Risk behaviors after hepatitis C virus seroconversion in young injection drug users in San Francisco.
BACKGROUND
The rationale for screening populations at risk for hepatitis C virus infection (HCV) includes the possibility of altering risk behaviors that impact disease progression and transmission. This study prospectively examined young injection drug users (IDU) to determine if behaviors changed after they were made aware of HCV seroconversion.


METHODS
We estimated the effects of HCV seroconversion coupled with post-test counseling on risk behaviors (alcohol use, non-injection and injection drug use, lending and sharing injecting equipment, and having sex without a condom) and depression symptoms using conditional logistic regression, fitting odds-ratios for immediately after disclosure and 6 and 12 months later, and adjusting for secular effects.


RESULTS
112 participants met inclusion criteria, i.e. they were documented HCV seronegative at study onset and subsequently seroconverted during the follow-up period, with infection confirmed by HCV RNA testing. HCV seroconversion was independently associated with a decreased likelihood of consuming alcohol (OR=0.52; 95% CI: 0.27-1.00, p=0.05) and using non-injection drugs (OR=0.40; 95% CI: 0.20-0.81, p=0.01) immediately after disclosure, however, results were not sustained over time. There were significant (p<0.05) declines in the use of alcohol, injection and non-injection drugs, and sharing equipment associated with time that were independent from the effect of seroconversion.


CONCLUSIONS
Making young IDU aware of their HCV seroconversion may have a modest effect on alcohol and non-injection drug use that is not sustained over time.
Tsui
Judith I
JI
Department of Medicine, Boston University School of Medicine, Boston, MA, United States. Judith.tsui@bmc.org
Vittinghoff
Eric
E
Hahn
Judith A
JA
Evans
Jennifer L
JL
Davidson
Peter J
PJ
Page
Kimberly
K
D000328:Adult; D015331:Cohort Studies; D003376:Counseling; D005260:Female; D005544:Forecasting; D006526:Hepatitis C / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000276:immunology / Q000523:psychology*; D055815:Young Adult