P182 Hepatitis C Among Gay Men at Risk for HIV Acquisition in San Francisco

Wednesday, March 10, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Emalie P. Huriaux, MPH1, Robert Wilder Blue2, Tim Ryan, RN, MSN2, Steven B. Gibson, MSW2, Christopher S. Hall, MD, MS2 and Grant N. Colfax, MD1, 1HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA, 2Magnet, San Francisco AIDS Foundation, San Francisco, CA

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.

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