Chronicles of an Epidemic Forthtold: Alarming increase of HCV and HIV among People Who Inject Drugs in Colombia

Author: Pedro Mateu-Gelabert, Dedsy Berbesi, Sara Ramos Jaraba, Jenny Fagua

Theme: Epidemiology & Public Health Research Year: 2023

Background: While high income countries aim at HCV elimination, HCV (and HIV) among PWID in numerous low- and middle-income countries remain unaddressed and, in the case of Colombia, increasing at an alarming rate. Despite numerous warnings by researchers and public health officials few prevention efforts have been implemented.

Methods: Secondary analysis of a series of cross-sectional studies across six Colombian cities using respondent-driving sampling of people who inject drugs (PWID) over 18 years of age. HIV and HCV antibody testing were administered on-site. Data collection occurred in Medellin and Pereira (years 2010, 2013-14, and 2021) and Bogota, Cucuta, Armenia, and Cali (years 2013-14 and 2021).

Results: The rates of HIV among PWID from 2013 to 2021 have close to double in Pereira (from 8.9 % to 17.6%) and nearly tripled in Medellin (from 4.4% to 11.2%). Similarly, the rates of HCV exposure increased drastically in Armenia (from 28% to 62.8%) and Pereira (47% to 71.65%) and more than tripled in Cucuta (from 21% to 69.6%).

Conclusions: Despite repeated concerns, raised as early as 2006 in national and international forums, the HIV and HCV epidemic has followed a predictable course with minimal implementation of harm reduction efforts that could have prevented its current impact. Will this prevention failure serve as a warning to neighboring countries regarding the spread of a drug injection-related HCV/HIV epidemic elsewhere in Latin America?

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