Despite High Risk Behaviors, Including Chemsex, Barriers Exist for HCV Testing in MSM Throughout India

Author: Norton BL, Dange A, Rawat S, Arnsten JH, Patel VV

Theme: Epidemiology & Public Health Research Year: 2018

Background: Knowledge of HCV serostatus is critical to optimize HCV linkage to care
and treatment outcomes, yet little is known about HCV-related behaviors or testing
patterns among high-risk Indian men who have sex with men (MSM).
Methods: Using online dating applications and social media pages, we recruited a
national sample of sexually active adult MSM for a survey about HIV and HCV testing,
and sexual risk behaviors.
Results: From 1/2017-2/2017, 4,150 MSM completed the survey, with all states
represented, including 17% from rural areas and 18% responding in Hindi. The median
age was 26 years. Most respondents identified as gay/homosexual (49%) or bisexual
(46%). Most (76%) reported anal sex, 42% reported condomless anal sex (CAS), and
41% reported greater than six sexual partners in the past 6 months. 5% reported drug
use with sex in the last 12 months, including meow meow (stimulant), heroin, cocaine,
and crystal meth. Overall, only 20% had ever been tested for HCV and only 25% of
those who reported drug use with sex in the past 12 months had been tested. 2% of all
persons tested reported a positive test. In multivariable analysis, factors associated with
never having an HCV test were: younger age, lower income, less education,
non-disclosure of sexual identity or behavior, no access to a comfortable testing site,
and perceived stigma (p< 0.05 for all variables). Conclusions: In a large diverse sample of Indian MSM, the majority had never been tested for HCV, including those practicing condomless anal sex and chemsex. Interventions that reduce stigma and increase structural support are needed to increase testing among a high-risk group of Indian MSM. Conflicts of Interest: All authors have no conflicts of interest.

Download abstract Download presentation Watch video