Hepatitis C virus infection and needle exchange use among young injection drug users in San Francisco.
Young injection drug users (IDUs) in San Francisco may be at high risk for hepatitis C virus (HCV) infection despite access to several needle exchange venues. The authors conducted a cross-sectional study from 1997 to 1999 in San Francisco to estimate the prevalence and incidence of antibody to HCV (anti-HCV) among street-recruited IDUs under age 30, and to examine risk behaviors and sources of sterile needles. Among 308 participants, the prevalence of anti-HCV was 45%. Using statistical modeling, incidence of HCV infection was estimated to be 11 per 100 person years. Independent risk factors for anti-HCV included age (odds ratio [OR], 1.17 per year; 95% confidence interval [CI], 1.05-1.30), years injecting (OR, 1.21 per year; 95% CI, 1.10-1.34), years in San Francisco (OR, 1.06 per year; 95% CI, 1.00-1.14), first injected by a sex partner (OR, 4.06; 95% CI, 1.74-9.52), injected daily (OR, 3.85; 95% CI, 2.07-7.17), ever borrowed a needle (OR, 2.56; 95% CI, 1.18-5.53), bleached last time a needle was borrowed (OR, 0.50; 95% CI, 0.24-1.02), snorted or smoked drugs in the prior year (OR, 0.48; 95% CI, 0.26-0.89), and injected by someone else in the prior month (OR, 0.50; 95% CI, 0.25-0.99). In the prior month, 88% used at least 1 of several needle exchange venues, and 32% borrowed a needle. We conclude that anti-HCV prevalence is lower than in previous studies of older IDUs, but 11% incidence implies high risk of HCV infection in a long injecting career. Despite access to sterile needles, borrowing of needles persisted.
Hahn
J A
JA
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA. jhahn@epi.ucsf.edu
Page-Shafer
K
K
Lum
P J
PJ
Ochoa
K
K
Moss
A R
AR
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage; D015233:Models, Statistical; D015999:Multivariate Analysis; D016485:Needle Sharing; D018671:Needle-Exchange Programs; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012725:Sexual Behavior; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous; D013997:Time Factors
D018937:Hepatitis C Antibodies; D008694:Methamphetamine