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Fisting was the sexual risk practice most strongly associated with the sexual transmission of hepatitis C virus amongst HIV-positive gay men in a study conducted in London and published in the August 1 st edition of Sexually Transmitted Infections. Although unprotected anal sex has been associated with the transmission of hepatitis C in previous studies, investigators from the Sex, Health and Anti-Retrovirals Project SHARP found that after controlling for numbers of sexual partners, fisting was the only factor significantly associated with contracting hepatitis C during four years of follow-up.

In recent years there has been a marked increase in the incidence of acute hepatitis C infection seen in HIV-positive gay men in the UK. Unprotected anal intercourse and fisting have been particularly linked with the sexual transmission of hepatitis C, but the exact factors affecting transmission are uncertain. Investigators therefore analysed data provided by HIV-positive gay men about their recent sexual, behaviour together with blood tests used to monitor hepatitis C seroconversion, to see if there were any sexual or other risk factors associated with the transmission of hepatitis C.

Patients were recruited to the study between and and had CD4 cell counts, HIV viral load and hepatitis C infection status monitored until April A total of eleven men seroconverted for hepatitis C during this period. Receptive anal intercourse refers to the act of being penetrated during anal intercourse. In relation to sex, a term previously used to describe sex without condoms.

However, we now know that protection from HIV can be achieved by taking PrEP or the HIV-positive partner having an undetectable viral load, without condoms being required. The term has fallen out of favour due to its ambiguity. Seroconversion may be accompanied with flu-like symptoms. Fisting, the investigators stress, was the sexual activity most strong associated with sexual transmission of hepatitis C, with individuals engaging in this practice being at least nine times more likely to become infected with hepatitis C.

However, five of the eleven men who contracted hepatitis C did not report fisting as a sexual activity. All but one of those who contracted hepatitis C reported anal fingering, and nine of eleven reported rimming. Further statistical analysis was then performed by the investigators who found that, once they controlled for new anal sex partners and more than 30 sexual partners in the past year, fisting remained the only sexual activity significantly associated with the transmission of hepatitis C.

However, the investigators do not rule out a role for unprotected sex in the transmission of hepatitis C — but only as part of a wider sexual repertoire that includes fisting. Turner JM et al. Behavioural predictors of subsequent hepatitis C diagnosis in a UK clinic sample of HIV-positive men who have sex with men. Sex Transm Infect — , Primary tabs View active tab Preview. Michael Carter.

Estimated reading time 3 minutes. This article is more than 19 years old. Click here for more recent articles on this topic. Glossary receptive Receptive anal intercourse refers to the act of being penetrated during anal intercourse. Find out more in our About HIV pages. Related topics. Men who have sex with men MSM.