunity to develop openness for behavioral change; 2) adapting sexual risk reduction interventions to sense-making patterns could help to improve its effectiveness. Support for reducing infection risk and raising awareness of preventative measures are additional benefits. Trial registration Clinical Trial Number: NCT02785666, 30.05.2016.

Sustained Effect on Hepatitis C Elimination Among Men Who Have Sex With Men in the Swiss HIV Cohort Study: A Systematic Re-Screening for Hepatitis C RNA Two Years Following a Nation-Wide Elimination Program

“…In Switzerland, an HCV micro-elimination program, termed Swiss HCVree Trial, targeted to and the discussion of its potential impact are published elsewhere (8,9). The trial finished with a rescreening from March until November 2017 ("P se C") (Figure 1).…”

Usability, acceptability, and self-reported impact of an innovative hepatitis C risk reduction intervention for men have sex with men: A mixed methods study

“…Informing men at risk about the possible HCV risk factors other than anal intercourse, as well as motivating them to integrate such risk reduction strategies into their sex lives are essential. The first HCV specific sexual risk reduction intervention was developed in 2016 as part of the Swiss HCVree trial [12]: an intervention for HIV/HCV co-infected MSM provided in combination with DAA treatment and consisting of individual counselling sessions aimed at reducing sexual risk taking [13]. In 2017, we initiated the NoMoreC project, a multilevel intervention aimed at reducing HCV transmission among all MSM at risk of HCV in Amsterdam [14].…”

Feasibility of using Facebook for HIV prevention: Implications for translational research among justice-involved women who use drugs in rural Appalachia

“…The lack of differences between groups is likely attributable to all intervention content being derived from the NIDA Standard, which is the same in both conditions and only varied based on the delivery platform and frequency of session content. Understanding the extent of knowledge about HIV https://doi.org/10.1017/cts.2022.497 Published online by Cambridge University Press and HCV risks is critical in the delivery of prevention interventions because there can be a conceptual gap between knowledge of a risk and implementation of strategies to change risk behaviors 34,35 . Future research should focus on the unique challenges that may exist between knowledge of risk and risk behavior change for rural Appalachian women.…”