Factors Associated With Hepatitis B Exposure Among People Who Report Using Methamphetamine: National Health and Nutrition Examination Survey 2009–2016

Abstract

Background With the nation’s focus on the opioid crisis, methamphetamine has made a comeback, potentially increasing risk for hepatitis B. We examined factors associated with hepatitis B virus (HBV) exposure among people who reported ever using methamphetamine in a nationally representative survey. Methods We used the National Health and Nutrition Examination Survey to examine factors associated with HBV exposure among participants who reported ever using methamphetamine using bivariate and multivariable logistic regression. Results Overall, 847 participants met the study inclusion criteria. In multivariable logistic regression, female sex (adjusted odds ratio, 3.83; 95% confidence interval, 1.65–8.90), living below the poverty threshold (3.17; 1.39–7.21), injection drug use (4.89; 1.95–12.26), active hepatitis C virus infection (3.39; 1.10–12.26), and identifying as men who have sex with men (28.21; 5.19–153.38) were significantly associated with HBV exposure. Conclusions The odds of HBV exposure for female participants who reported using methamphetamine were 4 times than that for male participants. Poverty, injection drug use, and hepatitis C virus infection were also associated. As methamphetamine use increases, it is critical to identify those at risk of acquiring HBV infections in order to target testing and vaccination.

Risk Factors Associated With Infection of Blood-Borne Virus among People Who Used Methamphetamine

“…A recent study concluded that women using methamphetamine were four times as likely to be infected by HBV as males [12]. While our study did not nd sex statistically signi cantly associated with BBV positive result, the odds ratio did indicate that women are more likely to be exposed to HBV compared to men.…”

“…According to previous literature [4,5,12,30,31], demographic characteristics (age, gender, race/ethnicity), socio-economic status (poverty index, health insurance, healthcare access, education), sexual activity (number of sexual partners in the past year, sexual identity), and drug use behaviors (number of drug use, IDU, number of times used methamphetamine in lifetime use, age started using methamphetamine) were known factors associated with infection of BBV. Therefore, these variables were included as potential confounders in the analyses.…”

“…A study characterizing methamphetamine use and HIV serological status in San Diego found that 54% of the people who use methamphetamine were HIV positive [11]. Another study examined risk factors associated with HBV infections among people who used methamphetamine [12]. A prospective cohort study conducted in Canada determined that injecting methamphetamine independently predicted HCV infection among young, street-involved persons with injection drug use (IDU) [13].…”

“…A dynamic model investigating the excess risk of HIV and HCV infections among people who inject stimulants estimated that a median of 5-10% of new HIV and 3-7% of new HCV infections in the following year could each be attributed to 10% increase in the prevalence of stimulant injection use [4]. Another recent study found that women, poverty, IDU, and HCV infection were associated with increased risk of HBV infection among people who use methamphetamine [12]. CDC and a few state health departments have developed vulnerability assessment tools to identify counties at high risk of HIV and HCV; however, these tools do not include HBV [21,24].…”

Risk Factors Associated With Infection of Blood-Borne Virus among People Who Used Methamphetamine

“…A study characterizing methamphetamine use and HIV serological status in San Diego found that 54% of the people who used methamphetamine were HIV positive [11]. Another study examined risk factors associated with HBV infections among people who used methamphetamine [12]. A prospective cohort study conducted in Canada determined that injecting methamphetamine predicted HCV infection among young, streetinvolved persons with injection drug use (IDU) [13].…”