Exploring group differences in the response to a sexual risk reduction intervention to prevent hepatitis C virus reinfection in HIV-infected MSM: a mixed-methods study. AIDS Care
Counseling individuals with HIV after successful treatment of hepatitis C (HCV) coinfection aims to reduce the risk of reinfection. Condomless anal sex, receptive fisting, sexualized drug use, and injection drug use are the main risk behaviors for HCV infection among men who have sex with men. In the present study, Künzler-Heule et al. conducted a mixed-methods study within the framework of the Swiss HCVree trial to evaluate different response patterns to HCV risk reduction interventions.
Fifty-one individuals from the HCVree trial received four individual counseling sessions delivered by a trained nurse. The authors identified three distinct response patterns to the intervention:
(1) Avoid risks – a group aiming to stay free of HCV for life.
(2) Minimize risks – a group aiming to remain HCV-free for as long as possible.
(3) Accept risks – a group choosing to live with the risk of HCV reinfection.
During the counseling sessions, participants set personalized risk reduction goals, which varied substantially across the three groups. Risk avoiders focused on consistent condom use, while risk minimizers primarily set goals related to reducing blood exposure and planning for safer dating. Individuals in the risk acceptor group mainly set goals around safer dating and disclosing their HCV status to sexual partners.
Quantitative data showed that these attitudes translated into distinct behavioral outcomes. While risk avoiders maintained low-risk behaviors throughout, risk acceptors continued to engage in high levels of condomless sex and sexualized drug use. These findings support the development of more effective, personalized approaches to prevent HCV reinfection in high-risk populations.