title: Gender differences in hepatitis C infection and risks among persons with severe mental illness.
abstract: OBJECTIVE
  The authors assessed gender differences in hepatitis C infection and associated risk behaviors among persons with severe mental illness.
  
  
  METHODS
  S: The sample consisted of 777 patients (251 women and 526 men) from four sites.
  
  
  RESULTS
  Across sites, the rate of hepatitis C infection among men was nearly twice that among women. Clear differences were noted in hepatitis C risk behaviors. Men had higher rates of lifetime drug-related risk behaviors: needle use (23.1 percent compared with 12.5 percent), needle sharing (17.6 percent compared with 7.7 percent), and crack cocaine use (45.2 percent compared with 30.8 percent). Women had significantly higher rates of lifetime sexual risk behaviors: unprotected sex in exchange for drugs (17.8 percent compared with 11.2 percent), unprotected sex in exchange for money or gifts (30.6 percent compared with 17 percent), unprotected vaginal sex (94 percent compared with 89.7 percent), and anal sex (33.7 percent compared with 22.6 percent). Gender appeared to modify some sex risks. Unprotected sex in exchange for drugs increased the risk of hepatitis C seropositivity for both men and women. In the multivariate model, gender was not significantly associated with hepatitis C seropositivity after adjustment for other risk factors.
  
  
  CONCLUSIONS
  S: Gender differences in the lifetime rates of drug risks explain the higher rates of hepatitis C infection among men with severe mental illness.
authors.affiliation: Health Services Research and Development Service (152), Department of Veterans Affairs (VA) Medical Center, 508 Fulton Street, Durham, North Carolina 27705, USA.
authors.forename: Marian I
authors.initials: MI
authors.lastname: Butterfield
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
authors.forename: Keith G
authors.initials: KG
authors.lastname: Meador
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.forename: Susan M
authors.initials: SM
authors.lastname: Essock
authors.forename: Fred C
authors.initials: FC
authors.lastname: Osher
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Goodman
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Swanson
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.forename: Ronnie D
authors.initials: RD
authors.lastname: Horner
mesh_terms: D000208:Acute Disease; D017848:Blood-Borne Pathogens; D015897:Comorbidity; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex / Q000706:statistics & numerical data; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D014481:United States / Q000453:epidemiology