Hepatitis C sero-positivity prevalence and correlates among men who have sex with men (MSM) in Vancouver, British Columbia
D. Moore1, R. Hogg1, S. Kanters1, R. Gustafson2, T. Trussler3, R. Marchand3, P. Banks4, M. Kwag2, M. Comptom2, A. Schilder1, M. MacGuire5, S. Ogunnaike-Cooke5, M. Perrin5, T. Wong5, C. Archibald5, W. Michelow1, M. Gilbert6, The Man Count Study Team
1BC Centre for Excellence in HIV/AIDS, Vancouver, Canada, 2Vancouver Coastal Health, Vancouver, Canada, 3Community Based Research Centre, Vancouver, Canada, 4Health Initiative for Men, Vancouver, Canada, 5Public Health Agency of Canada, Ottawa, Canada, 6BC Centre for Disease Control, Vancouver, Canada
Background: The importance of sexual transmission of Hepatitis C virus (HCV) among MSM is unclear. We examined HCV antibody serology and self-reported risk behaviour among MSM from a sero-prevalence survey conducted in Vancouver, Canada.
Methods: The ManCount Survey recruited gay, bisexual and other MSM aged ≥18 years from August 2008 – February 2009 at venues which cater to MSM. Participants self-administered a questionnaire and provided dried blood spot (DBS) samples for HCV and HIV testing. We examined factors associated with HCV sero-positivity among all study participants using logistic regression analysis. We described differences in risk behaviour between HCV positive participants and HCV negative participants who reported never having used injection drugs (non-IDUs).
Results: 1169 men completed questionnaires and 1132 (96.8%) had HCV antibody results. Of these 743 (65.6%) reported previously having tested for HCV. A total of 56 (4.9%) were HCV sero-positive and 34 (60.7%) were also HIV-positive by DBS. In the multivariate model, HCV sero-positivity was associated with past or current non-steroidal IDU (AOR =23.75; 95% CI 9.36-60.28); exchanging sex for goods/drugs/money (AOR = 5.96; 95% CI 2.68-13.3); and sex with a woman in the last six months (AOR =2.27; 95% CI 1.11-6.46). 11(20%) of HCV sero-positive positive individuals were non-IDUs. These individuals were older (median age 50 years vs. 32) than HCV negative non-IDUs. They were also more likely to be HIV positive (82% vs. 13%), report ever having gonorrhea (67% vs. 21%) or syphilis (33% vs. 6%), report Aboriginal ethnicity (36 vs. 2%); and less likely to self-identify as gay (54 vs. 84%; p< 0.001 for all values).
Conclusion: HCV sero-positivity among a ample MSM in Vancouver was approximately 5% and was most strongly associated with IDU. Sexual transmission may play a role in HCV transmission particularly among HIV-positive MSM.