Theme: Epidemiology & Public Health Research Year: 2024
Background: While Global North focuses on HCV elimination, low- and middle-income countries continue to grapple with unaddressed HIV and HCV epidemics among people who use drugs (PWUD). Notably, Colombia is experiencing an alarming increase in these rates. In Latin America, many countries lack basic data on HIV/HCV prevalence among PWUD, exacerbating the urgency of addressing this public health issue.
Methods: This study presents results from a field-based methodology for community serosurveys, developed in collaboration with local researchers and community-based organizations. Utilizing respondent-driven sampling, participants were recruited and tested for HCV antibodies (Ab) and RNA using rapid testing and dried blood spot samples (DBS) in Puerto Rico. In Colombia, testing for HCV and HIV antibodies occurred in five cities over time. The data enabled reporting on the cascade of HCV care in Puerto Rico and tracked changes in HIV/HCV prevalence over time.
Results: In Colombia, from 2013 to 2021, HIV rates among PWID nearly doubled in Pereira (8.9% to 17.6%) and tripled in Medellin (4.4% to 11.2%). Similarly, rates of HCV exposure saw significant increases in Armenia (28% to 62.8%), Pereira (47% to 71.65%), and more than tripled in Cucuta (21% to 69.6%). In Puerto Rico, a 2022 study among 150 participants, 73% (109/150) tested positive for HCV antibodies, and 53% (79/150) were RNA positive with very few engaged in HCV treatment.
Conclusion: Despite ongoing concerns about the HIV and HCV epidemic among PWID in Latin America, few countries possess reliable prevalence data. In those with available data, high prevalence coexists with minimal treatment and harm reduction efforts. Community serosurveys are needed urgently to systematically collect data, accurately assess the scope of the problem, and develop effective prevention strategies.
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