Sharing of Noninjection Drug-Use Implements as a Risk Factor for Hepatitis C

Abstract

This study examined sharing noninjection drug implements as a risk factor for hepatitis C (HCV) infection among women drug users (n = 123) with no history of drug injection. Participants were street-recruited from East Harlem, New York City, between October 1997 and June 1999. Participants were administered a survey measuring risk factors for HCV. Prevalence of HCV and HIV infections was 19.5% and 14.6%, respectively. Multiple logistic regression determined significant associations between sharing noninjection drug-use implements and HCV infection. “Ever shared both oral and intranasal noninjection drug implements” was independently associated with HCV infection [Odds ratio (OR) 2.83; Confidence interval (CI) 1.04, 7.72; p = 0.04]; “ever shared noninjected heroin implements with an injector” was a trend (OR 3.06; CI. 85, 10.79; p = 0.08). The strongest association between sharing noninjection drug-use implements and HCV infection was found among HIV positive individuals (χ² = 8.8, 1 d.f., p < 0.01). These findings, if supported by future research, indicate a need to reassess policies regarding HCV infection.

• Risk factors for HCV infection
• HCV infection and drug use
• HCV and HIV co-infections

Resumen

Este estudio examinó el compartimiento de implementos de drogas no injectadas como factor de riesgo para la infección de Hepatitis C (HCV) entre mujeres usuarias de droga (n = 123) sin historial de injección de droga. Las participantes fueron reclutadas en las calles de Harlem Oriental, NYC, entre octubre 1997 y junio 1999. Las participantes fueron administradas una entrevista midiendo los factores del riesgo para HCV. La frequencia de HCV e infecciones de VIH fueron de 19.5% y 14.6%, respectivamente. Múltiples retrocesos logísticos determinaron las asociaciones significativas entre compartir implementos de uso de drogas no injectadas e infección de HCV. “Alguna vez compartió implementos para el uso de droga no injectada ambas orales e internasales” se asoció independientemente con la infección de HCV (OR 2.83; CI 1.04, 7.72; p = 0.04); “compartió alguna vez implementos para el uso de heroína no injectada con un inyector” fué una tendencia (OR 3.06; CI. 85, 10.79; p = 0.08). La asociación más fuerte entre compartir implementos para el uso de drogas no injectada e infección de HCV fue encontrada entre individuos positivos de VIH (χ² = 8.8, 1 D.F., p < 0.01). Estas conclusiones, si las apoyamos con investigación futuras, indican una necesidad de revalorar las normas con respecto a la infección de HCV.

Résumé

Cette étude a examiné le partage d’instruments d’utilisation de drogues de non-injectées comme facteur de risque pour l’infection de l’hépatite C (HCV) parmi les femmes utilisatrices de drogues (n = 123) qui n’avaient pas d’histoire d’injection de drogue. Les participants furent recrutées dans les rues de Harlem Est à New York City entre octobre 1997 et juin 1999. Un questionnaire qui mesure les facteurs de risque de HCV fut administré. La prévalence du HCV et du VIH étaient 19,5% et 14,6%, respectivement. La régression logistique multiple a déterminé des associations significatives entre le partage d’instruments d’utilisation de drogues de non-injectées et l’infection de HCV. “Avoir partagé des instruments oraux et intranasaux de drogues non-injectées” était indépendamment associés à l’infection du HCV (OR 2.83; CI 1.04, 7.72; p = 0.04); “avoir partagé des instruments d’utilisation d’héroïne non-injectees avec un injecteur” était une tendance (OR 3.06; CI. 85, 10.79; p = 0.08). L’association la plus forte entre le partage d’instruments de drogue non-injectées et l’infection de HCV a été trouvée parmi les individus positifs pour le VIH (χ² = 8.8, 1 d.f., p< 0.01). Ces résultats, s’ils sont soutenus à l’avenir, indiquent un besoin de réévaluer des pratiques concernant l’infection de HCV.

Additional information

Notes on contributors

Stephanie Tortu

Stephanie Tortu, Ph.D., a Social Psychologist, is currently an Associate Professor at the Tulane University School of Public Health and Tropical Medicine. She is also Principal Investigator of “Women Drug Users, Their Male Partners, and HIV Risk,” a grant funded by the National Institute on Drug Abuse. Since 1998, she has conducted research on drugs and AIDS, authored many scientific publications, and presented at national and international conferences. She also served as the President of the Board of Directors of the New York Harm Reduction Educators from 1994 to 2000.

James M. McMahon

James M. McMahon, Ph.D., is Project Director of a federally funded study that examines HIV and Hepatitis B and C risk behaviors among heterosexual drug-using couples in East Harlem, New York. His interests and publications span several diverse areas, including quantitative methods, mathematical modeling, evolutionary biology, osteopathology, and behavioral epidemiology.

Enrique R. Pouget

Enrique R. Pouget is a Senior Research Associate at the National Development and Research Institutes, Inc. (NDRI) in New York. He has coauthored many publications using advanced quantitative methods to study communication and mental health. His current research is focused on sexual behavior, drug-use, and HIV risk.

Rahul Hamid

Rahul Hamid, has been working in AIDS research for the last 12 years at NDRI on several different research projects. He is currently a research associate working on a study examining HIV risk among drug-using couples. He is also completing his doctoral degree in film criticism at New York University.