Response to a sexual risk reduction intervention provided in combination with hepatitis C treatment by HIV/HCV co-infected men who have sex with men: a reflexive thematic analysis.
HIV
Health behavior
Hepatitis C
MSM
Qualitative
Sense-making
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
06 Apr 2021
06 Apr 2021
Historique:
received:
12
11
2020
accepted:
16
03
2021
entrez:
7
4
2021
pubmed:
8
4
2021
medline:
20
4
2021
Statut:
epublish
Résumé
Hepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the program regarding sexual risk taking. Based on the participants' input, we hoped to judge the intervention's potential for scale-up. Seventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention. We evaluated the responses via reflexive thematic analysis and applied the concept of sense-making. Giving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1. Avoid risks: get rid of hepatitis C for life. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes. 2. Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. 3. Accept risks; live with the risk of hepatitis C. These men perceived behavioral changes as much more difficult than "easy" medical treatment. They expected to either undergo repeated rounds of treatment or stay HCV re-infected. These results illustrate the diversity of men's responses and their decisions regarding sexual risk behavior after participating in a combination of antiviral treatment and a sexual risk reduction intervention. Two major aspects were identified: 1) Teachable moments, particularly at the time of diagnosis/treatment, could offer an opportunity to develop openness for behavioral change; 2) adapting sexual risk reduction interventions to sense-making patterns could help to improve its effectiveness. Support for reducing infection risk and raising awareness of preventative measures are additional benefits. Clinical Trial Number: NCT02785666 , 30.05.2016.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the program regarding sexual risk taking. Based on the participants' input, we hoped to judge the intervention's potential for scale-up.
METHODS
METHODS
Seventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention. We evaluated the responses via reflexive thematic analysis and applied the concept of sense-making.
RESULTS
RESULTS
Giving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1. Avoid risks: get rid of hepatitis C for life. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes. 2. Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. 3. Accept risks; live with the risk of hepatitis C. These men perceived behavioral changes as much more difficult than "easy" medical treatment. They expected to either undergo repeated rounds of treatment or stay HCV re-infected.
CONCLUSION
CONCLUSIONS
These results illustrate the diversity of men's responses and their decisions regarding sexual risk behavior after participating in a combination of antiviral treatment and a sexual risk reduction intervention. Two major aspects were identified: 1) Teachable moments, particularly at the time of diagnosis/treatment, could offer an opportunity to develop openness for behavioral change; 2) adapting sexual risk reduction interventions to sense-making patterns could help to improve its effectiveness. Support for reducing infection risk and raising awareness of preventative measures are additional benefits.
TRIAL REGISTRATION
BACKGROUND
Clinical Trial Number: NCT02785666 , 30.05.2016.
Identifiants
pubmed: 33823783
doi: 10.1186/s12879-021-06003-z
pii: 10.1186/s12879-021-06003-z
pmc: PMC8022541
doi:
Substances chimiques
Antiviral Agents
0
Banques de données
ClinicalTrials.gov
['NCT02785666']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
319Références
Antivir Ther. 2016;21(1):1-8
pubmed: 26110692
J Acquir Immune Defic Syndr. 2015 Apr 15;68(5):585-93
pubmed: 25763786
AIDS. 2016 Jun 19;30(10):1683-4
pubmed: 27243777
Infection. 2017 Jun;45(3):309-321
pubmed: 28005195
Hepatology. 2016 Dec;64(6):1856-1869
pubmed: 27531615
JMIR Form Res. 2020 Sep 11;4(9):e19100
pubmed: 32915157
BMJ. 2010 Apr 27;340:c1900
pubmed: 20423957
Clin Infect Dis. 2010 Dec 1;51(11):1314-22
pubmed: 21034200
Arch Sex Behav. 2011 Aug;40(4):817-27
pubmed: 20878223
Cult Health Sex. 2008 Aug;10(6):601-10
pubmed: 18649198
AIDS. 2015 Nov;29(17):2335-45
pubmed: 26258525
Hepatol Med Policy. 2018 Aug 4;3:8
pubmed: 30288331
Open Forum Infect Dis. 2015 Jun 03;2(2):ofv077
pubmed: 26180827
Clin Med (Lond). 2016 Apr;16(2):189-92
pubmed: 27037392
Clin Infect Dis. 2019 Nov 27;69(12):2127-2135
pubmed: 30810158
Am J Health Promot. 1997 Sep-Oct;12(1):38-48
pubmed: 10170434
Clin Infect Dis. 2019 Feb 1;68(4):569-576
pubmed: 30107485
Patient Educ Couns. 2011 Nov;85(2):e8-15
pubmed: 21183305
Int J Infect Dis. 2016 Aug;49:47-58
pubmed: 27270138
J Int AIDS Soc. 2019 May;22(5):e25288
pubmed: 31111671
Clin Infect Dis. 2020 Aug 22;71(5):1248-1254
pubmed: 31562816
Patient Educ Couns. 2009 Jul;76(1):25-30
pubmed: 19110395
BMC Infect Dis. 2018 Dec 18;18(1):678
pubmed: 30563503
J Hepatol. 2016 Oct;65(1 Suppl):S33-S45
pubmed: 27641987
BMC Infect Dis. 2019 Sep 18;19(1):821
pubmed: 31533734
Health Psychol. 1995 May;14(3):255-64
pubmed: 7641667
Liver Int. 2018 Mar;38(3):424-431
pubmed: 28741901
J Biomed Inform. 2015 Aug;56:406-17
pubmed: 26071681
Int J Epidemiol. 2010 Oct;39(5):1179-89
pubmed: 19948780
Health Promot Int. 2016 Dec;31(4):782-792
pubmed: 26092853
Clin Infect Dis. 2020 Aug 06;:
pubmed: 32761122
Semin Liver Dis. 2018 Aug;38(3):181-192
pubmed: 29986353
Clin Infect Dis. 2020 May 6;70(10):2131-2140
pubmed: 31504296
PLoS One. 2012;7(9):e44819
pubmed: 23024766
Swiss Med Wkly. 2015 Feb 06;145:w14093
pubmed: 25658972
AIDS. 2019 Mar 15;33(4):685-689
pubmed: 30829744
Cult Health Sex. 2013;15(10):1133-47
pubmed: 23863102
Fam Pract. 1996 Dec;13(6):522-5
pubmed: 9023528
PLoS One. 2011 Mar 08;6(3):e17781
pubmed: 21408083
Curr Opin HIV AIDS. 2011 Nov;6(6):451-8
pubmed: 22001890