Another dragon in the kitchen: Psychological experiences of hepatitis C treatment among HIV-hepatitis C co-infected gay men

Background: Increasing numbers of HIV-infected gay men acquire hepatitis C virus (HCV) co-infection, which causes serious medical consequences. Treatment for HCV is associated with many severe side effects, in some cases psychological, and many patients subsequently fail to adhere, even when psychological services are utilised, to improve treatment adherence. Objective: This qualitative study aimed to explore the experiences of HIV-infected gay men undergoing treatment for HCV in order to inform psychological services to better meet specific treatment needs of this population. Methods: Thirteen HIV-infected gay men who had undergone HCV treatment were interviewed and a qualitative analysis was conducted. Participants described HCV and its treatments in the context of their relationships and lifestyles. Findings: Four domains emerged: HCV diagnosis and treatment; HCV treatment education; change in sense of self; and sexual risk-taking. Adhering to treatment was a significant challenge for all participants and emerged across all domains. Discussion: Psychological services for this population of co-infected gay men should assist this clinical population not only with adherence to hepatitis C treatment but should also be available at an earlier stage in the process to help patients make informed choices about whether or not to begin a course of treatment. Assessing factors such as coping strategies, treatment readiness and knowledge, self-awareness, and level of risk-taking, can guide clinicians in tailoring treatment and adherence planning for HIV/HCV-co-infected gay men.