No abstract

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.

To assess acceptability and feasibility of rapid HIV and HCV tests in HRP; to identify HIV and HCV prevalence rates in HRP; to identify the percentage of PWID with a reactive test that attend hospital for confirmation and follow-up. Rapid oral tests for HCV and HIV were offered to users of 13 HRP from both mobile units and facility-based centres. A total of 172 HCV and 198 HIV tests were performed, with a refusal rate of 1.7% and 10.4%, respectively. Injectors made up 64.9% of all drug users and 35.1% did not inject drugs. Overall, 20.3% of HCV tests and 2.5% of HIV test were reactive. Only 24 of the 35 reactive HCV could be confirmed (68.6%) and one was false-negative. Of the five HIV reactive cases, only two could be confirmed (40%) with 1 false-positive case. Acceptability of rapid HIV and HCV tests among HRP users was high. The usefulness of oral rapid tests in HRP has been demonstrated, especially in mobile HRP.

This study demonstrated differences in sexual risk behaviours between male and female IDU, but failed to find gender differences in injecting risk behaviours. Apart from that, the higher prevalence of HIV among women than among men, together with a lower prevalence of HCV, provides evidence that sexual transmission of HIV is important among female IDU. Additional studies are needed to analyze in-depth these specific risk factors for women in order to develop appropriate prevention and health education programs.