title: Risk factors for hepatitis C virus infection among homeless adults.
abstract: OBJECTIVE
  To describe the prevalence of hepatitis C virus (HCV) infection in a sample of homeless and impoverished adults and examine risk factors for HCV infection in the overall sample and as a function of injection drug use.
  
  
  METHODS
  Assays were conducted on stored sera. Sociodemographic characteristics and risky sexual activity were measured by content-specific items. Substance use was measured by a structured questionnaire. HCV antibodies were tested by enzyme-linked immunosorbent assay; a confirmatory level was defined by recombinant immunoblot assay.
  
  
  METHODS
  Shelters ( N = 36) and outdoor locations in Los Angeles.
  
  
  METHODS
  Eight hundred eighty-four homeless women and/or partners or friends.
  
  
  RESULTS
  Among this sample of 884 homeless and impoverished adults, 22% were found to be HCV infected. Lifetime injection drug users (IDUs) (cocaine, crack, and methamphetamine) and recent daily users of crack were more likely than nonusers or less-frequent users of these drugs to be HCV-infected. Similar results were found for those who had been hospitalized for a mental health problem. Among non-injection drug users and persons in the total sample, those who reported lifetime alcohol abuse were more likely than those who did not to be HCV infected. Controlling for sociodemographic characteristics, multiple logistic regression analyses revealed IDUs have over 25 times greater odds of having HCV infection than non-IDUs. HCV infection was also predicted by older age, having started living on one's own before the age of 18, and recent chronic alcohol use. Males and recent crack users had about one and a half times greater odds of HCV infection when compared to females and non-chronic crack users.
  
  
  CONCLUSIONS
  Targeted outreach for homeless women and their partners, including HCV testing coupled with referrals to HCV and substance abuse treatments, may be helpful.
authors.affiliation: University of California at Los Angeles, Factor Building Room 2-250, Box 95170, 2 Los Angeles, CA 90095-1702, USA. anyamath@sonnet.ucla.edu
authors.forename: Adeline M
authors.initials: AM
authors.lastname: Nyamathi
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Dixon
authors.forename: Wendie
authors.initials: W
authors.lastname: Robbins
authors.forename: Cynthia
authors.initials: C
authors.lastname: Smith
authors.forename: Dorothy
authors.initials: D
authors.lastname: Wiley
authors.forename: Barbara
authors.initials: B
authors.lastname: Leake
authors.forename: Douglas
authors.initials: D
authors.lastname: Longshore
authors.forename: Lillian
authors.initials: L
authors.lastname: Gelberg
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006703:Ill-Housed Persons; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D011203:Poverty; D012307:Risk Factors; D012494:Sampling Studies; D017678:Sex Distribution; D015819:Substance Abuse, Intravenous; D014505:Urban Population