Response to a sexual risk reduction intervention provided in combination with hepatitis C treatment by HIV/HCV co-infected men who have sex with men: a reflexive thematic analysis

BMC Infectious Diseases

Andreas Lehner¹  Manuela Rasi²  Jan Fehr³  Manuel Battegay⁴  Roger Kouyos⁵  Dominique Laurent Braun⁶  Patrick Schmid⁷  Axel Jeremias Schmidt⁸  Christiana Nöstlinger⁹  Jasmina Bogdanovic^1,10  Agnes Kocher^1,10  Patrizia Künzler-Heule^1,11  Dunja Nicca^1,12  Sandra Engberg^1,13  Katharina Fierz^1,14 

[1] AIDS-Hilfe Schweiz, Zurich, Switzerland;Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland;Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland;Medical Faculty, University of Basel, Basel, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland;Institute of Medical Virology, University of Zurich, Zurich, Switzerland;Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Sigma Research, London School of Hygiene and Tropical Medicine, London, UK;Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium;Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland;Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland;Department of Gastroenterology/Hepatology and Department of Nursing, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland;Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland;Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland;School of Nursing, University of Pittsburgh, Pittsburgh, USA;Zurich University of Applied Sciences (ZUAS), Winterthur, Switzerland;

关键词: Hepatitis C;    HIV;    MSM;    Sense-making;    Health behavior;    Qualitative;   

DOI  :  10.1186/s12879-021-06003-z

来源: Springer

【 摘 要 】

BackgroundHepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the program regarding sexual risk taking. Based on the participants’ input, we hoped to judge the intervention’s potential for scale-up.MethodsSeventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention. We evaluated the responses via reflexive thematic analysis and applied the concept of sense-making.ResultsGiving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1. Avoid risks: get rid of hepatitis C for life. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes. 2. Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. 3. Accept risks; live with the risk of hepatitis C. These men perceived behavioral changes as much more difficult than “easy” medical treatment. They expected to either undergo repeated rounds of treatment or stay HCV re-infected.ConclusionThese results illustrate the diversity of men’s responses and their decisions regarding sexual risk behavior after participating in a combination of antiviral treatment and a sexual risk reduction intervention. Two major aspects were identified: 1) Teachable moments, particularly at the time of diagnosis/treatment, could offer an opportunity to develop openness for behavioral change; 2) adapting sexual risk reduction interventions to sense-making patterns could help to improve its effectiveness. Support for reducing infection risk and raising awareness of preventative measures are additional benefits.Trial registrationClinical Trial Number: NCT02785666, 30.05.2016.

【 授权许可】

CC BY