Drug network identification predicts injecting risk behavior among people who inject drugs on hepatitis C virus treatment in Tayside, Scotland

Abstract

The risk of Hepatitis C Virus (HCV) acquisition among People Who Inject Drugs (PWID) remains high when injecting risk behavior within networks endures. Several psychosocial factors influence such behavior. Following a drive within Tayside, a geographic region in Scotland, to achieve World Health Organization HCV elimination targets, addressing HCV re-infection risk as a barrier to elimination is critically important. This cross-sectional study seeks to address this barrier to elimination by investigating associations between group identification (one’s subjective sense of belonging and connectedness to a social group coupled with a sense of shared goals, beliefs and values with the other members of the group) and injecting risk behavior among PWID on HCV treatment at needle and syringe provision sites in Tayside. Participants completed psychosocial questionnaires between treatment weeks zero and three of treatment. Correlation analyses were undertaken, and significant factors included in multiple linear regression models for injecting risk behavior. Injecting frequency, drug network identification, and family identification, were correlated with injecting risk behavior, and drug network identification had a positive predictive on injecting risk behavior. Identification with a social group, conventionally associated with improved health, may pose health risks in specific contexts. Healthcare providers should consider stratifying individuals with higher group identification with PWID networks for enhanced harm reduction engagement to mitigate transmissible infection risk among PWID. Additionally, psychological interventions to strengthen group identification with networks which impact positively on health behavior should be explored.

Keywords:

• group identification
• hepatitis C virus
• people who inject drugs
• re-infection

Author contributions

AM conceived and designed the study, collected the data, analyzed, and interpreted the results, and contributed to the first, and subsequent drafts, of the manuscript. CJB interpreted the results and contributed to the first, and subsequent drafts, of the manuscript. AE, KP, FS, and JFD, provided senior supervision of the research. All authors critically reviewed and approved the submitted manuscript.

Data availability

The anonymized data will be held by the research team. Sharing of data will be considered for researchers who provide a methodologically sound proposal.

Disclosure statement

CJB has received honoraria from the International Network on Health and Hepatitis in Substance Users (INHSU), unrelated to the submitted work. AM, FS, AE and KP have no declarations. JFD has received honoraria for lectures and research grants from Janssen-Cilag, Roche, Merck Sharp & Dohme, AbbVie, Bristol-Myers Squibb and Gilead Sciences, outside the submitted work.

Additional information

Funding

The researchers acknowledge the participants for their time and expertise. There was no funding associated with this work.