title: Prevalence and correlates of hepatitis C infection among users of North America's first medically supervised safer injection facility.
abstract: BACKGROUND
  North America's first medically supervised safer injection facility (SIF) for illicit drug users was opened in Vancouver, Canada on 22 September 2003. We examined the prevalence and correlates of hepatitis C (HCV) infection among a representative cohort of SIF users.
  
  
  METHODS
  Users of the Vancouver SIF were selected at random and asked to enrol in the Scientific Evaluation of Supervised Injecting (SEOSI) cohort. At baseline, venous blood samples were collected and an interviewer-administered questionnaire was performed. Participants who were HCV-positive were compared with HCV-negative subjects using bivariate and logistic regression analyses.
  
  
  RESULTS
  Between 1 December 2003 and 30 July 2004, 691 participants were enrolled into the SEOSI cohort, among whom 605 (87.6%) were HCV-positive at baseline. Factors independently associated with HCV infection in logistic regression analyses included: involvement with the sex trade [adjusted odds ratio (AOR) 3.7, 95% confidence interval (CI) 2.1-6.1], history of borrowing syringes (AOR 1.8, 95%CI 1.1-2.9), and history of incarceration (AOR 2.6, 95%CI 1.5-4.4). Daily heroin use was protective against HCV infection (AOR 0.6, 95%CI 0.3-0.9).
  
  
  CONCLUSIONS
  The SIF has attracted injection drug users with a high burden of HCV infection and a substantial proportion of uninfected individuals. Although cross-sectional, this study provides some insight into historical risks for HCV infection among this population, and prospective follow-up of this cohort will be useful to determine if use of the SIF is associated with reduced risk behaviour and HCV incidence.
authors.affiliation: Division of Epidemiology and Population Health, British Columbia Center for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada. ewood@cfenet.ubc.ca
authors.forename: E
authors.initials: E
authors.lastname: Wood
authors.forename: T
authors.initials: T
authors.lastname: Kerr
authors.forename: J
authors.initials: J
authors.lastname: Stoltz
authors.forename: Z
authors.initials: Z
authors.lastname: Qui
authors.forename: R
authors.initials: R
authors.lastname: Zhang
authors.forename: J S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: M W
authors.initials: MW
authors.lastname: Tyndall
mesh_terms: D002170:Canada / Q000453:epidemiology; D016021:Epidemiologic Studies; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D018671:Needle-Exchange Programs; D009339:Needles; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology*