HCV infection, risk factors and PrEP use among HIV-negative MSM and TW at a community health centre

Sexually transmitted hepatitis C virus (HCV) infection is widely reported in urban cohorts of HIV-positive men who have sex with men (MSM), with less data on HIV-negative MSM. High HCV incidence has been reported in cohorts of HIV-negative MSM using HIV pre-exposure prophylaxis (PrEP), but no previous studies have systematically offered HCV screening to PrEP users and non-PrEP users.

We offered point-of-care serology and/or PCR HCV screening to HIV-negative MSM and transgender women (TW) attending a peer-led community sexual health centre in Barcelona, Spain. We estimated HCV prevalence ratios using log-binomial models of sexual and drug-use behaviors and conducted descriptive analyses linking infection, PrEP use, and behavior patterns. The trial was registered with ClinicalTrials.gov (NCT06847958).

HCV screening was provided to 13,089 HIV-negative MSM and TW, including 3039 (23·1 %) current PrEP users. HCV prevalence was similar in PrEP users (0·10 %, 3/3039) and non-PrEP users (0·12 %, 12/10,122). We identified one case of acute infection; no HCV cases were identified among TW. HCV infection was associated with several behaviours including slamming, group sex, sharing syringes, fisting, and using drugs related to chemsex.

We found a relatively low prevalence of active HCV, and only one case of acute infection, among HIV-negative MSM and TW attending a community centre. At a descriptive level, HCV-infected PrEP and non-PrEP users show markedly higher risk behaviors than PrEP and non-PrEP users without HCV, yet low prevalence render these findings exploratory and warrants larger analytic studies.

Gilead Sciences.