Qualitative research with HIV-positive gay and bisexual men in Australia who had been cured of hepatitis C infection revealed that having hepatitis C was more stigmatising than HIV infection. While being a member of certain social and sexual networks increased the chances of reinfection with hepatitis C, leaving these networks and abstinence from drug use could lead to social isolation.
Engagement with treatment services for hepatitis C often led to a better understanding of hepatitis C infection risks and an improvement in strategies to avoid reinfection. Participants also reported that engagement in hepatitis C care encouraged a reduction in sexualised drug use (often called 'chemsex' or 'party ‘n’ play'). This was reported in the Journal of the International AIDS Society by Sophia Schroeder and colleagues at the Burnet Institute in Melbourne.
Hepatitis C co-infection in gay men living with HIV has been on the rise in Europe, Australia, Asia and North America over the past decade. Specifically, gay men who inject methamphetamine and engage in condomless group sex are at greater risk for co-infection with hepatitis C. Stigma around hepatitis C (linked to stereotypes regarding drug use and the type of individual who may have hepatitis C) limits conversations pertaining to infection status, knowledge about hepatitis C diagnosis and management.
Hepatitis C can be cured with direct-acting antivirals and this treatment has been publicly subsidised for all with hepatitis C in Australia since 2016. However, reinfection after successful hepatitis C treatment is common due to repeated exposure to risk factors involved with hepatitis C. While the scale-up of treatment could lead to a possible elimination of hepatitis C, repeated reinfections seen in a sub-group of men indicate the need for more research into the social and behavioural factors linked to reinfection, as well as men’s perceptions and attitudes towards reinfection with hepatitis C.