The factors involved in the sexual transmission of hepatitis C virus amongst HIV-positive gay men may be more complex than previously thought, according to German research presented to the recent 4th International AIDS Society Conference in Sydney.
Investigators from Bonn initially found, in common with several other recent studies, that unprotected anal intercourse was associated with a risk of hepatitis C. But in subsequent statistical analysis, only snorting drugs and rectal bleeding after sex were risk factors for infection with hepatitis C. The study’s researchers fear that hepatitis C prevention that focuses only on consistent condom use could be too narrow in its cope and overlook potentially more important risk behaviours.
Doctors from across Europe have been observing mini-epidemics of hepatitis C virus in HIV-positive gay men. Several studies have implicated unprotected anal sex as a significant risk factor for the sexual transmission of hepatitis C, with other research showing an association with fisting, drug use and some sexually transmitted infections.
Although few would seriously doubt that hepatitis C is being sexually transmitted between HIV-positive gay men, there is, nevertheless, very little evidence of sexual transmission of the virus in HIV-negative gay men, or in HIV-positive heterosexual couples. Although one study found that hepatitis C was more likely to be found in the semen of those with HIV, therefore explaining transmission of the virus via unprotected sex, some investigators believe that the factors involved in the sexual transmission of hepatitis C may be much more complex.
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