Trends in hepatitis C virus seroprevalence and associated risk factors among men who have sex with men in Montréal: results from three cross-sectional studies (2005, 2009, 2018)
Date
2021
Authors
Cox, Joseph
Klein, Marina
Lambert, Gilles
Grace, Daniel
Lachowsky, Nathan J.
Maheu-Giroux, Mathieu
Lanièce Delaunay, Charlotte
Journal Title
Journal ISSN
Volume Title
Publisher
Sexually Transmitted Infections
Abstract
Objectives: To eliminate the hepatitis C virus (HCV)
by 2030, Canada must adopt a microelimination
approach targeting priority populations, including gay,
bisexual and other men who have sex with men (MSM).
Accurately describing HCV prevalence and risk factors
locally is essential to design appropriate prevention and
treatment interventions. We aimed to estimate temporal
trends in HCV seroprevalence between 2005 and 2018
among Montréal MSM, and to identify socioeconomic,
behavioural and biological factors associated with HCV
exposure among this population.
Methods: We used data from three cross-sectional
surveys conducted among Montréal MSM in 2005
(n=1795), 2009 (n=1258) and 2018 (n=1086). To
ensure comparability of seroprevalence estimates
across time, we standardised the 2005 and 2009
time-location
samples to the 2018 respondent-driven
sample. Time trends overall and stratified by HIV
status, history of injection drug use (IDU) and age were
examined. Modified Poisson regression analyses with
generalised estimating equations were used to identify
factors associated with HCV seropositivity pooling all
surveys.
Results: Standardised HCV seroprevalence among all
MSM remained stable from 7% (95% CI 3% to 10%)
in 2005, to 8% (95% CI 1% to 9%) in 2009 and 8%
(95% CI 4% to 11%) in 2018. This apparent stability
hides diverging temporal trends in seroprevalence
between age groups, with a decrease among MSM <30
years old and an increase among MSM aged ≥45 years
old. Lifetime IDU was the strongest predictor of HCV
seropositivity, and no association was found between
HCV seroprevalence and sexual risk factors studied
(condomless anal sex with men of serodiscordant/
unknown HIV status, number of sexual partners, group
sex).
Conclusions: HCV seroprevalence remained stable
among Montréal MSM between 2005 and 2018.
Unlike other settings where HCV infection was strongly
associated with sexual risk factors among MSM, IDU
was the pre-eminent
risk factor for HCV seropositivity.
Understanding the intersection of IDU contexts, practices
and populations is essential to prevent HCV transmission
among MSM.
Description
The principal investigators of Argus are Michel Alary, Chris
Archibald, Joseph Cox, Louis-Robert
Frigault, Marc-André
Gadoury, Gilles Lambert,
René Lavoie, Robert Remis, Paul Sandstrom, Cécile Tremblay, François Tremblay and
Jon Vincelette. The authors would like to thank all men who agreed to participate in the
Argus surveys, as well as the owners and managers of the establishments where
the participants were recruited. The authors would also like to thank the gay community
organisations in Montréal who supported this research. The principal investigators of
Engage are Joseph Cox, Daniel Grace, Trevor Hart, Jody Jollimore, Nathan Lachowsky,
Gilles Lambert and David Moore. The authors would like to thank all the Engage participants,
the community engagement committee members and the affiliated community
agencies.
Keywords
Citation
Delaunay, C. L., Cox, J., Klein, M., Lambert, G., Grace, D., Lachowsky, N. J., & Maheu-Giroux, M. (2020). “Trends in hepatitis C virus seroprevalence and associated risk factors among men who have sex with men in Montréal: results from three cross-sectional studies (2005, 2009, 2018).” Sexually Transmitted Infections, 97, 290-296. DOI: https://doi.org/10.1136/sextrans-2020-054464