Risk behaviors and antibody hepatitis B and C prevalence among injecting drug users in south-western Sydney, Australia.
OBJECTIVE
Hepatitis C virus (HCV) infection is now the leading notifiable disease in Australia. The current study aimed to determine the prevalence of HCV and hepatitis B virus (HBV) infection and associated risk behaviors among injecting drug users (IDUs) screened in south-western Sydney as part of a multisite prospective cohort study.


METHODS
Using a combination of snowball sampling and word-of-mouth recruitment strategies, 377 IDUs were interviewed using a structured questionnaire and tested for exposure to HCV and HBV. Entry criteria were injecting drug use in the previous 6 months and antibody HCV serostatus not known to be positive.


RESULTS
More than one-third (36.6%) tested HCV antibody positive and one-quarter (28%) had been exposed to HBV. Independent predictors of HCV seropositivity were HBV core antibody positive serostatus, incarceration in the past year, injecting in public, Asian ethnicity and duration of injecting. Individual risk behaviors, including sharing needles and syringes, sharing other injecting equipment and being injected by others, were not significant in either bivariate or multivariate models.


CONCLUSIONS
Results indicate an urgent need for structural interventions designed to reduce the exposure of IDUs, particularly indigenous Australian and Asian injectors, to risk environments. Structural interventions, including population-based hepatitis B immunization, expanded access to needle and syringe programs and drug treatment, prison diversion programs and medically supervised injecting facilities, should be incorporated into existing blood-borne virus prevention efforts.
Maher
Lisa
L
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia. L.Maher@unsw.edu.au
Chant
Kerry
K
Jalaludin
Bin
B
Sargent
Penny
P
D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006510:Hepatitis B Antibodies / Q000097:blood; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*
D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies