Development and testing of a counselling strategy in the framework of the ‘The Swiss HCVree Trial’*
*Impact of a "treat, cure and counsel strategy" on the hepatitis C prevalence in men who have sex with men with hepatitis C infection in the Swiss HIV Cohort Study
Evaluation of the Swiss HCVree behavioral intervention feasibility testing and consideration about scalability (Patrizia Künzler-Heule)
Swiss HIV Cohort Study (SHCS)
Ort der Datenerhebung
– University Hospital Basel
– Cantonal Hospital St. Gallen
– University Hospital Zurich
– University Hospital Bern
– Centre Hospitalier Universitaire Vaudois Lausanne
– University Hospital Geneva
– Center for Infectious Diseases, Klinik im Park Zurich
2016 bis 2020
Reducing the risk of Hepatitis C virus (HCV) transmission in HIV positive men who have sex with men (MSM+) is a major challenge for public health. Re-infections after successful treatment are frequent and no behavioural intervention to complement the highly effective HCV treatment is currently available.
Within the frame of the Swiss HIV Cohort Study (SHCS), the Swiss HCVree Trial was implemented aiming to interrupt the HCV transmission chain in MSM+ by a combination of interventions including:1) HCV screening of all MSM+ in the SHCS, 2) HCV-treatment (Grazoprevir/Elbasvir) and 3) behavioral counseling focusing on risk reduction for HCV-reinfection. This study (going HCVree) includes the development and evaluation of the behavioral counseling intervention.
The overall aim of the proposed study is to develop and evaluate a population and setting tailored behavioural intervention focusing on HCV risk reduction by improving self-regulation to risks associated with sexual risk behaviour and sexualised drug use.
To develop the intervention we used a systematic approach from “implementation science”, building on an existing HIV-specific behavioural intervention trial (CISS)1 and:
- conducted qualitative interviews with HCV co-infected MSM+ to adapt the CISS-content.
- employed a user-centred design to develop the intervention prototype (theory based, e-health assisted risk counselling) and to obtain input from several stakeholders.
- used an observational pre-post design to assess intervention feasibility and outcomes among MSM reporting condomless sex within the last year.
Erwarteter Nutzen / Relevanz
Modelling studies show that behavioral change of MSM+ is needed for a sustainable population based effect of the highly effective HCV treatment. Our study indicates the feasibility and acceptability of adding a behavioural intervention to HCV treatment of co-infected MSM+. If found effective, the intervention can be a powerful tool to prevent HCV-reinfection in the group of MSM+.