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Observational Study
. 2021 Aug 16;18(1):52.
doi: 10.1186/s12981-021-00378-4.

Factors associated with testing for HIV and hepatitis C among behaviorally vulnerable men in Germany: a cross-sectional analysis upon enrollment into an observational cohort

Trevor A Crowell  1   2 , Haoyu Qian  3   4 , Carsten Tiemann  5 , Clara Lehmann  6 , Christoph Boesecke  7 , Albrecht Stoehr  8 , Jukka Hartikainen  9 , Stefan Esser  10   11 , Markus Bickel  12 , Christoph D Spinner  13 , Stephan Schneeweiß  14 , Christiane Cordes  15 , Norbert Brockmeyer  16   17 , Heiko Jessen  18 , Merlin L Robb  4 , Nelson L Michael  19 , Klaus Jansen  20 , Hendrik Streeck  21 ; BRAHMS Study Team
Affiliations
Observational Study

Factors associated with testing for HIV and hepatitis C among behaviorally vulnerable men in Germany: a cross-sectional analysis upon enrollment into an observational cohort

Trevor A Crowell et al. AIDS Res Ther. .

Abstract

Background: HIV and hepatitis C virus (HCV) have shared routes of transmission among men who have sex with men (MSM). Routine testing facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We evaluated factors associated with HIV and HCV testing in a behaviorally vulnerable cohort of predominantly MSM.

Methods: From June 2018 through June 2019, the BRAHMS study enrolled adults at ten German outpatient clinics that serve gender and sexual minority populations. Participants completed behavioral questionnaires that captured prior experience with HIV and HCV testing. Multivariable robust Poisson regression was used to evaluate factors potentially associated with testing in the previous 6 months.

Results: Among 1017 participants with median age 33 (interquartile range 28-39) years, 1001 (98.4%) reported any lifetime history of HIV testing and 787 (77.4%) reported any HCV testing, including 16 (1.6%) known to be living with HCV. Testing within the last 6 months was reported by 921 (90.6%) and 513 (50.4%) for HIV and HCV, respectively. Recent HIV testing was more common among participants with higher education level and recent HCV testing. Recent HCV testing was more common among participants with non-cisgender identity, lifetime history of illicit drug use, hepatitis B immunity or infection, and recent HIV testing.

Conclusion: Prior testing for HIV was common in this cohort, but interventions are needed to improve HCV risk stratification and access to testing. HIV testing infrastructure can be successfully leveraged to support HCV testing, but differentiated preventive care delivery is needed for some vulnerable populations.

Keywords: Europe; Hepatitis C virus; Human immunodeficiency virus; Screening practices; Sexual and gender minorities; Voluntary counseling and testing.

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Conflict of interest statement

CDS reports grants and/or personal fees from AbbVie, Aperion, Eli Lilly, Formycon, Gilead Sciences, MSD, Janssen-Cilag, and GSK/ViiV Healthcare outside the submitted work. The other authors report no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Interval since last reported HIV and HCV tests. At cohort enrollment, participants were asked if they had ever been tested for HIV and hepatitis C. If the answer was affirmative, they were asked when the last test was performed. Participants who were known to be living with hepatitis C were categorized separately because repeat testing is not indicated in this population
See this image and copyright information in PMC

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