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Injection Behaviors Among Injection Drug Users in Treatment: The Role of Hepatitis C Awareness.

Addictive Behaviors 2012;37(4):552-555. [doi: 10.1016/j.addbeh.2011.12.001]

P. Todd Korthuis, MD, MPH (Oregon Health & Science University, WS Node), Daniel J. Feaster, PhD (Miller School of Medicine, University of Miami, FNA Node), Zoilyn L. Gomez (Miller School of Medicine, University of Miami, FNA Node), Moupali Das, MD, MPH (San Francisco Department of Public Health, WS Node), Susan Tross, PhD (New York State Psychiatric Institute, GNY Node), Katharina Wiest, PhD (CODA, Inc., WS Node), Antoine B. Douaihy, MD (Western Psychiatric Institute and Clinica, ATS Node), Raul N. Mandler, MD (Center for the Clinical Trials Network, NIDA), James L. Sorensen, PhD (University of California, San Francisco, WS Node), Grant N. Colfax, MD (San Francisco Department of Public Health, WS Node), Dennis McCarty, PhD (Oregon Health & Science University, WS Node), Stephanie E. Cohen, MD (San Francisco Department of Public Health, WS Node), Patricia E. Penn, PhD (La Frontera Center, Inc., WS Node), Diane Lape (CODA, Inc., WS Node), Lisa R. Metsch, PhD (Miller School of Medicine, University of Miami, FNA Node).

Injection drug use (IDU) is a primary vector for blood-borne infections. Awareness of Hepatitis C virus (HCV) infection status may affect risky injection behaviors. This study determined the prevalence of risky injection practices and examined associations between awareness of positive HCV status and risky injection behaviors. In the study, part of protocol CTN-0012, a national HIV screening trial, individuals seeking treatment for substance abuse at 12 community treatment programs were surveyed. Participants reported socio-demographic characteristics, substance use, risk behaviors, and HCV status. Researchers used multivariable logistic regression to test associations between participant characteristics and syringe/needle sharing. The 1281 participants included 244 (19%) individuals who reported injecting drugs in the past 6 months and 37.7% of IDUs reported being HCV positive. During the six months preceding baseline assessment, the majority of IDUs reported obtaining sterile syringes from pharmacies (51.6%) or syringe exchange programs (25%), but fewer than half of IDUs always used a sterile syringe (46.9%). More than one-third (38.5%) shared syringe/needles with another injector in the past 6 months. Awareness of positive HCV vs. negative/unknown status was associated with increased recent syringe/needle sharing (aOR 2.37, 95% CI 1.15, 4.88) in multivariable analysis.

Conclusions: Risky injection behaviors remain prevalent and awareness of HCV infection was associated with increased risky injection behaviors. This study highlights the need for broadly implemented HCV prevention interventions for all IDUs seeking addiction treatment, and suggests such interventions might particularly decrease transmission behaviors of those aware of their HCV infection and prevent HCV infections in those HCV-negative/unaware. As HCV screening and treatment options advance, community based treatment programs have a greater opportunity to play a central role in reducing HCV transmissions and engaging HCV-infected IDUs in treatment. (Article (Peer-Reviewed), PDF, English, 2012)

Keywords: Community health services | Health services research | Hepatitis C | Injection drug use | Sexually transmitted diseases | Addictive Behaviors (journal)

Document No: 788, PMID: 22209655, PMCID: PMC3288438.

Submitted by CTN Dissemination Librarians (1/4/2012).

Cohen, Stephanie E. search
Colfax, Grant N. search mail
Das, Moupali search mail
Douaihy, Antoine B. search mail
Feaster, Daniel J. search mail
Gomez, Zoilyn L. search
Korthuis, P. Todd search mail
Lape, Diane search mail
Mandler, Raul N. search mail
McCarty, Dennis search mail
Metsch, Lisa R. search mail
Penn, Patricia E. search mail
Sorensen, James L. search mail
Tross, Susan search mail
Wiest, Katharina search mail
NIDA-CTN-0012 search www
All Nodes and CTPs were asked to participate in this study

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 5/2012 --