Theme: Epidemiology & Public Health Research Year: 2017
An antibody positive hepatitis C (anti-HCV+) diagnosis has been shown to have short-term impacts on injecting risk practices among people who inject drugs (PWID). However, behaviours among those unaware of their status are not as well understood. We aimed to determine if PWID who are unaware of their anti-HCV status engage in higher injecting risk practices than their diagnosed counterparts.
Two years (2013 and 2016) of data from an Australian national cross-sectional survey of PWID regularly were used (repeat participants were removed from the second year data). Participants were a convenience sample of PWID aged ≥18 years. Information on demographic, drug use, self-reported HCV status and receptive and distributive syringe sharing practices was collected via interviewer-administered survey.
Participants were a mean age of 41 years and reported a mean of 21 years of injecting; 65% were male. Among 1485 cases analysed, 113 (7%) participants reported either no prior HCV testing or were unaware of the result. Of 1,374 participants reporting a test and knowing the result, 907 (66%) reported being anti-HCV positive and 467 (34%) reported being anti-HCV negative. Controlling for age and years injecting, anti-HCV positive participants were more likely to report receptive syringe sharing (adjusted odds ratio (AOR) 3.5, 95% confidence interval (CI) 1.9, 6.4) than anti-HCV negative participants. Those that reported being anti-HCV unknown were also more likely to report receptive syringe sharing (AOR 4.8, 95% CI 2.2, 10.5) than those who self-reported negative antibody status.
A small proportion of PWID in Australia remain unaware of their HCV status. Independent of age and duration of injecting, people unaware of their HCV status were higher risk injectors than those whose last test result was anti-HCV negative. This high risk group may require innovative tailored strategies to reduce risk and promote testing uptake.