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J Subst Abuse Treat. 2017 Jun;77:13-20. doi: 10.1016/j.jsat.2017.03.003. Epub 2017 Mar 9.

Undiagnosed HIV and Hepatitis C infection in people who inject drugs: From new evidence to better practice.

Author information

1
Public Health Agency of Barcelona, 1 Pl. de Lesseps, Barcelona 08023, Spain; Institute of Biomedical Research Sant Pau, 167 Sant Antoni Maria Claret, Barcelona 08025, Spain.
2
Public Health Agency of Barcelona, 1 Pl. de Lesseps, Barcelona 08023, Spain; Institute of Biomedical Research Sant Pau, 167 Sant Antoni Maria Claret, Barcelona 08025, Spain; Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona, Plaça Cívica, Bellaterra 08093, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Biomedical Research Centre Network for Epidemiology and Public Health (Spain), 5 Monforte de Lemos, Madrid 28029, Spain. Electronic address: aespelt@aspb.cat.
3
CIBER en Epidemiología y Salud Pública (CIBERESP), Biomedical Research Centre Network for Epidemiology and Public Health (Spain), 5 Monforte de Lemos, Madrid 28029, Spain; Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, 81 Roc Boronat, Barcelona 08005, Spain; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Pública, Facultat de Medicina, Autonomous University of Barcelona, Plaça Cívica, Bellaterra 08093, Spain.
4
Subdirecció General de Drogodependències, Departament de Salut de la Generalitat de Catalunya, 131 Travessera de les Corts, Barcelona 08021, Spain.
5
Microbiology Service, Hospital Universitari Germans Trias i Pujol, Carretera Can Ruti, Badalona 08916, Spain.

Abstract

BACKGROUND:

The objective of this study was to estimate the proportion of undiagnosed HIV or Hepatitis C virus (HCV) infection and to assess the risk factors associated with an undiagnosed infection.

METHODS:

A questionnaire was distributed among people who inject drugs (PWID) in harm reduction centres in Catalonia, Spain 2008-2012 (n=2243). Self-report of HIV and HCV was compared to oral fluid tests to calculate the proportion of undiagnosed infection. Associations of undiagnosed HIV and HCV with age, origin, risk and protective factors of infection and services use were calculated using a Poisson regression model with robust variance.

RESULTS:

The sensitivity of HIV self-report was 78.5% (75.2%-81.5%) and of HCV was 81.2% (79.1%-83.2%), being lower in younger and foreign-born PWID. Specificity for HCV was 55.9% (51.6%-60.1%). PWID who engaged in infection risk behaviors had lower risk of being undiagnosed. Being foreign-born and younger increased the risk of undiagnosed infection. PWID who had not accessed medical care in the last 6months had 1.46 (1.10-1.93) times more risk of undiagnosed HIV and 1.37 (1.11-1.70) times more risk of undiagnosed HCV.

CONCLUSION:

Outreach programmes are essential to provide PWID, specially foreign-born and younger PIWD, access to HIV and HCV test.

KEYWORDS:

HIV infection; Hepatitis C; Injecting drug users; Self-report; Undiagnosed infection

PMID:
28476265
DOI:
10.1016/j.jsat.2017.03.003
[Indexed for MEDLINE]

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