Gay men need to talk about Hepatitis C

Today, with the use of PrEP, Treatment as Prevention (TasP), and the growing confidence in what it means to have an undetectable viral load, we have a new sense of sexual liberation for both HIV-positive and negative people.

This is opening the doors to new pleasures and risks. We are more sexually active with each other across the sero-divide (between HIV-negative and HIV-positive men) than ever before.

Back in 2015, when Positive Life wrote ‘In The Blood’, the idea that Hepatitis C (HCV) could be passed on through sex was still being questioned and the assumption was heavily tilted towards injecting drugs as the only risk.

A recent study in March presented in Seattle at CROI (Conference on Retroviruses and Opportunistic Infections), highlighted that we’re seeing HCV in HIV-negative guys presenting for PrEP in places like Amsterdam, San Francisco, and London (Hoornenborg Study).

As gay men in Sydney and Australia we need to be talking about this.

Today, the idea that HCV risk is confined to injecting drug use is misleading. In the light of PrEP and an easing of fears around contracting HIV, these recent studies are showing a rise in HCV not only among people living with HIV (PLHIV) but also in those who are HIV-negative.

Now, you could argue the risk of HCV transmission in Australia among gay men is rapidly waning.

HCV is a robust and more infectious virus than HIV and has similar risks for men who fuck with other men. The three main factors highlighted by researchers as risks associated with picking up sexually transmitted HCV is ‘raw sex’ (fucking without a condom), the presence of an STI, and sexual practices such as fisting, using toys, and drug use without needles.

It is worthwhile noting the researchers in the HCV Hoornenborg study presented at CROI reported the majority of men who contracted HCV were unrelated to injecting drug use. This means we need to acknowledge HCV risk doesn’t just sit within the party and play (PNP) ‘chemsex’ injecting scene.

While we have an ongoing uneasiness to talk about HCV and the possibility of sexual transmission, we owe it to ourselves and our sexual partners to talk about our options openly and honestly. Today with less shame and more freedom, a hot raw fuck is easier than ever to find. We need to be aware that HCV is out there and find ways to have a great fuck while taking care of each other.

Hep C is a highly stigmatised virus, perhaps ever more so than HIV. Assuming ‘I’m not one of those people’ or ‘I can’t be at risk’ puts you in the danger zone.

I know. Before I was diagnosed with HIV, I was that man. As a guy who hated amyl and used bars and discos, rather than fuck clubs and saunas, I assumed I wasn’t at risk of HIV and it had nothing to do with me or who I was fucking. Or so I thought. A virus doesn’t hang out in one place. That holds true for HCV as well.

Despite these new risks, it’s still possible to have sex the way you like. Getting tested regularly and talking with fuck buddies about shared risk means we take care of each other.

The bottom line is know your risk, test regularly for STIs, HIV and HCV. There are excellent treatments for all of these now including very effective and easier to tolerate treatments.

Call the Treatments Officers at Positive Life NSW on (02) 9206-2177 if you have any concerns about HIV, HCV and STIs.