title: The association between use of non-injection drug implements and hepatitis C virus antibody status in homeless and marginally housed persons in San Francisco.
abstract: BACKGROUND
  Up to 17,000 persons in the USA became infected with hepatitis C virus (HCV) in 2007, and many cases have unknown transmission routes. To date research on transmission of HCV via shared implements used to snort or smoke non-injection drugs has been inconclusive.
  
  
  METHODS
  We tested stored sera for HCV antibodies (anti-HCV) in a large population-based study of homeless and marginally housed persons in San Francisco. We examined the association between sharing implements used for snorting and smoking drugs and anti-HCV while controlling for sociodemographic variables in those who denied ever injecting drugs (n = 430). We also examined the association of anti-HCV status with history of incarceration, tattoo and piercing history, sexual history and alcohol consumption.
  
  
  RESULTS
  Seventeen percent of our sample was anti-HCV positive. We found no statistically significant associations with sharing implements used to smoke or snort drugs with anti-HCV status in our various multivariate models. There was a statistically significant negative association between ever snorting cocaine and anti-HCV status (adjusted odds ratio: 0.39; 95% confidence interval: 0.21-0.73). There were no other statistically significant associations with any other measured covariates in multivariate analyses.
  
  
  CONCLUSIONS
  Our findings suggest that sharing implements to snort or smoke drugs is not a significant risk factor for anti-HCV-positive status.
authors.affiliation: Department of Psychiatry, University of California-San Francisco, 401 Parnassus Ave., Box 0984, San Francisco, CA 94143-0984, USA. keith.hermanstyne@ucsf.edu
authors.forename: Keith A
authors.initials: KA
authors.lastname: Hermanstyne
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.forename: Karen
authors.initials: K
authors.lastname: Hennessey
authors.forename: Cindy
authors.initials: C
authors.lastname: Weinbaum
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000302:isolation & purification*; D006703:Ill-Housed Persons; D018451:Homosexuality, Male; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011634:Public Health; D012111:Residence Characteristics; D018570:Risk Assessment; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies; D013287:Illicit Drugs