Factors Associated With Hepatitis C Testing Uptake Among People Who Inject Image And Performance Enhancing Drugs.

Author: Hope V, McVeigh J, Begley E, Bates G, Glass R, Edmundson C, Heinsbroek E, Kean J, Campbell J3, Morgan G, Acreman D, Smith J

Theme: Epidemiology & Public Health Research Year: 2018

Historically, people who inject image and performance enhancing drugs (IPEDs) were not
perceived as being at high risk of hepatitis C virus (HCV) infection. However, recent UK
studies indicate the HCV antibody prevalence in this group (around 5%) is about 10-times
that in the general population. Worryingly, the majority of HCV infections remain
undiagnosed. We examined HCV testing uptake using survey data.
People who inject IPEDs, recruited from community settings and needle-syringe
programmes (NSPs) across England, Scotland and Wales during 2016, self-completed a
behavioural questionnaire. Factors associated with ever being HCV tested were examined
using multivariate analysis. Potential missed testing opportunities were also explored.
The participants’ (N=580; 24% NSP recruited) median age was 31 years, 97% were men,
4.4% identifying as lesbian, gay or bisexual (LGB), 17% had ever been imprisoned, and
5.7% had ever injected a psychoactive drug. Overall, 31% had ever been tested for HCV (for
60% their most recent test was during 2014-16). Testing was associated with identifying as
LGB (AOR=5.9, 95%CI 2.5-14); ever injecting a psychoactive drug (AOR=2.2, 95%CI 1.03-
5.0); NSP recruitment (AOR=3.1, 95%CI 2.0-4.7); injecting peptide-hormones and allied
drugs (AOR=2.0 95%CI 1.4-2.9); and ever imprisonment (AOR=2.2, 95%CI 1.4-3.6). Of
those never tested, 50% had used a health service during the preceding year where they
could have been tested (41% had used primary care). Overall, 14% had ever shared a drugs
vial (10% NSP recruited vs. 16% community recruited, p=0.084).
Majority are untested, with testing associated with other risks: injecting psychoactive drugs
and imprisonment. Previous studies of this group have focused recruitment on NSPs,
potentially over-estimating testing uptake and the proportion aware of their HCV status.
Targeted HCV testing interventions, focused on those not using NSPs, or without a history of
psychoactive drug injection or imprisonment, are needed for those injecting IPEDs.
Disclosure of Interest Statement:
We have no disclosures.

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