ChemSex and HCV transmission among UK MSM

Published: February 2, 2015

BMJ Blogs
Leslie Goode
Original Article:

Reports of substantial rises in the incidence of HCV among MSM populations in the UK  (STI/Yaphe & Klein;  STI/Ghosn & Chaix) have attracted some attention in STI journal.  Not least because intravenous drug use is the most obvious mode of transmission for this blood-borne virus, and MSM have in the past tended not to use this route of administration.  The question then arises what specific factors in the environment of these MSM populations are increasing their risk?  The question is all the more urgent as – whatever those factors may be – MSM populations seem as yet largely incapable of reducing them – to judge by the large proportion of successfully treated MSM who become re-infected within two years (40% according to a N. London hospital). A number of recent contributions to STI journal consider the role of MSM sex in HCV transmission (STI/Stall & McFarland; STI/Valencia & Salas), and what it is in the practices or lifestyle of MSM that puts them at particular risk. Associations have been identified with number of partners, casual anal sex, sex parties (STI/Marcellin & Spire): specific practices such as fisting, rimming, recreational use of intra-nasal drugs (STIs/Turner & Stephenson): interactions between these practices and certain self-described MSM lifestyle groups such as “leather”, or “lycra & rubber” (STI/Matser & van der Loeff).

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