HCV and Men

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HCV and Men

Hepatitis C and Men

Men and women have differentexperiences in many aspects of theirhealth, from life expectancy andthe types of illnesses they will develop, tothe number of visits they make to their GP.Men’s health issues have generally receivedless attention; only recently have events like“Movember†started to recognise the specialhealth needs of men, and the best ways ofcommunicating with them.

Generalisations about men’s health include suchthings as: men take less care of their health; mentake more risks in life; and men are less willing tovisit health professionals.

Like all generalisations,they are not entirely true, and don’t considermany other factors affecting health, but docontain some important truths about men’shealth. There are more men than women withhep C, and their health outcomes tend to be lessfavourable – there are many reasons for this,which include transmission, progression andtreatment of hep C.

Hep C affects men and women differentlyMen use injecting drugs more than women, andit is generally accepted that men are involvedin more risky behaviours; these are some of theknown reasons why men more so than womendevelop chronic hep C. What is less wellunderstood is the way in which men are moresusceptible than women to hep C infection. Somepeople are able to combat initial hep C infectionand avoid progressing to chronic hep C; womenare more likely to achieve this than men. Liverfibrosis occurs faster and more frequently in men,and they also experience more long-term liverdamage. Men who have cirrhosis are five timesmore likely to develop liver cancer than womenwho have cirrhosis.

Men typically consume more alcohol thanwomen; this goes some way to explainingwhy men have more liver problems, but it isnot the whole story. /

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, Professorof Gastroenterology and Hepatic Medicine atthe University of Sydney, says that hormonaldifferences between men and women may bepart of the reason for liver fibrosis occurring faster

in men, and for the greater incidence of livercancer in men.

What are the barriers to men seekingtreatment?/

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Evidence has shown that men are less likelythan women to seek medical treatment in mostcircumstances. There are no simple explanationsfor this; but, as reported in the AustralianGovernment Department of Health and Ageinginformation paper Development of a NationalMen’s Health Policy 2008, men attend GPs lessfrequently, after being unwell for longer periods,and they have shorter, less in-depth consultations.These barriers to men being tested for hep C alsoaffect their access to treatment.

Not being able to work while on treatment is areal fear for a lot of people. In cases where a manis the major income earner in a household, this isa very large consideration. Given that there is nocertainty of clearing hep C, men may think twicewhen making decisions about treatment. (from Sydney) successfully completedtreatment for hep C. He was initially reluctantto seek treatment. His general reasons includedfear of the various side effects of treatment, andpossibly having to re-visit long-closed chapters ofhis life. also highlighted some factors thatmay specifically influence men’s decisions abouttreatment.

“The potential loss of hair is something men justdon’t like to face. Many men will also fear a lossof libido on treatment,†he says. “Doing treatmentmeans explaining how you got hep C to thoseclose to you, and especially your mates.â€Professor adds that men sometimes havea more chaotic lifestyle, and more psychiatricproblems such as schizophrenia and depression;in some cases this may be a result of long-termdrug use. These issues make it harder to accesstreatment, as well as making hep C treatment lessof a priority.

Improving outcomes for men with hep CUnderstanding that early detection can improvelong-term prognosis may encourage men to betested; this is especially relevant where men thinkthey may have been exposed to hep C but have nosymptoms. Barriers to testing can also be brokendown if men understand that treatment is readilyavailable, and will be given without judgement. Ifthey know exactly where to go for treatment andhow to approach it, they are probably more likelyto pursue a treatment program – and the fewersteps involved, the

better.

Women respond to combination treatment forhep C better than men do, and have a higherclearance rate; this can make adherence moredifficult for men.

Men who are suffering badlyfrom side effects may be more likely to stoptreatment when they consider they may have asmaller chance of clearing their hep C.Health professionals who understand men’s issuesand provide appropriate support are vital toimproving outcomes for men with hep C. ’sGP strongly encouraged him to start treatment,and to have a plan. By having 48 weeklyappointments for his interferon injections he gotgreat support throughout treatment. These regularmeetings helped greatly during the difficulttimes; the supervised injections helped him withcompliance.

Some men may be more likely to considertreatment if they can see examples of otherswho have successfully completed treatment.Professor points out that most men donot lose their jobs and are able to continueworking throughout treatment. He believesthat men would be more open to treatment ifthey could clearly see the benefits of clearinghep C. Some men may feel that hep C issomething they just have to live with, or that thenegatives of treatment outweigh the positivesof clearance; exploring these issues further mayhelp to highlight the importance of treatment.Putting the side effects of treatment intocontext with some of the long-term symptomsof chronic hep C may help; for example, menwho are worried about experiencing sexualdysfunction while on treatment may not beaware that impotence is a common symptom inmen with advanced cirrhosis.

was initially suspicious of the way themedical profession seemed to be pushingtreatment so hard; he says he would have feltmore confident about starting treatment if hehad been able to speak with someone who hadbeen through it, and discuss the reasons for theirdecision. This is where services such as HepConnect can help; medical professionals canrecommend treatment, but talking to someonewho has had the same experience can reallyinfluence decisions.

There is a gap between providing treatmentresources and making these resources easilyaccessible; targeting hep C treatment informationto men would help close this gap. Men usehealth services less than women do, but thiscannot be solely attributed to men’s attitudestowards their health. Development of a NationalMen’s Health Policy 2008 shows that men dorespond to health messages aimed at them, andservices that target men and present themselvesas accessible are well utilised.

• Rigg is a freelance health writer whowrites for The Hep Review: adrian.rigg@...

http://www.hepc.org.au/documents/articles/HepCandMen-300KB.pdf

http://Hepatitis Cnewdrugs.blogspot.com/2010/03/hcv-and-men.html