Injection behaviors among injection drug users in treatment: the role of hepatitis C awareness.
BACKGROUND
Injection drug use (IDU) is a primary vector for blood-borne infections. Awareness of Hepatitis C virus (HCV) infection status may affect risky injection behaviors. This study determines the prevalence of risky injection practices and examines associations between awareness of positive HCV status and risky injection behaviors.


METHODS
We surveyed individuals seeking treatment for substance use at 12 community treatment programs as part of a national HIV screening trial conducted within the National Drug Abuse Treatment Clinical Trials Network. Participants reported socio-demographic characteristics, substance use, risk behaviors, and HCV status. We used multivariable logistic regression to test associations between participant characteristics and syringe/needle sharing.


RESULTS
The 1281 participants included 244 (19.0%) individuals who reported injecting drugs in the past 6 months and 37.7% of IDUs reported being HCV positive. During the six months preceding baseline assessment, the majority of IDUs reported obtaining sterile syringes from pharmacies (51.6%) or syringe exchange programs (25.0%), but fewer than half of IDUs always used a sterile syringe (46.9%). More than one-third (38.5%) shared syringe/needles with another injector in the past 6 months. Awareness of positive HCV vs. negative/unknown status was associated with increased recent syringe/needle sharing (aOR 2.37, 95% CI 1.15, 4.88) in multivariable analysis.


CONCLUSIONS
Risky injection behaviors remain prevalent and awareness of HCV infection was associated with increased risky injection behaviors. New approaches are needed to broadly implement HCV prevention interventions for IDUs seeking addiction treatment.
Department of Medicine and Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. korthuis@ohsu.edu
P Todd
PT
Korthuis
Daniel J
DJ
Feaster
Zoilyn L
ZL
Gomez
Moupali
M
Das
Susan
S
Tross
Katharina
K
Wiest
Antoine
A
Douaihy
Raul N
RN
Mandler
James L
JL
Sorensen
Grant
G
Colfax
Dennis
D
McCarty
Stephanie E
SE
Cohen
Patricia E
PE
Penn
Diane
D
Lape
Lisa R
LR
Metsch
D000328:Adult; D001364:Awareness; D005260:Female; D006526:Hepatitis C / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000523:psychology / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data; D012309:Risk-Taking; D057566:Self Report; D015819:Substance Abuse, Intravenous / Q000523:psychology / Q000534:rehabilitation*