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Subst Use Misuse. 2016 Jan 28;51(2):250-60. doi: 10.3109/10826084.2015.1092991. Epub 2016 Jan 28.

High Prevalence and Incidence of HIV and HCV Among New Injecting Drug Users With a Large Proportion of Migrants--Is Prevention Failing?

Author information

1
a Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agéncia de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya , Badalona , Spain.
2
b CIBER Epidemiología y Salud Pública (CIBERESP) , Spain.
3
c Fundació Institut d'Investigació Germans Trias i Pujol (IGTP) , Badalona , Spain.
4
d Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Pública, Facultat de Medicina, Universitat Autònoma de Barcelona , Bellaterra (Cerdanyola del Vallés) , Spain.
5
e Agéncia de Salut Pública de Barcelona , Spain.
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f Departament de Psicologia i Metodologia de les Ciéncies de la Salut, Universitat Autònoma de Barcelona , Bellaterra (Cerdanyola del Vallés) , Spain.
7
g Subdirecció General de Drogodependéncies, Agéncia Salut Pública de Catalunya (ASPC), Departament de Salut de la Generalitat de Catalunya.
8
h Ámbit Prevenció , Barcelona , Spain.
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i Microbiology Service, Hospital Universitari Germans Trias i Pujol , Badalona , Spain.
10
j European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) , Lisbon , Portugal.

Abstract

OBJECTIVES:

The aim of this study was to assess differences in the prevalence of HIV and HCV infection and associated risk factors between new (injecting for ≤5 years) and long-term injectors and to estimate HIV/HCV incidence among new injectors.

METHODS:

Cross-sectional study among people who inject drugs (PWID) who attended harm reduction centers in Catalonia in 2010-11. Anonymous questionnaires and oral fluid samples were collected. Poisson regression models were applied to determine the association between HIV/HCV infection and risk factors.

RESULTS:

Of the 761 participants, 21.4% were new injectors. New injectors were younger than long-term injectors (mean age = 31.6 vs. 37.8) and were more likely to be immigrants (59.0% vs. 33.4%). HIV and HCV prevalence was 20.6% and 59.4% among new injectors, and estimated HIV and HCV incidence 8.7 and 25.1 /100 person-years, respectively. Among new injectors, HIV infection was associated with homelessness (PR = 3.10) and reporting a previous sexually transmitted infection (PR = 1.79). Reporting front/backloading (PR = 1.33) and daily injection (PR = 1.35) were risk-factors for HCV infection. For long-term injectors, HIV risk factors were: having shared syringes (PR = 1.85), having injected cocaine (PR = 1.38), reporting front/backloading (PR = 1.30) and ever having been in prison (PR = 2.03).

CONCLUSION:

A large proportion of PWID in Catalonia are new injectors, a subgroup with a high level of both sexual and parenteral exposure and a high incidence rate of HIV/ HCV infections. It is important to improve early diagnosis of these infections among this group, in particular among migrants. To identify and address risk factors for homelessness PWID should be a priority.

KEYWORDS:

HIV, injecting drug use; Hepatitis C; migrants; new injectors

PMID:
26820260
DOI:
10.3109/10826084.2015.1092991
[Indexed for MEDLINE]

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