[Limited impact of the harm-reduction policy on HCV among drug-users. The ANRS-Coquelicot survey example].
BACKGROUND
In France, a harm-reduction policy was implemented in the late 1980s with the aim of reducing the prevalence of HIV and hepatitis C virus infection among drug users. The ANRS-Coquelicot survey was designed to measure the prevalence of HIV and HCV infection among drug users, and to examine determinants of at-risk behaviors.


METHODS
In 2002, information was collected from 166 drug users recruited in all types of services specializing in drug use and harm reduction in Marseille, France. Self-reported HIV and HCV serostatus was compared with the results of serological tests done on capillary blood collected on filter paper.


RESULTS
The self-reported and biologically documented prevalence rates of HIV infection were identical (22 %). In contrast, the self-reported prevalence of HCV infection was 52 %, while the biologically documented prevalence was 73 %. Overall, 30 % of HCV-infected drug users were unaware of their status. Forty-four per cent of drug users under 30 years of age were HCV-seropositive, suggesting that they had been infected early during drug use.


CONCLUSIONS
The harm-reduction policy seems to have had a marked impact on HIV transmission among drug users, but a much more limited impact on HCV transmission.
Jauffret-Roustide
M
M
Institut de Veille Sanitaire, Saint-Maurice. m.jauffret@invs.sante.fr
Emmanuelli
J
J
Desenclos
J C
JC
D000328:Adult; D003625:Data Collection; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012942:Social Sciences; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology; D011795:Surveys and Questionnaires