Insight: Gay men and hepatitis C
Hepatitis Hepatitis C is the single biggest threat to the health of HIV positive gay men on the party scene. It’s the elephant in the room. Men don’t like talking about it. There’s a stigma attached to it that is far worse than HIV, says Robert Fieldhouse, Editor, BASELINE magazine.
Breaking the stigma of hepatitis C in gay men
Fearful of being outcast from their HIV positive peers, and most importantly, sexual partners, many gay men will choose to stay silent about their hepatitis C status, yet disclose their HIV status freely. More gay men in big cities are injecting, with high rates of needle sharing fuelling transmission. Hepatitis C in gay men is nothing new. There’s been a growing number of HIV positive gay men being diagnosed with an acute hepatitis C infection for the past decade in London, Manchester and Brighton. HIV can complicate hepatitis C, potentially leading to faster time to liver cirrhosis. The good news is, for many people, hepatitis C treatment is a cure. Current therapy can be tough and some treatments can cause severe depression and leave you feeling like you permanently have the flu. But there’s an avalanche of hepatitis C medicines, currently in late stage testing, offering hope for the future. In the coming two or three years, new treatments will become available and it’s completely possible that hepatitis C could be eradicated once and for all. While reinfection rates among ‘traditional’ injecting drug users are low post-completion of treatment, among gay men with HIV who typically inject amphetamine-based legal and illegal highs such as mephedrone and crystal meth, it’s a different story. Crystal meth eats your immune system for breakfast and lowers your sexual inhibitions, leaving users vulnerable to hepatitis C. There’s a big job to be done to help gay men to fully understand how they are catching hepatitis C. Is it unprotected sex? Having sex with more than one person at once? It’s a mixture of things and that’s what makes it hard to avoid. NAT’s Policy Director, Yusef Azad recently called for London-wide integrated drug and sexual health services. He said: “We need services to work together to meet the needs of gay men, reduce problematic drug use and reduce HIV and hepatitis C transmissions linked to drug use.”
Right now, there’s only one agency, Antidote at London Friend, who offer specialist drugs and alcohol support for gay men. Their own research suggests the number of crystal meth and mephedrone users injecting in a sexualised setting jumped from 20 per cent in 2011 to 80 per cent in 2012. Antidote suggests that 70 per cent of those injecting are sharing needles.