title: Seroprevalence of HIV, hepatitis B virus, and HCV among injection drug users in Connecticut: understanding infection and coinfection risks in a nonurban population.
abstract: OBJECTIVE
  We examined HIV, hepatitis B virus (HBV), and HCV seroprevalence in an interim analysis and the potential risk factors associated with these infections among injection drug users (IDUs) residing in nonurban communities of southwestern Connecticut.
  
  
  METHODS
  We recruited and interviewed active adult IDUs about their injection-associated risk and conducted serological tests for HIV, HBV, and HCV. Regression analyses were performed to identify risk factors for infection and coinfection.
  
  
  RESULTS
  Among 446 participants, 51.6% carried at least 1 infection, and 16.3% were coinfected. Infection risk was associated with longer duration of injection use, overdose, substance abuse treatment, depression, and involvement with the criminal justice system. Coinfection was associated with longer injection drug use, lower education, overdose, and criminal justice involvement. Multivariate models identified injection drug use duration, substance abuse treatment, and criminal justice involvement as the most significant predictors of infection; injection drug use duration and education were the most significant predictors of coinfection.
  
  
  CONCLUSIONS
  Suburban IDUs are at significant risk for acquiring single and multiple viral infections. Effective harm reduction strategies are needed to reach users early. There might be roles for interventions in the treatment and justice systems in which IDUs interact.
authors.affiliation: At the time of the study, Hana Akselrod was with the Yale School of Public Health, New Haven, CT, and Mount Sinai School of Medicine, New York, NY. Lauretta E. Grau, Russell Barbour, and Robert Heimer are with the Yale School of Public Health and the Yale Center for Interdisciplinary Research on AIDS, New Haven.
authors.forename: Hana
authors.initials: H
authors.lastname: Akselrod
authors.forename: Lauretta E
authors.initials: LE
authors.lastname: Grau
authors.forename: Russell
authors.initials: R
authors.lastname: Barbour
authors.forename: Robert
authors.initials: R
authors.lastname: Heimer
mesh_terms: D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D003237:Connecticut / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D062787:Drug Overdose / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology*; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology*; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000453:epidemiology* / Q000534:rehabilitation; D013997:Time Factors