Injecting drug use and knowledge and self-report of hepatitis C among Australian gay and homosexually active men

Multiple strategies are required to address the information and support needs of gay and bisexual men with hepatitis C in Australia

BACKGROUND

Hepatitis C virus (HCV) infection is increasingly reported among gay and bisexual men. However, little is known about the personal and social dimensions of HCV-related experience among these men in Australia.

METHODS

An online survey of 474 Australian gay and bisexual men was conducted from August to December 2013. A subsample of 48 HCV mono-infected and HIV/HCV co-infected men was analysed to explore HCV knowledge, sources of information, unmet information needs and use of HCV-related services.

RESULTS

More than half of respondents in the subsample were unaware that HIV infection increases the risk of sexually acquired HCV and most wanted information about how to prevent the sexual transmission of HCV. A majority of respondents requested gay-specific HCV services, and approximately similar proportions of men indicated that they would like these services delivered by a hepatitis organization, a lesbian, gay, bisexual, transgender and intersex (LGBTI) organization and a HIV organization. Men in receipt of HIV antiretroviral treatments were most likely to request that gay-specific HCV information and support services be delivered by a LGBTI or HIV organization (OR = 8.63).

CONCLUSION

These findings suggest that a variety of organizations are required to address the information and support needs of Australian gay and bisexual men with HCV.

Injecting drug use among gay and bisexual men in Sydney: prevalence and associations with sexual risk practices and HIV and hepatitis C infection

Injecting drug use is commonly reported among gay and bisexual men in Australia. We examined the prevalence and covariates of injecting drug use among men participating in the Sydney Gay Community Periodic Survey between 2004-06 and 2011. In 2004-06, data was collected about which drugs were injected, while in 2011, data was collected about hepatitis C (HCV) and esoteric sexual practices. In 2004-06, 5.6 % of men reported injecting drugs in the previous 6 months; 3.4 % reported methamphetamine injection and 0.4 % heroin injection. In 2011, men who injected drugs were less likely to be employed full-time, and more likely to be HCV-positive, HIV-positive, to have used party drugs for sex, and to have engaged in esoteric sexual practices. The strong associations between injecting drug use, sexual risk practices and blood-borne virus infection suggests the need for combined sexual health and harm reduction services for gay and bisexual men who inject drugs.

Estimating population distribution and HIV prevalence among homosexual and bisexual men

Objectives: To estimate the extent of the homosexual and bisexual male population in inner Sydney and HIV prevalence within this population. Methods: Data from the 2000/2001 Sydney Gay Community Periodic Survey (SGCPS) and the Australian Study of Health and Relationships were used. Results: A re-analysis of responses from men in some inner east and inner west postcode areas of Sydney indicated that: the proportion of men who identified as homosexual or bisexual ranged from 4.4% to 48.1%; from 9.8% to 51.5% of men reported same-sex experiences during their lifetime; and 12.9% to 52.8% of men had ever experienced feelings of same-sex attraction. HIV prevalence among respondents to the SGCPS in these same areas varied from 9.1% to 21.3%. Conclusion: These findings indicate elevated proportions of men with same-sex identity, experience or attraction living in these inner Sydney locations compared with other geographic areas and illustrate how gay communities cluster.

Evaluation of health care needs and patient satisfaction among hepatitis C patients treated at a hospital-based, viral hepatitis clinic

OBJECTIVE

To define self-reported hepatitis C knowledge, health care needs, and patient satisfaction in a representative cohort of hepatitis C virus (HCV)-infected adults treated at a university hospital-based viral hepatitis clinic in Canada.

METHODS

A questionnaire package evaluating HCV knowledge, health care needs, and patient satisfaction was administered to 111 consecutive consenting HCV patients during their first and 10-month follow-up HCV clinic visits.

RESULTS

At their first HCV clinic visit, 52% of patients rated their current HCV knowledge as "fair" or "poor". Patients identified HCV education, quality medical care, medication coverage, and psychological counselling as important HCV health care needs. Health care satisfaction outcome data at 10-month follow-up indicated that patients felt significantly better informed, more satisfied, and more actively involved in their HCV health care.

CONCLUSION

A bio-psychosocial framework in which medical, psychological, educational, and social issues are addressed is desirable for optimal HCV health care.