Oct 12, 2011
There is increasing consensus that HCV is sexually transmitted amongst gay men with HIV. Do we have any idea what behaviors are likely to transmit hepatitis C in gay seroconcordant sex? Do we know whether or not any of these constitute a "realistic" risk, or a "get hit by lightning" risk?
Secondly, as a point of curiosity, WHY is the data so bad? I've read numerous accounts online of the virus being transmitted by plain unprotected receptive anal sex with ejaculation. Why isn't there a greater effort made to examine cases of, say, two poz guys in a relationship where only one is infected with HCV, or HIV+ HCV- gay men who don't report bottoming during their period of infection? It seems that this would help us better understand what behaviors are leading to transmission.
Response from Dr. McGovern
This is an excellent question.
A recent study published by Schmidt and colleagues used a detailed questionnaire to ask HIV infected study participants, with and without hepatitis C infection, about potential risk factors for transmission.
The study showed that compared to those without HCV, persons who became HCV positive were more likely to have:
Use of nasally administered drugs (eg, cocaine) and receptive fisting without gloves were also associated risk factors.
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