title: "The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil.
abstract: The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus) infection were investigated. Injection drug users (IDUs) (N = 606) were recruited in "drug scenes" (public places, bars) in Rio de Janeiro, Brazil, interviewed, and tested for HCV. Sharing of needles/syringes was more prevalent at the first injection (51.3%) than at the baseline interview (36.8%). Those who shared syringes/needles at first injection were more likely to be currently engaged in direct/indirect sharing practices. Among young injectors (< 30 years), those reporting sharing of needles/ syringes at the first injection were about four times more likely to have been infected by HCV. Hepatitis C virus prevalence among active IDUs (n = 272) was 11%. Prison history and longer duration of drug injection were identified as independent predictors of HCV infection. To effectively curb HCV transmission among IDUs and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs.
authors.affiliation: Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. mlaoliveira@fiocruz.br
authors.forename: Maria de Lourdes Aguiar
authors.initials: ML
authors.lastname: Oliveira
authors.forename: Mariana A
authors.initials: MA
authors.lastname: Hacker
authors.forename: Sabrina Alberti Nóbrega de
authors.initials: SA
authors.lastname: Oliveira
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Telles
authors.forename: Kycia Maria Rodrigues do
authors.initials: KM
authors.lastname: O
authors.forename: Clara Fumiko Tachibana
authors.initials: CF
authors.lastname: Yoshida
authors.forename: Francisco I
authors.initials: FI
authors.lastname: Bastos
mesh_terms: D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects* / Q000706:statistics & numerical data; D012309:Risk-Taking; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology