Living With HCV
Meet Phil
Phil is 35 years old and lives with his roommate in a house just outside of central Philadelphia. He works as a bartender 6 nights a week and sleeps a lot during the day.
A Closer Look
Phil struggles with insomnia and anxiety due to his flipped schedule but chooses not to treat them. He has come close to losing his job many times because he overslept and missed the beginning of his shift. His lifestyle is casual and frivolous, without regard for the realities of his financial situation. This often leads him to buy things he can’t afford. Phil avoids long-term commitments and isn’t very well connected with his family. His peer group is supportive, but some of Phil’s friends perpetuate his active use of injectable drugs.
A Look Ahead
Phil also has a history of multiple male sexual partners. He takes pre-exposure prophylaxis (PrEP) to avoid contracting HIV, but doesn’t realize that he can still get viruses like hepatitis C when engaging in unprotected sex.
Healthcare Outlook
Phil has begun to notice symptoms but thinks he probably just has a cold. He falsely believes he is protected against sexually transmitted infections (STIs) and other viruses, and has no intention of seeking care. Phil also does not regularly participate in STI testing, despite having multiple sexual partners. Part of Phil’s hesitance to testing and potential treatment is a belief that he will face stigma related to his lifestyle and injection drug use.
The Bigger Picture
To overcome these barriers, HCV screening for men who have sex with men should be performed annually or more frequently with present risk factors (high HCV prevalence, high-risk sexual behavior, and ulcerative STIs)2
To reduce the risk of sexually transmitted HCV and other STIs, men who have sex with men should be counseled to use condoms with all sex acts2
Additional Resources
AASLD/IDSA: Guidelines on Men Who Have Sex With Men
Guidelines for HCV screening, treatment, and reinfection among men who have sex with men
CDC: Men Who Have Sex With Men and Viral Hepatitis
Recommendations for men who have sex with men include vaccination and testing against viral hepatitis
CDC: Sexual Transmission of Viral Hepatitis
Vaccination and testing for viral hepatitis are important for sexually active adults
CDC: Viral Hepatitis Information for Gay and Bisexual Men
Gay and bisexual men are at increased risk for viral hepatitis and should take precautions to reduce their risk
HCV Screening Guide
An overview of the AASLD/IDSA guidelines for the screening and diagnosis of patients with hepatitis C
HCV Patient Brochure
Patient-focused material containing basic details on causes, symptoms, disease characteristics, treatment, and reinfection of HCV
References
- WHO-commissioned global systematic review finds high HCV prevalence and incidence among men who have sex with men. World Health Organization. November 17, 2020. Accessed August 21, 2024. https://www.who.int/news/item/17-11-2020-who-commissioned-global-systematic-review-finds-high-hcv-prevalence-and-incidence-among-men-who-have-sex-with-men
- HCV in key populations: men who have sex with men. AASLD-IDSA. Updated October 24, 2022. Accessed August 21, 2024. https://www.hcvguidelines.org/unique-populations/msm
