Sexual and drug use risk behaviour trajectories among people treated for recent HCV infection: the REACT study.

Carson, Joanne M; Barbieri, Sebastiano; Cunningham, Evan; Mao, Eric; van der Valk, Marc; Rockstroh, Jürgen K; Hellard, Margaret; Kim, Arthur; Bhagani, Sanjay; Feld, Jordan J; Gane, Ed; Thurnheer, Maria C; Bruneau, Julie; Tu, Elise; Dore, Gregory J; Matthews, Gail V; Martinello, Marianne (2023). Sexual and drug use risk behaviour trajectories among people treated for recent HCV infection: the REACT study. Journal of the International AIDS Society, 26(9), e26168. BioMed Central 10.1002/jia2.26168

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INTRODUCTION

Exploration of sexual and drug use behaviours following treatment for recent hepatitis C virus (HCV) is limited. This analysis modelled behavioural trajectories following treatment for recent HCV and assessed reinfection.

METHODS

Participants treated for recent HCV in an international trial (enrolled 2017-2019) were followed at 3-monthly intervals for up to 2 years to assess longitudinal behaviours. Population-averaged changes were assessed using generalized estimating equations. Distinct behavioural trajectories were identified using group-based trajectory modelling. HCV reinfection incidence was calculated using person-years (PY) of observation.

RESULTS

During the follow-up of 212 participants (84% gay and bisexual men [GBM]; 69% HIV; 26% current injecting drug use [IDU]), behavioural trajectories for IDU and stimulant use (past month) did not change. However, population-averaged decreases in the likelihood of daily IDU (adjusted odds ratio [AOR] 0.83; 95% CI 0.72, 0.95) and opioid use (AOR 0.84; 95% CI 0.75, 0.93) were observed. Among GBM, behavioural trajectories for chemsex did not change. Population-averaged decreases in condomless anal intercourse with casual male partners (CAI-CMP) (AOR 0.95; 95% CI 0.90, 0.99) and group-sex (AOR 0.86; 95% CI 0.80, 0.93) were observed, but masked distinct trajectories. While a proportion had a decreased probability of CAI-CMP (23%) and group-sex (59%) post-treatment, a substantial proportion retained a high probability of these behaviours. High HCV reinfection incidence was observed for the sustained high probability IDU (33.0/100 PY; 95% CI 17.7, 61.3) and chemsex (23.3/100 PY; 95% CI 14.5, 37.5) trajectories.

CONCLUSIONS

Limited sexual and drug use behavioural change was observed following treatment for recent HCV, supporting access to surveillance and (re)treatment.

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5 Citations in Web of Science ®
6 Citations in Scopus

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