When ‘raw sex’ turns to a ‘raw deal’ … taking the opportunity to think about sex? Interviews with HIV-positive gay men diagnosed with acute hepatitis C

Abstract

Since 2001, cases of hepatitis C virus (HCV) sexual transmission have been reported in France, among HIV-positive gay men who do not inject drugs. An earlier study focused on the incidence of acute hepatitis C and risk factors associated with HCV transmission. The present study, based on in-depth interviews, aimed to highlight the biography, the sexual practices and the experiences of gay men infected with HCV. Beyond an apparent uniformity, the group of interviewees illustrates a variety of situations, life stories and health pathways, depending on their age. These well-adjusted gay men were used to engaging in unprotected sexual practices, but before their diagnosis they largely ignored HCV-transmission risk, which was associated in their mind with a pejorative drug addict image. Once diagnosed with acute hepatitis C, they experienced a critical and emotional period during which they were open to discuss their sexual practices and reconsider risk-reduction procedures, without being willing to give up on their satisfying sex life. Health educators should consider labelling hepatitis C as an STI in order to disrupt its negative image and to help HIV-positive gay man raise their awareness of HCV-transmission risks and implement better risk-reduction strategies.

Comparison of risk factors in HIV-infected men who have sex with men, coinfected or not with hepatitis C virus (ANRS VESPA2 French cross-sectional national survey)

“…The results obtained confirm those of qualitative7 8 and quantitative9 studies previously conducted in France in smaller samples.…”

Living with Hepatitis C Virus: A Systematic Review and Narrative Synthesis of Qualitative Literature

“…Studies reported that some patients were shocked or surprised by their HCV diagnosis [23, 25, 33, 34, 36, 40, 43, 44, 51, 52, 60, 63], while others were not surprised or had expected a positive HCV result [23, 33, 36, 38]. Those who were not shocked or surprised at the time of diagnosis were often current IDUs who viewed contracting HCV as inevitable [22, 23, 25, 36, 38], often thinking of HCV as a “legacy of drug use…the junky flu, that's one of the by-products” [40].…”

Hepatitis C seroconversions in HIV infection across Europe: which regions and patient groups are affected?

“…transmitted HCV (12)(13)(14)(15), which would also explain the recently reported increasing number of re-infections with HCV after successful clearance or treatment of the first episode (16). Taken together, both patient groups continue to see new cases of HCV infection either on the basis of absent changes in behavioural patterns or missing needle exchange programs.…”

“…Among the first, several outbreaks of acute HCV infection have been described in Australia, Europe and North America over the last decade . Studies have suggested that these outbreaks are explained by an increase in sexually transmitted HCV , which would also explain the recently reported increasing number of re‐infections with HCV after successful clearance or treatment of the first episode . Taken together, both patient groups continue to see new cases of HCV infection either on the basis of absent changes in behavioural patterns or missing needle exchange programs.…”