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

ABSTRACT

To prevent hepatitis C virus (HCV) reinfection, within the Swiss HCVree Trial, a preventive risk reduction intervention was implemented alongside curative treatment. Formative qualitative research identified three response patterns to the intervention. This mixed-methods study's aim was to cross-validate group differences in (a) the content of sexual risk reduction goals set during intervention and (b) the extent of their behavioural change in condomless anal intercourse with non-steady partners (nsCAI), sexualised and intravenous drug use at start and six-month post-intervention. Qualitative thematic analysis was used to summarise goal setting domains. Quantitative descriptive analysis was used to evaluate group differences based on assumptions of the group descriptions. Results largely confirmed assumptions on inter-group response differences in goal setting and behaviour: as expected group 1 Avoid risks showed the lowest HCV risk profile with changes in nsCAI. Group 2 Minimize-risks and Group 3 Accept-risks showed unchanged nsCAI. Group 3 had the highest HCV risk profile. Differences in their goal preferences (1: condom use; 2 reduction blood exposure; 3 safer dating) highlight diversity in attitudes to behavioural change. Our results improve understanding of variability in intervention responses such as changes in attitudes and behaviour. This provides evidence for intervention tailoring and outcome measurement.

TRIAL REGISTRATION NUMBER:

• NCT02785666

KEYWORDS:

• Homosexuality
• male
• hepatitis C
• HIV infections
• sex counselling
• harm reduction

Acknowledgements

We thank all the men who took part in the study and the members of the Swiss HIV Cohort Study who supported this research project:

Anagnostopoulos A, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Calmy A, Cavassini M, Ciuffi A, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Günthard HF (President of the SHCS), Haerry D (deputy of “Positive Council”), Hasse B, Hirsch HH, Hoffmann M, Hösli I, Huber M, Kahlert CR (Chairman of the Mother & Child Substudy), Kaiser L, Keiser O, Klimkait T, Kouyos RD, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Marzolini C, Metzner KJ, Müller N, Nicca D, Paioni P, Pantaleo G, Perreau M, Rauch A (Chairman of the Scientific Board), Rudin C, Scherrer AU (Head of Data Centre), Schmit P, Speck R, Stöckle M (Chairman of the Clinical and Laboratory Committee), Tarr P, Trkola A, Vernazza P, Wandeler G, Weber R, Yerly S.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data

The individual level datasets generated and/or analysed during the current study are not publicly available because open access to all SHCS data is currently not possible. These data are too dense and comprehensive to preserve patient privacy in patients with HIV infection. Free access to the data would be incompatible both with the SHCS informed consent policy and with preserving patient privacy. Investigators with requests for selected data should send a proposal to the corresponding author. The provision of data will be considered by the study team and the Scientific Board of the SHCS.

Additional information

Funding

This study has been financed within the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (grant #177499), by SHCS project 795 and by the SHCS research foundation. The SHCS data used for this study were collected by seven SHCS centres including overall five Swiss university hospitals, two cantonal hospitals, 15 affiliated hospitals and 36 private physicians (listed in http://www.shcs.ch/180-health-care-providers). Representatives of SHCS centres were involved in the process of data collection, data analysis and publication. The medication for the Swiss HCVree Trial was funded by Merck. Merck provided no funding for this part of the study or for the development and evaluation of the behavioural intervention.