Theme: Epidemiology & Public Health Research Year: 2016
PAST INCARCERATION EXPERIENCE AND THE RISK OF HEPATITIS C INFECTION AMONG PEOPLE WHO INJECT DRUGS: RESULTS FROM A SERO-BEHAVIORAL SURVEY AMONG CURRENT INJECTORS IN GERMANY
Gassowski M1, Nielsen S1,2, Wenz B1, an der Heiden M1, Hamouda O1, Bremer V1, Ross RS3, Bock CT4, Marcus U1 and Zimmermann R1
1 Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany
2 Charité University Medicine, Berlin, Germany
3 Institute of Virology, National Reference Centre for Hepatitis C, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
4 Department of Infectious Diseases, Division for Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Robert Koch Institute, Berlin, Germany
Background: People who inject drugs (PWID) are at higher risk of incarceration as well as hepatitis C infection (HCV) than the general population in Germany. To examine whether past incarceration experience (PIE) and positive HCV serostatus are associated, data from the first large German sero-behavioral survey of PWID (DRUCK-study) was used.
Methods: Respondent driven sampling was used to recruit current injectors (IV-drug use in the last 12 months) in eight German cities in 2011-2014. PIE was differentiated by duration and frequency, including no experience. A multivariable logistic regression model was used to examine the association of HCV serostatus with PIE, correcting for known risk factors for HCV. In a second step, reported in-prison risk behaviors were included in the model.
Results: 1,998 participants were included in the analysis. Of these, 19.9% reported no PIE, 28.6% short and rare (SR), (3.5 year in total, ≤3 times) PIE, 12.1% short but frequent (SF) PIE, 7.1% long but rare (LS) PIE and 32.4% long and frequent (LF) PIE. After correcting for age, gender, region of origin, duration of IV-drug use, being unprofessionally tattooed/pierced outside of prison and study site the association between PIE and HCV serostatus remained statistically significant with following odds ratios (OR): SR 1.4 (95% confidence interval (CI) 1.0-1.9), SF 2.1 (95% CI 1.4-3.0), LR 3.3 (95% CI 2.0-5.4), LF 3.8 (95% CI 2.7-5.3). By adjusting the model for in-prison risk behaviors the OR of PIE were reduced but remained significant: SR 1.3 (95% CI 1.0-1.8), SF 1.8 (95% CI 1.3-2.7), LR 2.7 (95% CI 1.6-4.4), LF 2.8 (95% CI 1.9-4.1).
Conclusion: The proportion of HCV positive PWID seems to increase with both frequency and duration of incarceration, but this cannot fully be explained by in-prison risk behaviors. Further research is needed to investigate HCV-risks associated with the period upon release.
Disclosure of interest statement: The study was funded by the Robert Koch Institute and the German Ministry of Health (Bundesministerium für Gesundheit). All authors declare that they do not have any conflict of interestDownload abstract Download poster