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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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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T2 - Implications for prevention

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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