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Why Aren't More People With Hep C on PrEP?

Photo by Ketut Subiyanto

HIV and hepatitis C are contracted in similar ways, leading researchers to wonder what more can be done to limit HIV in the hep C community.

Research posted on Open Forum Infectious Diseases showed that individuals with hepatitis C (HCV) may also benefit from pre-exposure prophylaxis (PrEP), considering the overlapping risk factors and methods of transmission with HCV and HIV.

Poz noted that in 2012, 68 percent of new HIV cases in the U.S. were men who have sex with men, whereas 7 percent came from injection drug use and 4 percent included both risk factors.

An observational study team led by Kristi Hill, MD, of Harvard Medical School assessed PrEP awareness in participants in the Geomapping Resistance and Viral Transmission in Risky Populations study.

The study collected epidemiological data and blood samples from those with HIV or hepatitis C in Washington, D.C. and Baltimore between March 2016 and November 2020.

Most of the recruits were sex workers, people who inject drugs and gender and sexual minorities. Of the 314 people with hepatitis C alone, two-thirds were cisgender men and a third were cisgender women; 88 percent were Black and 78 percent identified as heterosexual.

Over 100 (109) of the 314 participants surveyed had an indication for PrEP (an indication means a person for who a drug, like PrEP, is typically prescribed) and 48 people within that group reported HIV risk due to injection drug use. Only 85 of the participants had even heard of PrEP, only 32 had been offered it by a provider, and only six people were currently taking the preventative HIV medication.

“Though indications for PrEP were prevalent among individuals with HCV in this cohort, most patients were unaware of PrEP, had never been offered PrEP and were not using PrEP,” the report said.

Those who considered themselves at higher risk for HIV — which was twice as often among women as men — were more likely to be interested in PrEP. However, “More qualitative data are needed to explore the reasons for lack of interest in PrEP uptake among people who perceive themselves to be high risk and how interest may change with options for different PrEP modalities such as injectable PrEP.”

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