Usability, acceptability, and self-reported impact of an innovative hepatitis C risk reduction intervention for men have sex with men: A mixed methods study.

Tamara Prinsenberg,Paul Zantkuijl,Joël Illidge,Maria Prins,Marc van der Valk,Udi Davidovich,Maarten Bedert,Benjamin R. Bavinton

doi:10.1371/journal.pone.0263654

Abstract

Hepatitis C virus (HCV) elimination among men who have sex with men (MSM) is unlikely to be feasible without effective behavioural interventions. We developed a multilevel intervention to reduce HCV transmission among MSM in Amsterdam. The intervention includes a toolbox to facilitate risk reduction among MSM and support health care professionals in risk reduction counselling. To assess the use of the toolbox and its impact on behavior, we conducted a mixed-methods study. We collected data through online questionnaires (n = 49), and in-depth interviews with MSM at risk of HCV (n = 15) and health care professionals (n = 7). We found that the toolbox has been well received by MSM, increased awareness of HCV risks and has facilitated preventive behaviours and risk-reduction communication with peers. Professionals reported the toolbox to be a useful aid for discussions about HCV risk and risk reduction strategies with their clients.

Highlights

Since 2000, hepatitis C virus (HCV) outbreaks among HIV-positive men who have sex with men (MSM) have been reported globally [1]
Our study adds to the understanding of how MSM at risk of HCV and health care professionals respond to an innovative HCV risk reduction intervention such as the NoMoreC toolbox
The HCV prevention toolbox was well-received by both MSM at risk and professionals

Summary

Introduction

Since 2000, hepatitis C virus (HCV) outbreaks among HIV-positive men who have sex with men (MSM) have been reported globally [1]. In the Netherlands, a decline in primary HCV infection and HCV reinfection has been observed in this population after the introduction of unrestricted access to direct-acting antivirals (DAAs) in 2015 [2]. Between 2008 and 2015 the HCV incidence fluctuated between 8.7 and 13.0 per 1000 person-years and significantly declined to 6.1 per 1000 person years in 2016. Between 2017 and 2019, HCV incidence fluctuated between 4.1 and 4.9 per 1000 person-years. HCV reinfection incidence declined from 41.4 per 1000 person-years in 2016 to 11.4 per 1000 person-years in 2019, but it remained high, illustrating the ongoing HCV transmission in HIV-positive MSM in the Netherlands [2].

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Discussion

Conclusion