Hepatitis C virus risk behaviors within the partnerships of young injecting drug users

Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.
Addiction (Impact Factor: 4.74). 07/2010; 105(7):1254-64. DOI: 10.1111/j.1360-0443.2010.02949.x
Source: PubMed


Young injection drug users (IDU) are at high risk for hepatitis C virus (HCV). We sought to determine whether perceiving one's injecting partner to be HCV positive was associated with decreased odds of engaging in receptive needle/syringe sharing (RNS) or ancillary equipment sharing (AES) with that partner.
Cross sectional study.
2003 to 2007 in San Francisco.
212 young (under age 30) IDU who were HCV antibody negative reported on 492 injecting partnerships.
Self-reported RNS and AES within injecting partnerships.
RNS and AES (in the absence of RNS) occurred in 23% and 64% of injecting partnerships in the prior month. The odds of engaging in RNS were significantly lower for relationships in which the participant reported that his/her partner was HCV positive (odds ratio [OR] 0.49; 95% confidence interval [CI] 0.25-0.95). This association was attenuated when adjusted for reusing one's own needle/syringe (adjusted OR 0.57; 95% CI 0.28-1.15). The odds of engaging in AES were lower for participants who did not know the HCV status of their partner, only among non-sexual partnerships (OR 0.47; 95% CI 0.29-0.76).
Because perceiving one's partner to be HCV positive was associated with decreased RNS, increased HCV testing and partner disclosure may be warranted. AES was common and was decreased only among non-sexual partnerships in which the HCV status of the partner was not known. This suggests that interventions to reduce AES in young IDU must be widespread.

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    • "There is a value in recognizing the injecting partnership as a unit of study and intervention (Rhodes and Quirk, 1998) given the social nature of injection drug use and that risk for infection occurs when contaminated equipment is shared between at least two people. However, much of the literature on the social nature of injection drug use focuses on the risk of sharing syringes (Davey-Rothwell et al., 2010; Hahn et al., 2010; Harris and Rhodes, 2013). M a n u s c r i p t "
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    ABSTRACT: Background: Studies have shown intimate injection partners engage in higher rates of syringe and injecting equipment sharing. We examined the drug use context and development of injection drug use behaviors within intimate injection partnerships. Methods: In-depth interviews (n=18) were conducted with both members of nine injecting partnerships in Sydney, Australia. Content analysis identified key domains related to the reasons for injecting with a primary injection partner and development of drug injection patterns. Main findings: Most partnerships (n=5) were also sexual; three were blood-relatives and one a friend dyad. The main drug injected was heroin (66%) with high rates of recent sharing behaviors (88%) reported within dyads. Injecting within a primary injection partnership provided perceived protection against overdose events, helped reduce stress, increased control over when, where, and how drugs were used, and promoted the development of an injecting pattern where responsibilities could be shared. Unique to injecting within primary injection partnerships was the social connection and companionship resulted in a feeling of fulfillment while also blinding one from recognizing risky behavior. Conclusions: Findings illuminated the tension between protection and risks within primary injection partnerships. Primary injection partnerships provide a potential platform to expand risk reduction strategies.
    Drug and alcohol dependence 09/2015; DOI:10.1016/j.drugalcdep.2015.09.025 · 3.42 Impact Factor
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    • "Our study showed that the higher likelihood of syringe sharing among HCV-positive PWID was diminished after adjusting for network composition, including network HCV status (see model 1 vs. model 2, Table 4). Since all data on network members is provided by the participant (i.e., by proxy), this finding suggests that the perceived HCV status of one's partner may be an important predictor of risk behaviors within young PWID partnerships as previously reported (Hahn et al., 2010). Consistent with much past research (Davey-Rothwell and Latkin, 2007; Gollub et al., 1998; Latkin et al., 1998a; Miller and Neaigus, 2001; Tracy et al., 2014), women were more likely to share syringes with male partners, many of whom are also sex partners, after adjusting for participant and network characteristics (Table 4). "
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    ABSTRACT: Little is known about young persons who inject drugs (PWID), who are increasingly from suburban communities and predominantly non-Hispanic white. We conducted a cross-sectional personal network (egocentric) and geographic study of young PWID and their drug-using, sexual, and support network members in 2012-13 in metropolitan Chicago, Illinois, U.S. We enrolled 164 young (median age=26), mostly male (65%), non-Hispanic white PWID (71%), with a self-reported HCV prevalence of 13%. Many (59%) reported multiple residences (i.e., were transient) in the past year, 45% of whom reported living in both urban and suburban places (i.e., were cross-over transients). In multivariable analyses that adjusted for participant and network member characteristics, (1) large injection networks were more common among homeless participants; and (2) syringe sharing was (a) highest among cross-over transients compared to suburban (OR=4.19 95% CI 1.69-10.35) and urban only residents (OR=2.91 95% CI 1.06-8.03), (b) higher among HCV-unknown compared HCV-negative participants (OR=4.62 95% CI 1.69-10.35), (c) more likely with network members who were cross-over transients compared to urban (OR=4.94, 95% CI 2.17-11.23) and (d) less likely with network members with HCV-unknown compared to HCV-negative status (OR=0.4 95% CI 0.19-0.84). We identified homelessness as a significant risk factor for large networks and cross-over transience as a significant risk factor for syringe sharing. Further research is needed to understand the role of geographic factors promoting higher risk among these crossover transient PWID. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Drug and alcohol dependence 07/2015; 154. DOI:10.1016/j.drugalcdep.2015.06.042 · 3.42 Impact Factor
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    • "Drug use among young injection drug users (IDU) is a highly social activity (Koester et al., 2005; Stimson et al., 1998). Young IDU frequently inject with other IDU and have risk behaviors that put them at high risk for blood-borne disease transmission, such as sharing injecting equipment (Hahn et al., 2010, 2002). Selfreported data are frequently used to assess the behavioral risks associated with parenteral disease transmission, however, these data are subject to reporting biases, such as social desirability bias due to the sensitive nature of the subject matter (Latkin et al., 1993). "
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    ABSTRACT: Introduction Young injection drug users (IDU, under age 30) often inject with other IDU, creating an environment for risk of blood-borne disease transmission through sharing of needles and drug preparation equipment. Epidemiologic studies rely on self reported injection behavior data for measures of transmission risk, therefore we sought to quantify the degree of concordance of reported injecting risk behaviors between injecting dyads. Methods From May, 2006 through 2013 we enrolled 72 injecting dyads in San Francisco, California, who were hepatitis C virus (HCV) RNA discordant. Each partnership was followed prospectively for up to six months. Monthly interviews from each partner were date-matched and responses to relationship characteristics and risk behavior questions were compared. Concordance of reporting was estimated with the concordance correlation coefficient for longitudinal data (CCC) and the prevalence adjusted bias adjusted kappa (PABAK). Results Participants had a median age of 26 (IQR: 23, 28) years and median years injecting of 7.0 (IQR: 3.0, 10.6). Thirty-eight percent of the injecting dyads were also sexual partners. Concordance levels were highest for partnership characteristics, such as length of acquaintance, number of days cohabitating, and sexual intercourse in the past month (CCC = 0.95; 0.82, and 0.90 respectively). Shared injection risk behaviors such as injecting with the HCV+ partner's previously used syringe and using contaminated injection preparation equipment had slight to fair agreement (CCC = 0.22; 0.23; PABAK = 0.43, 0.36, respectively). Conclusions Concordance levels ranged from low to high. Potential sources of measurement error for low agreement items include recall and social-desirability biases and question interpretation.
    Drug and Alcohol Dependence 09/2014; 142. DOI:10.1016/j.drugalcdep.2014.06.028 · 3.42 Impact Factor
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