title: Can intranasal drug use reduce HCV infection among injecting drug users?
abstract: BACKGROUND
  Preventing HCV infection among people who inject drugs is a difficult public health challenge. We examined the potential role of intranasal drug use in reducing HCV acquisition.
  
  
  METHODS
  Subjects were recruited from IDUs entering the Beth Israel drug detoxification program from 2005 to 2010. A structured interview was administered and serum samples were collected for HCV testing.
  
  
  RESULTS
  726 active injecting drug users were recruited from 2005 to 2010. HCV prevalence was 71%, 90% reported recent heroin injection and 44% reported recent intranasal heroin use. In a multiple logistic regression analysis, being HCV seropositive was associated with more years injecting, Latino ethnicity, previous testing for HCV, and recent injection of speedball, and negatively associated with recent intranasal use of heroin (AOR=0.52, 95% CI 0.33-0.82) and intranasal use of speedball (AOR=0.41, 95% CI 0.31-0.80). The association between intranasal heroin use and lower HCV seroprevalance was observed among both new injectors and persons with long injecting histories (16+ years since first injection).
  
  
  CONCLUSIONS
  Encouraging intranasal use as an alternative to injection among persons currently injecting drugs may be a viable strategy for reducing HCV transmission.
authors.affiliation: Beth Israel Medical Center, New York, NY 10038, USA. dcdesjarla@aol.com
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
authors.forename: Kamyar
authors.initials: K
authors.lastname: Arasteh
authors.forename: Courtney
authors.initials: C
authors.lastname: McKnight
authors.forename: Salaam
authors.initials: S
authors.lastname: Semaan
authors.forename: David C
authors.initials: DC
authors.lastname: Perlman
mesh_terms: D000281:Administration, Intranasal / Q000379:methods; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000139:chemically induced / Q000453:epidemiology* / Q000517:prevention & control*; D003932:Heroin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D003932:Heroin