September 12, 2006
The authors of the current study sought to examine the associations between self-reported high-risk sexual behaviors and subsequent diagnosis of hepatitis C virus (HCV) infection.
The Sex, Health and Anti-Retrovirals Project (SHARP) was a cross-sectional study of sexual behavior in HIV-infected men who have sex with men (MSM) attending an outpatient clinic in London. From July 1999 to August 2000, study participants completed a computer-assisted self-interview questionnaire on recent sexual behavior, recreational drug use, and detailed information on the last two sexual encounters involving different partners. Results were combined with routine clinic data and subsequent testing for HCV up until April 21, 2005. A new HCV diagnosis was defined as anti-HCV antibody seroconversion or positive HCV RNA following a prior negative. Using Poisson regression in Stata (version 9), the authors calculated incident rate ratios (IRR). Participants contributed time at risk from interview until either their diagnosis or their last negative test result.
Seventy-three percent (308) of the 422 men who completed questionnaires had sufficient clinical and HCV testing data available for analysis. Incident HCV infection was identified in 11 men in the sample. HCV infection was associated with unprotected anal intercourse, more than 30 sex partners in the previous year, higher numbers of new anal sex partners, rimming (oro-anal sex), fisting, sex toy use, and intranasal recreation drug use. Multivariate analysis showed only fisting remained associated with HCV (adjusted IRR 6.27, p=0.005).
"In this study of HIV-positive MSM, fisting is strongly associated with HCV infection," the authors concluded. "Where individuals report high-risk sexual behaviors, clinicians should offer appropriate testing for HCV infection."