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Background: Recent reports have suggested an increasing incidence of hepatitis C virus (HCV) among sexually active gay and other men who have sex with men (G/MSM) without a history of drug injection, in particular those engaging in fisting and other sexual practices with potential exposure to a partner’s blood (e.g., flogging, play-piercing, etc.).
Objectives: By the end of the presentation participants will be able to discuss the prevalence of sexually transmitted HCV among non-injecting G/MSM accessing an HIV testing center in San Francisco.
Methods: Counseling and testing for HCV antibody was integrated into the existing rapid HIV testing protocol at Magnet. An HCV antibody test (Siemens Centaur HCV assay, Deerfield, IL) was offered to G/MSM who: had engaged in unprotected receptive or insertive anal sex with HIV+ or unknown status partners; reported fisting or activity involving exposure to a partner’s blood within 12 months; were diagnosed with certain sexually transmitted infections; or had a drug injection history. A six-month testing initiative commenced April 7, 2009.
Results: By September 18, 2009, 242 G/MSM had undergone HCV antibody testing. One individual (0.6%) had detectable HCV antibodies; risk factors were insertive anal sex without a condom with an unknown partner, and insertive and receptive fisting. The remaining 241 individuals (99.4%) were HCV-negative. Of 1,569 persons HIV-tested in this period, 17 were Ab+ and 1 was Ab-/RNA+.
Conclusions: Interim data reflect a low prevalence of HCV among G/MSM engaged in sexual practices involving potential for exposure to a partner’s blood and risk for HIV acquisition.
Implications for Programs, Policy, and/or Research: Organizations and medical settings serving sexually active HIV-negative G/MSM may find a low proportion of HCV on screening. Further research is needed to identify specific sexual behavioral risk factors associated with HCV infection to develop cost-effective, targeted screening efforts.