title: Gender influences on hepatitis C incidence among street youth in a Canadian setting.
abstract: OBJECTIVE
  Few studies have examined gender-based differences in the risk of hepatitis C virus (HCV) infection among street-involved youth. We compared rates of HCV infection among male and female street-involved youth in a Canadian setting.
  
  
  METHODS
  The At-Risk Youth Study is a prospective cohort of drug-using street-involved youth. Study recruitment and follow-up occurred in Vancouver, Canada, between September 2005 and November 2011. Eligible participants were illicit drug-using youth aged 14-26 years at enrollment, recruited by street-based outreach. We evaluated rates of HCV antibody seroconversion, measured every 6 months during study follow-up, and used Cox proportional hazards regression to compare risk factors for HCV incidence between male and female street youth.
  
  
  RESULTS
  Among 512 HCV-seronegative youth contributing 836 person-years of follow-up, 56 (10.9%) seroconverted to HCV. Among female participants, the incidence density of HCV infection was 10.9 per 100 person-years, and in males, it was 5.1 per 100 person-years (p = .009). In multivariate analyses, female gender was independently associated with a higher rate of HCV seroconversion (adjusted hazard ratio, 2.01; 95% confidence interval, 1.18-3.44). Risk factors were similar in gender-stratified analyses and included heroin injection and crystal methamphetamine injection, although syringe sharing was only associated with HCV incidence among males.
  
  
  CONCLUSIONS
  Among street-involved youth in this setting, females had double the incidence of HCV seroconversion demonstrating the need for gender-focused HCV prevention interventions for this population.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Nitasha
authors.initials: N
authors.lastname: Puri
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; School of Public Policy, Simon Fraser University, Vancouver, British Columbia, Canada.
authors.forename: Kora
authors.initials: K
authors.lastname: DeBeck
authors.affiliation: School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Cindy
authors.initials: C
authors.lastname: Feng
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; School of Public Policy, Simon Fraser University, Vancouver, British Columbia, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Family Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Launette
authors.initials: L
authors.lastname: Rieb
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: urhi-ew@cfenet.ubc.ca.
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000453:epidemiology*; D018453:Homeless Youth; D006801:Humans; D013287:Illicit Drugs; D015994:Incidence; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
chemical_list: D013287:Illicit Drugs
keywords: Crystal methamphetamine; Gender; Hepatitis C; Heroin; Street youth