title: Higher HCV antibody prevalence among Indigenous clients of needle and syringe programs.
abstract: OBJECTIVE
  To compare prevalence of hepatitis C virus (HCV) antibody and associated risk behaviours among Indigenous and non-Indigenous participants in the Australian Needle and Syringe Program Survey.
  
  
  METHODS
  During 1 or 2 weeks each October from 1998 to 2008, clients of participating needle and syringe programs (NSPs) completed a self-administered questionnaire on demographics and risk behaviour and provided a capillary blood sample for HIV and HCV antibody testing. After de-duplication, 16,132 individuals participated during the 11 years, of whom 1,380 (8.6%) identified as Indigenous.
  
  
  RESULTS
  Higher proportions of Indigenous than non-Indigenous participants were HCV antibody positive (57% versus 51%, p<0.001). In an overall multivariable analysis, Indigenous status (OR 1.17; CI 1.03-1.32) and female gender (OR 1.25; CI 1.16-1.35) were independently associated with HCV antibody seropositivity. Indigenous participants also reported higher rates of risk behaviour, including receptive sharing of needle syringes (21% vs 16%; p<0.001), receptive sharing of ancillary injecting equipment (38% vs 33%; p<0.001), having been injected by others (18% vs 13%; p<0.001), and injecting in public (54% vs 49%; p<0.001).
  
  
  CONCLUSIONS
  These results highlight the need for targeted, culturally appropriate programs to minimise risks for bloodborne viral transmission among Indigenous people who inject drugs.
authors.affiliation: The Kirby Institute, University of New South Wales, 45 Beach Street, Coogee, NSW 2010. Jward@nchecr.unsw.edu.au
authors.forename: James
authors.initials: J
authors.lastname: Ward
authors.forename: Libby
authors.initials: L
authors.lastname: Topp
authors.forename: Jenny
authors.initials: J
authors.lastname: Iversen
authors.forename: Handan
authors.initials: H
authors.lastname: Wand
authors.forename: Snehal
authors.initials: S
authors.lastname: Akre
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects*; D018671:Needle-Exchange Programs; D009339:Needles; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000208:ethnology; D019966:Substance-Related Disorders / Q000150:complications* / Q000208:ethnology; D011795:Surveys and Questionnaires; D013594:Syringes
chemical_list: D018937:Hepatitis C Antibodies