title: Prevalence, distribution, and correlates of hepatitis C virus infection among homeless adults in Los Angeles.
abstract: OBJECTIVE
  We documented the prevalence, distribution, and correlates of hepatitis C virus (HCV) infection among urban homeless adults.
  
  
  METHODS
  We sampled a community-based probability sample of 534 homeless adults from 41 shelters and meal programs in the Skid Row area of downtown Los Angeles, California. Participants were interviewed and tested for HCV, hepatitis B, and HIV. Outcomes included prevalence, distribution, and correlates of HCV infection; awareness of HCV positivity; and HCV counseling and treatment history.
  
  
  RESULTS
  Overall, 26.7% of the sample tested HCV-positive and 4.0% tested HIV-positive. In logistic regression analysis, independent predictors of HCV infection for the total sample included older age, less education, prison history, and single- and multiple-drug injection. Among lifetime drug injectors, independent predictors of HCV infection included older age, prison history, and no history of intranasal cocaine use. Among reported non-injectors, predictors of HCV infection included older age, less education, use of non-injection drugs, and three or more tattoos. Sexual behaviors and snorting or smoking drugs had no independent relationship with HCV infection. Among HCV-infected adults, nearly half (46.1%) were unaware of their infection.
  
  
  CONCLUSIONS
  Despite the high prevalence of HCV infection, nearly half of the cases were hidden and few had ever received any HCV-related treatment. While injection drug use was the strongest independent predictor, patterns of injection drug use, non-injection drug use, prison stays, and multiple tattoos were also independent predictors of HCV. Findings suggest that urgent interventions are needed to screen, counsel, and treat urban homeless adults for HCV infection.
authors: University of California at Los Angeles, David Geffen School of Medicine, Department of Family Medicine, Los Angeles, CA 90024, USA. lgelberg@mednet.ucla.edu
authors: Lillian
authors: L
authors: Gelberg
authors: Marjorie J
authors: MJ
authors: Robertson
authors: Lisa
authors: L
authors: Arangua
authors: Barbara D
authors: BD
authors: Leake
authors: Gerald
authors: G
authors: Sumner
authors: Ardis
authors: A
authors: Moe
authors: Ronald M
authors: RM
authors: Andersen
authors: Hal
authors: H
authors: Morgenstern
authors: Adeline
authors: A
authors: Nyamathi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000914:Antibodies, Viral / Q000097:blood; D004522:Educational Status; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification*; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral