Changing the odds: motives for and barriers to reducing HCV-related sexual risk behaviour among HIV-infected MSM previously infected with HCV

Abstract

BackgroundAmong HIV-infected MSM who have been treated for HCV infection, the HCV reinfection rate is high. It is therefore essential to understand their perceptions of HCV risk behaviour and risk-reducing strategies.MethodsThis qualitative study among 20 HCV-infected MSM, the majority treated in the era before direct acting antivirals, provides insight into their ideas, motives, and barriers concerning HCV risk reduction, and aims to strengthen prevention strategies for both primary HCV infection and HCV reinfection.ResultsThe strongest motive to implement risk reduction strategies was the reward of avoiding HCV retreatment and its side effects, but this may change with the current implementation of less burdensome HCV treatment. Also, the sexual risk norms in the MSM scene, including social pressure towards risk-taking, HCV stigma, and non-disclosure of HCV status, all form barriers to safe sex. Drug use, strongly present in the context of clubs and group sex, directly impedes the self-efficacy of men to take risk reduction measures.ConclusionsTailored prevention messages, empowerment of self-efficacy for risk reduction, and more insight into risk behaviour over time are ingredients for effective HCV prevention among these men.

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

“…In other words, while the prospect of not having to take HCV medications again motivated some towards changing their behavior, that was not universal. This supports the findings of a recent study in which Lambers et al [ 45 ] described the impact of perceived treatment burden on motivation towards behavior change. However, the variety of experience, ranging from treatment instead of behavioral change, towards treatment as an option if risk reduction fails to treatment as the one single change to get rid of HCV , has not been described so far and is informative for prevention initiatives combining treatment and counseling.…”

“…To our knowledge, this is the first time that negative feelings towards an HCV cure have been noted in the perceptions of MSM. This contrasts sharply with the results of a study during the era of interferon-based therapy, in which all interviewed HIV-positive MSM spoke completely positively about their HCV-free status [ 45 ]. Understanding more will require further research on this topic and the potential consequences to meet the care needs of MSM.…”

Impact of Sexualized Substance Use and Other Risk Practices on HCV Microelimination in gbMSM Living with HIV: Urgent Need for Targeted Strategies. Results of a Retrospective Cohort Study

“…These results differ slightly from those observed in other countries and other Spanish regions, where mephedrone was one of the main sexualized drugs among MSM [ 29 , 30 ], and demonstrate the dynamic nature and cultural variation of chemsex phenomenon, a fact that has to be taken into account when designing specific prevention strategies [ 31 ]. The social and personal factors involved in chemsex are as diverse as the barriers to reduce HCV-related sexual risk behaviour in this population, including social pressure, and HCV-HIV and drug consumption stigma [ 32 ]. This points to the importance of thorough characterization of risk factors in patients attending our clinics to offer effective prevention interventions.…”

Neural Correlates of Self-Construal Priming in the Ultimatum Game

“…To prime self-construal, we used the Mission prime employed by Flinkenflogel et al (2017), which emphasizes either independent or interdependent norms within the context of a shared identity (i.e., belonging to the student body). Prior research suggests that the effects of social norms become more pronounced when group identity is made salient (Glynn, 1997; Hogg and Reid, 2006; Rimal and Lapinski, 2015). Based on a previous study, we predicted that emphasizing interdependent values to females would result in lower rejection rates in response to unfair offers, as females tend to construct a more relational interdependent self (Flinkenflogel et al, 2017).…”