Risk Correlates of Prevalent HIV, Hepatitis B Virus, and Hepatitis C Virus Infections Among Noninjecting Heroin Users

Gyarmathy, V. Anna; Neaigus, Alan; Miller, Maureen C.; Friedman, Samuel R.; Jarlais, Don C. Des

doi:10.1097/00126334-200208010-00011

Cited by 5 publications

(8 citation statements)

References 14 publications

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“…The second finding is that for both IHUs and especially NIHUs, the prevalence is higher in women, and these differences are even larger after adjusting for the sociodemographic and behavioural factors. The combined analysis of these findings reflects a situation in sharp contrast to what Strathdee and colleagues describe in a reanalysis of various studies in North America [8,11,30,31], which shows that the differences in HIV prevalence and incidence between IDUs and NIDUs, and between men and women, are not as high as in Spain. Furthermore, in studies restricted to IDUs, certain sexual behaviours (prostitution, having injecting partners, men who have sex with men, etc.)…”

Section: Discussionmentioning

confidence: 64%

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Prevalence of HIV infection among young adult injecting and non-injecting heroin users in Spain in the era of harm reduction programmes: gender differences and other related factors

et al. 2006

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The aims were to assess the prevalence of HIV infection among young adult heroin users, including injecting heroin users (IHUs) and non-injecting heroin users (NIHUs), and to explore the differences by gender and other factors. The design was a cross-sectional cohort study between April 2001 and December 2003, which included 961 current heroin users (HU), aged 18-30 years: 422 in Madrid, 351 in Barcelona and 188 in Seville; 621 were IHUs and 340 were NIHUs. All were street-recruited by chain referral methods. Face-to-face interviews were conducted using a structured questionnaire with computer-assisted personal interviewing (CAPI). Samples for HIV testing (dried blood spot) were collected and tested with ELISA and Western Blot. Bivariate, logistic regression, and classification and regression tree analyses were performed. The overall prevalence of HIV infection among IHUs was 25.8% (95% CI 22.3-29.3) [32.4% (95% CI 26.6-38.1) in Madrid, 20.5% (95% CI 15.6-25.4) in Barcelona, and 20.6% (95% CI 9.8-31.4) in Seville], whereas in NIHUs it was 4.0% (95% CI 2.1-6.7), with no differences among cities. The prevalence was significantly higher in women than in men in NIHUs (10.9%, 95% CI 4.3-17.5 vs. 1.7%, 95% CI 0.5-4.2) and was non-significantly higher in IHUs (30.4%, 95% CI 23.0-37.8 vs. 24.1%, 95% CI 20.1-28.1). HIV prevalence in short-term IHUs was 12.9% (CI 8.8-17.02), with no differences among cities. In the logistic analysis, the variables associated with infection in IHUs were ever having injected with used syringes (OR 3.4, 95% CI 2.2-5.3), ever having been in prison (OR 2.6, 95% CI 1.6-4.0), and heroin as the first drug injected at least weekly (OR 2.3, 95% CI 1.1-4.5). Factors positively associated with HIV infection in NIHUs were female sex (OR 8.7, 95% CI 2.6-29.2) and age >25 years (OR 3.1, 95% CI 0.9-11.1), while primary educational level was inversely associated (OR 0.26, 95% CI 0.1-0.9). Although there are important geographic differences, HIV prevalence in IHUs remains high, even in short-term IHUs, whereas it was almost six times lower in NIHUs. The prevalence in women is higher than in men, particularly among NIHUs. A wide range of preventive strategies should be developed, aimed primarily at empowering women to negotiate safe sex.

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Section: Discussionmentioning

confidence: 64%

“…6-25 . 4) in Barcelona,[20][21][22][23][24][25][26][27][28][29][30][31] in Seville], whereas in NIHUs it was 4 . 0 % (95 % CI 2 .…”

mentioning

confidence: 99%

Prevalence of HIV infection among young adult injecting and non-injecting heroin users in Spain in the era of harm reduction programmes: gender differences and other related factors

et al. 2006

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“…Three studies of blood donors found an elevated HCV prevalence associated with a history of intranasal cocaine use [35,36], and drug inhalation, which could include either smoking or sniffing [37]. Other studies that recruited samples of non-injection drug users reported HCV prevalences in the range of 5-21% (Table 2) [38][39][40][41][42][43][44][45][46][47]. These studies have differed with respect to recruitment and geographical setting, but all have used a cross-sectional design, so there is weak evidence for any specific causal mechanism for HCV transmission infection in this population.…”

Section: Hepatitis C Virus Risk Factors In Non-injection Drug Usersmentioning

confidence: 99%

HIV/hepatitis C virus co-infection in drug users: risk behavior and prevention

Hagan¹,

Thiede

Jarlais

2005

Aids

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Studies of HIV-positive patients have consistently shown that drug users, in particular injection drug users (IDU), are far more likely to have hepatitis C virus (HCV) infection than other patient groups. HIV incidence and prevalence in IDU has declined in recent years, but HCV remains endemic in this population. HCV antibody prevalence among non-injection users of drugs such as heroin and cocaine is between 5 and 30%, although there are scant data on specific transmission risk behavior. The control of HIV/HCV co-infection must address HCV prevention. Epidemiological studies have suggested that HCV prevalence in IDU is subject to various influences, some of which may be modifiable by interventions. However, studies have not shown consistent effects of various prevention strategies on HCV transmission, including studies of HCV screening and education, drug treatment or needle exchange. Although some large cross-sectional studies in regions where needle exchange is available to a large number of drug injectors have reported declining HCV prevalence, the scale of services needed is a matter of considerable debate and has not been systematically quantified. Priorities for research related to the prevention of HIV/HCV co-infection should include estimating the effect on disease occurrence of eliminating specific risk factors, and specifying the level of resources needed to alter HCV incidence.

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“…Some studies have linked HCV infection to smoking and intranasal routes of drug administration (Rosenblum, Nuttbrock, McQuistion, Magura, & Joseph, 2001;Tortu et al, 2001), which suggests that non-injection risk behaviors are at play, such as unsafe sexual practices, body piercing, and tattooing, all of which have been implicated in the transmission of many infectious diseases (Atler et al, 1999;Donahue et al, 1991;Tortu, McMahon, Pouget, & Hamid, 2004;Van Ameijden, van den Hoek, Hartgers, & Coutinho, 1994). Although studies investigating the occurrence of HCV have been carried out in diverse drugabusing populations, most have been among heroin (Gyarmathy, Neaigus, Miller, Friedman, & Des Jarlais, 2005;Neaigus, Miller, Friedman, & Des jarlais, 2001;Samuel, Doherty, Bulterys, & Jenison, 2001) and cocaine (Callaghan & Cunningham, 2002;Conry-Cantilena et al, 1996;Harsch et al, 2000;Santibanez et al, 2005) users, with relatively few among methamphetamine (MA)-dependent users (e.g., Cherner et al, 2005;Hahn, PageShafer, Lum, Ochoa, & Moss, 2001;Letendre et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C virus infection among methamphetamine-dependent individuals in outpatient treatment

Gonzales

Marinelli‐Casey

Shoptaw

et al. 2006

Journal of Substance Abuse Treatment

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Risk Correlates of Prevalent HIV, Hepatitis B Virus, and Hepatitis C Virus Infections Among Noninjecting Heroin Users

Cited by 5 publications

References 14 publications

Prevalence of HIV infection among young adult injecting and non-injecting heroin users in Spain in the era of harm reduction programmes: gender differences and other related factors

Prevalence of HIV infection among young adult injecting and non-injecting heroin users in Spain in the era of harm reduction programmes: gender differences and other related factors

HIV/hepatitis C virus co-infection in drug users: risk behavior and prevention

Hepatitis C virus infection among methamphetamine-dependent individuals in outpatient treatment

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