Abstract：
OBJECTIVE: To identify sexual/sex-associated risk factors for hepatitis C transmission among men who have sex with men (MSM) and visualise behavioural trajectories from 2019 to 2021.
METHODS: We linked a behavioural survey to a hepatitis C cohort study (NoCo), established in 2019 across six German HIV/hepatitis C virus (HCV) treatment centres, and performed a case-control analysis. Cases were MSM with recent HCV infection, and controls were matched for HIV status (model 1) or proportions of sexual partners with HIV (model 2). We conducted conditional univariable and multivariable regression analyses.
RESULTS: In all, 197 cases and 314 controls completed the baseline questionnaire and could be matched with clinical data. For regression models, we restricted cases to those with HCV diagnosed since 2018 (N = 100). Factors independently associated with case status included sex-associated rectal bleeding, shared fisting lubricant, anal douching, chemsex, intravenous and intracavernosal injections, with population-attributable fractions of 88% (model 1) and 85% (model 2). These factors remained stable over time among cases, while sexual partner numbers and group sex decreased during COVID-19 measures.
CONCLUSIONS: Sexual/sex-associated practices leading to blood exposure are key factors in HCV transmission in MSM. Public health interventions should emphasize the importance of blood safety in sexual encounters. Micro-elimination efforts were temporarily aided by reduced opportunities for sexual encounters during the COVID-19 pandemic.
METHODS: We linked a behavioural survey to a hepatitis C cohort study (NoCo), established in 2019 across six German HIV/hepatitis C virus (HCV) treatment centres, and performed a case-control analysis. Cases were MSM with recent HCV infection, and controls were matched for HIV status (model 1) or proportions of sexual partners with HIV (model 2). We conducted conditional univariable and multivariable regression analyses.
RESULTS: In all, 197 cases and 314 controls completed the baseline questionnaire and could be matched with clinical data. For regression models, we restricted cases to those with HCV diagnosed since 2018 (N = 100). Factors independently associated with case status included sex-associated rectal bleeding, shared fisting lubricant, anal douching, chemsex, intravenous and intracavernosal injections, with population-attributable fractions of 88% (model 1) and 85% (model 2). These factors remained stable over time among cases, while sexual partner numbers and group sex decreased during COVID-19 measures.
CONCLUSIONS: Sexual/sex-associated practices leading to blood exposure are key factors in HCV transmission in MSM. Public health interventions should emphasize the importance of blood safety in sexual encounters. Micro-elimination efforts were temporarily aided by reduced opportunities for sexual encounters during the COVID-19 pandemic.
摘要：
目标：确定男男性行为者（MSM）中丙型肝炎传播的性/性相关危险因素，并可视化2019年至2021年的行为轨迹。
方法：我们将行为调查与丙型肝炎队列研究（NoCo）联系起来，2019年在六个德国艾滋病毒/丙型肝炎病毒（HCV）治疗中心成立，并进行了病例对照分析。病例为最近感染HCV的MSM，和对照组的HIV感染状况(模型1)或性伴侣感染HIV的比例(模型2)相匹配.我们进行了条件单变量和多变量回归分析。
结果：总而言之，197例和314例对照完成了基线问卷，可以与临床数据相匹配。对于回归模型，我们将病例限制为自2018年以来诊断的HCV患者(N=100).与病例状态独立相关的因素包括性别相关的直肠出血，共享fisting润滑剂，肛门冲洗,Chemsex,静脉注射和海绵体内注射，人口归因分数为88%(模型1)和85%(模型2)。随着时间的推移，这些因素在病例中保持稳定，而在COVID-19测量期间，性伴侣数量和群体性行为减少。
结论：导致血液暴露的性/性相关行为是MSM中HCV传播的关键因素。公共卫生干预措施应强调性接触中血液安全的重要性。在COVID-19大流行期间，性接触机会的减少暂时帮助了微量消除努力。
方法：我们将行为调查与丙型肝炎队列研究（NoCo）联系起来，2019年在六个德国艾滋病毒/丙型肝炎病毒（HCV）治疗中心成立，并进行了病例对照分析。病例为最近感染HCV的MSM，和对照组的HIV感染状况(模型1)或性伴侣感染HIV的比例(模型2)相匹配.我们进行了条件单变量和多变量回归分析。
结果：总而言之，197例和314例对照完成了基线问卷，可以与临床数据相匹配。对于回归模型，我们将病例限制为自2018年以来诊断的HCV患者(N=100).与病例状态独立相关的因素包括性别相关的直肠出血，共享fisting润滑剂，肛门冲洗,Chemsex,静脉注射和海绵体内注射，人口归因分数为88%(模型1)和85%(模型2)。随着时间的推移，这些因素在病例中保持稳定，而在COVID-19测量期间，性伴侣数量和群体性行为减少。
结论：导致血液暴露的性/性相关行为是MSM中HCV传播的关键因素。公共卫生干预措施应强调性接触中血液安全的重要性。在COVID-19大流行期间，性接触机会的减少暂时帮助了微量消除努力。
