title: "To share or not to share?" Serosorting by hepatitis C status in the sharing of drug injection equipment among NHBS-IDU2 participants.
abstract: BACKGROUND
  Persons who inject drugs (PWID) are at high risk for acquiring hepatitis C virus (HCV) infection. The Centers for Disease Control and Prevention estimates there are 17 000 new infections per year, mainly among PWID. This study examines injection equipment serosorting-considering HCV serostatus when deciding whether and with whom to share injection equipment.
  
  
  OBJECTIVE
  To examine whether injection equipment serosorting is occurring among PWID in selected cities.
  
  
  METHODS
  Using data from the National HIV Behavioral Surveillance System-Injection Drug Users (NHBS-IDU2, 2009), we developed multivariate logistic regression models to examine the extent to which participants' self-reported HCV status is associated with their injection equipment serosorting behavior and knowledge of last injecting partner's HCV status.
  
  
  RESULTS
  Participants who knew their HCV status were more likely to know the HCV status of their last injecting partner, compared to those who did not know their status (HCV+: adjusted odds ratio [aOR] 4.1, 95% confidence interval [CI], 3.4-4.9; HCV-: aOR 2.5, 95% CI, 2.0-3.0). Participants who reported being HCV+, relative to those of unknown HCV status, were 5 times more likely to share injection equipment with a partner of HCV-positive status (aOR 4.8, 95% CI, 3.9-6.0).
  
  
  CONCLUSIONS
  Our analysis suggests PWID are more likely to share injection equipment with persons of concordant HCV status.
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Bryce D
authors.initials: BD
authors.lastname: Smith
authors.forename: Amy
authors.initials: A
authors.lastname: Jewett
authors.forename: Richard D
authors.initials: RD
authors.lastname: Burt
authors.forename: Jon E
authors.initials: JE
authors.lastname: Zibbell
authors.forename: Anthony K
authors.initials: AK
authors.lastname: Yartel
authors.forename: Elizabeth
authors.initials: E
authors.lastname: DiNenno
mesh_terms: D000328:Adult; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016485:Needle Sharing / Q000706:statistics & numerical data*; D016017:Odds Ratio; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000821:virology; D014481:United States / Q000453:epidemiology
keywords: hepatitis C virus; injection drug use; serosorting; sharing injection equipment