HCV Infection Prevalence Lower Than Expected among 18–40-Year-Old Injection Drug Users in San Diego, CA

Abstract

San Diego, California shares the world's busiest land border crossing with Tijuana, Mexico-a city where 95 % of injection drug users (IDUs) test hepatitis C virus (HCV) antibody-positive. Yet, little is known about the prevalence and risk behaviors for HCVamong IDUs in San Diego. In 2009-2010 IDUs in San Diego County completed a risk assessment interview and serologic testing for HCV and HIV infection. Recruitment involved respondent-driven sampling, venue-based sampling at a syringe exchange program, and convenience sampling. Correlates of HCV infection were identified by multivariable logistic regression. Among 510 current IDUs, 26.9 % (95 % CI 23.0-30.7 %) and 4.2 % (95 % CI 2.4-5.9 %) had been infected with HCVand HIV, respectively. Overall, median age was 28 years; 74 % were male; 60 % white and 29 % Hispanic; and 96 % were born in the U.S. Median years of injecting was 6; 41 % injected daily; 60 % injected heroin most often; 49 % receptively shared syringes and 68 % shared other injection paraphernalia; and only 22 % reported always using new syringes in the past 3 months. Two thirds had ever traveled to Mexico and 19 % injected in Mexico. HCV infection was independently associated with sharing injection paraphernalia (adjusted odds ratio [AOR]= 1.69) and SEP use (AOR=2.17) in the previous 3 months, lifetime history of drug overdose (AOR=2.66), and increased years of injecting (AOR=2.82, all P values G0.05). Controlling for recruitment method did not alter results. HCV infection prevalence among IDUs in San Diego was modest compared to other US cities and much lower than Tijuana. Given that known individual-level HCV risk factors were common in San Diego, the city's lower HCV prevalence might be due to differences in social and structural factors between the cities.

Prevalence and Correlates of Heroin–Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico

“…Although the prevalence was lower among San Diego PWID compared with Tijuana PWID in the present study (19.8%), prevalence appears to have increased compared with results of an earlier study conducted in 2009-2010 (7.2%) (Garfein et al, 2013). This increase among PWID in San Diego should be interpreted cautiously, however, because the earlier cohort was restricted to PWID ages 18-40 years but open to PWID who had injected in the past 6 months (compared with in the previous month for the present study).…”

“…Injection drug use, a large red-light district (zona roja) attracting sex tourism, and high levels of social and economic disparities have contributed to a localized HIV epidemic in Tijuana. Given the substantial bidirectional traffic of people and goods in this region, there are significant implications for cross-border spread of unsafe injecting practices that heighten the risk of blood-borne infections, including HIV and hepatitis C. Although PWID are known to inject both heroin and methamphetamine (Darke & Hall, 1995;Garfein et al, 2013;Meacham et al, 2015;Roth et al, 2015;Rusch et al, 2009), less is known about the prevalence of and risks associated with mixed or co-injection of this depressant-stimulant combination.The present analysis examined the prevalence and correlates of heroin-methamphetamine co-injection among PWID in San Diego, California, and Tijuana, Baja California. Given the production of methamphetamine in Mexico and the limited access to healthcare and drug treatment services, we hypothesized that past-6-month prevalence of heroinmethamphetamine co-injection would be higher among PWID in Tijuana.…”

Factors associated with health-related quality of life among injection drug users at methadone clinics in Taipei, Taiwan

“…36 To reduce the recall and socially desirable bias, drug and sexual behaviors were determined shortly (e.g., 3 months) prior to the interview. 37 Third, data on comorbidities such as hepatitis B or hepatitis C infection, alcoholism, hypertension, diabetes mellitus, and liver/renal diseases were not available for this study. Studies about the association between medical comorbidities and HRQOL in IDUs are lacking 10,11 ; future studies are needed.…”

Hepatitis A and B among young persons who inject drugs—Vaccination, past, and present infection

“…PWID between ages 18-40 years-old in San Diego, California were recruited to participate in the Study to Assess Hepatitis C Risk (STAHR) between March 2009 and June 2010 [18]. Sociodemographic, drug use, behavioral, and access to care factors were assessed using audio computer assisted self-interviewing (ACASI) technology.…”