Article

Awareness of Biologically Confirmed HCV Among a Community Residing Sample of Drug Users in Baltimore City

Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1225 Center Drive, Room 3146, Gainesville, FL, 32611, USA, .
Journal of Community Health (Impact Factor: 1.28). 10/2013; 39(3). DOI: 10.1007/s10900-013-9782-x
Source: PubMed

ABSTRACT The present study sought to examine: (1) the prevalence and correlates of biologically confirmed Hepatitis C (HCV) and (2) the prevalence and correlates of prior HCV diagnosis and an unmet need for HCV treatment, among a community residing sample of drug users. The current study used a subset of HCV tested participants from the larger NEURO-HIV Epidemiologic Study from Baltimore, Maryland (Mage = 34.81, SD = 9.25; 46 % female). All participants were tested for HCV at baseline. Self-report was used to assess awareness of an HCV diagnosis and participation in treatment. Of the 782 participants tested for HCV, 19 % reported having received an HCV diagnosis in the past while 48 % tested positive for HCV. Only 6 % reported having received treatment for any form of hepatitis. Of those who tested HCV positive, 63 % reported never being diagnosed, and only 13 % received any treatment for HCV. We found that only 35 % of those who reported a prior HCV diagnosis received any treatment. The findings regarding lack of HCV awareness and diagnosis were considerable as expected. These deficits suggest that there are numerous gaps in patients' knowledge and beliefs regarding HCV that may interfere at multiple steps along the path from diagnosis to treatment. This study clearly demonstrates that a critical need exists to improve public knowledge of HCV risk factors, the need for testing, and the availability of effective treatment.

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    ABSTRACT: Objectives: Despite the fact that a considerable portion of hepatitis C virus (HCV) positive individuals are viraemic, the risk of transmitting HCV to others is context dependent. Prison is a particularly risky environment as HCV prevention tools are often unavailable. Using data from a cross-sectional study conducted in centres for HCV testing in southeastern France, we aimed to compare the patterns of risk factors in HCV-positive inmates with those in the general population. Setting: 26 centres for HIV/HCV testing in southeastern France (23 in the general population and 3 in prison). Primary outcome measure: HCV seropositivity measured with ELISA test. Methods: A propensity score method to ensure that the general and inmate populations could be compared and a multimodel averaging to estimate the degree (strong, weak, none) of the association of a number of specific factors with HCV seropositivity in each group. Results: Among the 52 082 participants, HCV infection prevalence was 1.5% and 5.2% in the general (n=46 125) and inmate (n=5957) populations, respectively. In both populations, 'drug injection without snorting' and 'drug injection with snorting' were very strongly associated with HCV seropositivity. Among inmates, 'drug snorting alone' (OR (95% CI) 2.21 (1.39 to 3.52) was also a strong correlate while tattoos, piercings (OR (95% CI) 1.22 (0.92 to 1.61)) and the sharing of toiletry items (OR (95% CI) 1.44 (0.84 to 2.47)) were weak correlates. Conclusions: The pattern of risk factors associated with HCV seropositivity is different between the general and prison populations, injection and snorting practices being more prevalent in the latter. Access to prevention measures in prisons is not only a public health issue but also a human right for inmates who deserve equity of care and prevention.
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