title: Sustained drug use changes after hepatitis C screening and counseling among recently infected persons who inject drugs: a longitudinal study.
abstract: BACKGROUND
  Notification of hepatitis C virus (HCV) positive status is known to have short-term impacts on subsequent alcohol, drug use and injection behaviors among persons who inject drugs (PWID). It remains to be established whether postscreening behavioral changes extend over time for PWID and whether screening test notification has behavioral impacts among HCV-negative PWID. This study sought to longitudinally assess substance use and injection behaviors after HCV status notification among HCV seroconverters and HCV-negative PWID.
  
  
  METHODS
  Initially HCV-seronegative PWID (n = 208) were followed prospectively between 2004 and 2011 in Montreal, Canada. Semiannual screening visits included blood sampling and an interview-administered questionnaire assessing substance use and injection behaviors. Multivariable generalized estimating equation analyses were conducted to assess substance use and behavior changes over time and compare changes between HCV seroconverters and HCV-seronegative participants while adjusting for baseline characteristics.
  
  
  RESULTS
  Of the 208 participants (83% male; mean age, 34.7 years, mean follow-up time, 39 months), 69 (33.2%) seroconverted to HCV. A linear decrease in syringe sharing behavior was observed over time after HCV and status notification, whereas a 10% decrease for each additional 3 months of follow-up was observed for injection cocaine and heroin use among HCV seroconverters but not among HCV-seronegative PWID (P < .05). No significant changes were observed in alcohol use.
  
  
  CONCLUSIONS
  Our results indicate that notification of HCV-positive status is associated with reduced injection drug use among seroconverters. Among PWID deemed seronegative after screening, there is no sustained trend for change in risk behavior.
authors.affiliation: Research Center, Centre Hospitalier de l'Université de Montréal.
authors.forename: Julie
authors.initials: J
authors.lastname: Bruneau
authors.forename: Geng
authors.initials: G
authors.lastname: Zang
authors.forename: Michal
authors.initials: M
authors.lastname: Abrahamowicz
authors.forename: Didier
authors.initials: D
authors.lastname: Jutras-Aswad
authors.forename: Mark
authors.initials: M
authors.lastname: Daniel
authors.forename: Elise
authors.initials: E
authors.lastname: Roy
mesh_terms: D000328:Adult; D003376:Counseling; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000523:psychology* / Q000628:therapy / Q000821:virology*
keywords: behavior change; hepatitis C; injection drug use; screening