Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City

Implications for prevention

Benjamin Eckhardt, Emily R. Winkelstein, Marla A. Shu, Michael R. Carden, Courtney Mcknight, Don Des Jarlais, Marshall J. Glesby, Kristen Marks, Brian R. Edlin

Research output: Contribution to journalArticle

Abstract

Background: Hepatitis C virus (HCV) infection remains a significant problem in the United States, with people who inject drugs (PWID) disproportionately afflicted. Over the last decade rates of heroin use have more than doubled, with young persons (18-25 years) demonstrating the largest increase. Methods: We conducted a cross-sectional study in New York City from 2005 to 2012 among young people who injected illicit drugs, and were age 18 to 35 or had injected drugs for <5 years, to examine potentially modifiable factors associated with HCV among young adults who began injecting during the era of syringe services. Results: Among 714 participants, the median age was 24 years; the median duration of drug injection was 5 years; 31% were women; 75% identified as white; 69% reported being homeless; and 48% [95% CI 44-52] had HCV antibodies. Factors associated with HCV included older age (adjusted odds ratio [AOR], 1.99 [1.52-2.63]; p<0.001), longer duration of injection drug use (AOR, 1.68 [1.39-2.02]; p<0.001), more frequent injection (AOR, 1.26 [1.09-1.45]; p = 0.001), using a used syringe with more individuals (AOR, 1.26 [1.10-1.46]; p = 0.001), less confidence in remaining uninfected (AOR, 1.32 [1.07-1.63]; p<0.001), injecting primarily in public or outdoors spaces (AOR, 1.90 [1.33-2.72]; p<0.001), and arrest for carrying syringes (AOR, 3.17 [1.95-5.17]; p<0.001). Conclusions: Despite the availability of harm reduction services, the seroprevalence of HCV in young PWID in New York City remained high and constant during 2005-2012. Age and several injection behaviors conferred independent risk. Individuals were somewhat aware of their own risk. Public and outdoor injection and arrest for possession of a syringe are risk factors for HCV that can be modified through structural interventions.

Original languageEnglish (US)
Article numbere0177341
JournalPLoS One
Volume12
Issue number5
DOIs
StatePublished - May 1 2017

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hepatitis C
Hepatitis C
Syringes
Hepatitis C virus
Viruses
seroprevalence
odds ratio
risk factors
Odds Ratio
Hepacivirus
syringes
drugs
Pharmaceutical Preparations
Injections
drug injection
injection
Hepatitis C Antibodies
Heroin
Street Drugs
homeless people

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City : Implications for prevention. / Eckhardt, Benjamin; Winkelstein, Emily R.; Shu, Marla A.; Carden, Michael R.; Mcknight, Courtney; Des Jarlais, Don; Glesby, Marshall J.; Marks, Kristen; Edlin, Brian R.

In: PLoS One, Vol. 12, No. 5, e0177341, 01.05.2017.

Research output: Contribution to journalArticle

Eckhardt, Benjamin ; Winkelstein, Emily R. ; Shu, Marla A. ; Carden, Michael R. ; Mcknight, Courtney ; Des Jarlais, Don ; Glesby, Marshall J. ; Marks, Kristen ; Edlin, Brian R. / Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City : Implications for prevention. In: PLoS One. 2017 ; Vol. 12, No. 5.
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title = "Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City: Implications for prevention",
abstract = "Background: Hepatitis C virus (HCV) infection remains a significant problem in the United States, with people who inject drugs (PWID) disproportionately afflicted. Over the last decade rates of heroin use have more than doubled, with young persons (18-25 years) demonstrating the largest increase. Methods: We conducted a cross-sectional study in New York City from 2005 to 2012 among young people who injected illicit drugs, and were age 18 to 35 or had injected drugs for <5 years, to examine potentially modifiable factors associated with HCV among young adults who began injecting during the era of syringe services. Results: Among 714 participants, the median age was 24 years; the median duration of drug injection was 5 years; 31{\%} were women; 75{\%} identified as white; 69{\%} reported being homeless; and 48{\%} [95{\%} CI 44-52] had HCV antibodies. Factors associated with HCV included older age (adjusted odds ratio [AOR], 1.99 [1.52-2.63]; p<0.001), longer duration of injection drug use (AOR, 1.68 [1.39-2.02]; p<0.001), more frequent injection (AOR, 1.26 [1.09-1.45]; p = 0.001), using a used syringe with more individuals (AOR, 1.26 [1.10-1.46]; p = 0.001), less confidence in remaining uninfected (AOR, 1.32 [1.07-1.63]; p<0.001), injecting primarily in public or outdoors spaces (AOR, 1.90 [1.33-2.72]; p<0.001), and arrest for carrying syringes (AOR, 3.17 [1.95-5.17]; p<0.001). Conclusions: Despite the availability of harm reduction services, the seroprevalence of HCV in young PWID in New York City remained high and constant during 2005-2012. Age and several injection behaviors conferred independent risk. Individuals were somewhat aware of their own risk. Public and outdoor injection and arrest for possession of a syringe are risk factors for HCV that can be modified through structural interventions.",
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AU - Eckhardt, Benjamin

AU - Winkelstein, Emily R.

AU - Shu, Marla A.

AU - Carden, Michael R.

AU - Mcknight, Courtney

AU - Des Jarlais, Don

AU - Glesby, Marshall J.

AU - Marks, Kristen

AU - Edlin, Brian R.

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N2 - Background: Hepatitis C virus (HCV) infection remains a significant problem in the United States, with people who inject drugs (PWID) disproportionately afflicted. Over the last decade rates of heroin use have more than doubled, with young persons (18-25 years) demonstrating the largest increase. Methods: We conducted a cross-sectional study in New York City from 2005 to 2012 among young people who injected illicit drugs, and were age 18 to 35 or had injected drugs for <5 years, to examine potentially modifiable factors associated with HCV among young adults who began injecting during the era of syringe services. Results: Among 714 participants, the median age was 24 years; the median duration of drug injection was 5 years; 31% were women; 75% identified as white; 69% reported being homeless; and 48% [95% CI 44-52] had HCV antibodies. Factors associated with HCV included older age (adjusted odds ratio [AOR], 1.99 [1.52-2.63]; p<0.001), longer duration of injection drug use (AOR, 1.68 [1.39-2.02]; p<0.001), more frequent injection (AOR, 1.26 [1.09-1.45]; p = 0.001), using a used syringe with more individuals (AOR, 1.26 [1.10-1.46]; p = 0.001), less confidence in remaining uninfected (AOR, 1.32 [1.07-1.63]; p<0.001), injecting primarily in public or outdoors spaces (AOR, 1.90 [1.33-2.72]; p<0.001), and arrest for carrying syringes (AOR, 3.17 [1.95-5.17]; p<0.001). Conclusions: Despite the availability of harm reduction services, the seroprevalence of HCV in young PWID in New York City remained high and constant during 2005-2012. Age and several injection behaviors conferred independent risk. Individuals were somewhat aware of their own risk. Public and outdoor injection and arrest for possession of a syringe are risk factors for HCV that can be modified through structural interventions.

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