背景:从事无公寓肛交和注射药物使用的性少数男性(SMM)感染病毒性丙型肝炎(HCV)的风险增加。此外,研究发现,在整个美国的HCV病例中存在种族差异。然而,很少有流行病学研究在HIV阴性的Black和LatinoSMM中检测与HCV感染相关的因素。本文描述了理论基础,设计,和前瞻性流行病学研究的方法,以量化HCV患病率和发病率,并调查HIV阴性患者中HCV感染的个体和环境水平预测因子,美国南部的黑人和拉丁裔SMM
方法:从2021年9月开始,400黑人和拉丁裔SMM,18岁及以上,将被识别,从两个研究地点招募并保留了超过12个月的随访:大华盛顿,DC和达拉斯,TX地区。书面知情同意后,参与者将接受艾滋病毒/性传播感染综合检测,包括HCV,艾滋病毒,梅毒,淋病,还有衣原体.随后,参与者将完成定量调查-包括社交和性网络清单-以及退出访谈,以审查测试结果并确认参与者的联系信息。个人,人际关系,和环境因素将在基线和随访(6个月和12个月)进行评估。主要结果是HCV患病率和发病率。次要结果是性行为,物质使用,和心理健康。
结果:迄今为止(2023年3月)共有162名参与者在DC研究中心完成了基线访视,161名参与者在德克萨斯州研究中心完成了基线访视。
结论:这项研究有几个影响,将直接影响黑人和拉丁裔SMM的健康和健康。具体来说,我们的结果将为更集中的HCV临床指南(即,在黑人/拉丁裔SMM中进行HCV筛查的有效策略),干预发展和其他预防和治疗活动,以及在未参保人员中治疗HCV的患者援助计划的发展,尤其是在南方深处,还没有扩大医疗补助。
BACKGROUND: Sexual minority men (SMM) who engage in condomless anal sex and injection drug use are at increased risk for viral Hepatitis C (HCV) infection. Additionally, studies have found racial disparities in HCV cases across the United States. However, very few epidemiological studies have examined factors associated with HCV infection in HIV-negative Black and Latino SMM. This paper describes the rationale, design, and methodology of a prospective epidemiological study to quantify the HCV prevalence and incidence and investigate the individual and environmental-level predictors of HCV infection among HIV-negative, Black and Latino SMM in the Southern U.S.
METHODS: Beginning in September 2021, 400 Black and Latino SMM, aged 18 years and above, will be identified, recruited and retained over 12-months of follow-up from two study sites: greater Washington, DC and Dallas, TX areas. After written informed consent, participants will undergo integrated HIV/STI testing, including HCV, HIV, syphilis, gonorrhea, and chlamydia. Subsequently, participants will complete a quantitative survey-including a social and sexual network inventory-and an exit interview to review test results and confirm participants\' contact information. Individual, interpersonal, and environmental factors will be assessed at baseline and follow-up visits (6 and 12 months). The primary outcomes are HCV prevalence and incidence. Secondary outcomes are sexual behavior, substance use, and psychosocial health.
RESULTS: To date (March 2023) a total of 162 participants have completed baseline visits at the DC study site and 161 participants have completed baseline visits at the Texas study site.
CONCLUSIONS: This study has several implications that will directly affect the health and wellness of Black and Latino SMM. Specifically, our results will inform more-focused HCV clinical guidelines (i.e., effective strategies for HCV screening among Black/Latino SMM), intervention development and other prevention and treatment activities and development of patient assistance programs for the treatment of HCV among uninsured persons, especially in Deep South, that have yet to expand Medicaid.