title: Hepatitis C virus infection and its relationship to certain sexual practices in men-who-have-sex-with-men in Spain: results from the European MSM internet survey (EMIS).
abstract: OBJECTIVE
  To compare sexual practices and risk behaviours between MSM who were first diagnosed with hepatitis C (HCV) in the previous 12 months and those who were never diagnosed; and, to identify factors associated with a diagnosis of HCV.
  
  
  METHODS
  The European-MSM-Internet-Survey (EMIS) was implemented for 3 months during 2010, mainly on websites for MSM. Data on socio-demographic characteristics, sexual behaviour, drug use, STI history, and other sexual health variables were collected. The Chi-square test and logistic regression analysis were used to analyse the data.
  
  
  RESULTS
  Data from 13,111 respondents were analysed. The proportion of MSM who had ever been diagnosed with HCV infection was 1.9% (n=250), and of those currently infected with the virus was 0.6% (n=78). The percentage of those first diagnosed in the last 12 months was 0.4% (n=46), of whom 70% were HIV-negative and 22% had HIV coinfection. Having a first diagnosis of HCV in the last 12 months was more common among HIV-positive than among HIV-negative MSM (0.9% vs 0.4%) and among MSM born abroad than among Spanish-born (0.7% vs 0.3%). MSM diagnosed with HCV in the last 12 months were more likely to have had: more than 10 sexual partners, sex abroad, receptive anal intercourse, insertive/receptive fisting, and unprotected anal intercourse with non-steady partners of unknown or discordant HIV-status. Likewise, they reported more frequent visits to sex-focused venues, higher drug use, as well as a higher proportion of STI diagnosis. In the multivariate model, visiting a public sex-focused venue, practicing receptive fisting, using erection enhancing medication and having a diagnosis of syphilis were independently associated with a first diagnosis of HCV in the last 12 months.
  
  
  CONCLUSIONS
  HCV infection does not seem to be restricted to HIV-infected MSM. Certain sexual behaviour (fisting, visiting sex-focused venues), drug use, and ulcerative STI seem to be associated with a diagnosis of HCV.
authors.affiliation: Centre de Estudis Epidemiològics sobre les ITS i SIDA de Catalunya (CEEISCAT); ICO/Departament de Salut, Spain; Research Department, Stop Sida, Barcelona, Spain; Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Ramón Llull University, Barcelona, Spain. Electronic address: percy@stopsida.org.
authors.forename: Percy
authors.initials: P
authors.lastname: Fernández-Dávila
authors.affiliation: Centre de Estudis Epidemiològics sobre les ITS i SIDA de Catalunya (CEEISCAT); ICO/Departament de Salut, Spain; CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain; Universitat Autònoma de Barcelona, Spain.
authors.forename: Cinta
authors.initials: C
authors.lastname: Folch
authors.affiliation: Centre de Estudis Epidemiològics sobre les ITS i SIDA de Catalunya (CEEISCAT); ICO/Departament de Salut, Spain; CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Ferrer
authors.affiliation: Asociación Alaira, Madrid, España.
authors.forename: Raúl
authors.initials: R
authors.lastname: Soriano
authors.affiliation: CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain; Centro Nacional de Epidemiología, Unidad de Epidemiología y Conductas de Riesgo, Madrid, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Diez
authors.affiliation: Centre de Estudis Epidemiològics sobre les ITS i SIDA de Catalunya (CEEISCAT); ICO/Departament de Salut, Spain; CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain; Universitat Autònoma de Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Casabona
mesh_terms: D000328:Adult; D005060:Europe; D006306:Health Surveys; D006526:Hepatitis C / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D020407:Internet; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior; D013030:Spain
keywords: Coinfección; Coinfection; Conducta sexual; HSH; Hepatitis C; Infección de transmisión sexual; MSM; Sexual behaviour; Sexually transmitted infection