Background HIV and hepatitis C (HCV) risk factors, infection status awareness and access to care among people who inject drugs (IDU) were compared across infection groups in a national enhanced surveillance sample.
Methods Phase 2 data collection for I-Track (Enhanced surveillance of HIV and HCV risk behaviours among IDU) was conducted from 2005 to 2008 in 10 Canada sites. Confidential face-to-face interviews collected data on demographics, drug-use and sexual risk behaviours, and HIV and HCV testing. Dried blood or oral fluid samples were collected for HIV and HCV antibody testing. Descriptive statistics for demographics, risk behaviours and access to care and treatment were compared across four exclusive infection groups—HIV-seropositive-only, HCV-seropositive-only, HIV-HCV seropositive and HIV-HCV seronegative individuals.
Results Of 2969 IDU, 1.7% were HIV-seropositive-only, 57.5% were HCV-seropositive-only, 11.6% were HIV–HCV seropositive, and 29.2% were HIV–HCV seronegative. The proportion of IDU who were accurately aware of their negative or positive HIV infection status (based on concordance between self-report and laboratory result) was 85.7% among HIV-seropositive-only, 87.5% among HCV-seropositive-only, 78.7% among HIV–HCV seropositives and 77.5% among HIV–HCV seronegatives. The highest proportions reporting needle borrowing (past 6 months 24.2%) and high drug injecting frequency (69.4% > once or twice per week) were in the HCV-seropositive-only group. The highest proportions reporting multiple sex partners (past 6 months 44.9%) and no condom use at last sex (33.8%) were among HIV–HCV seronegative IDU; this group was also least likely to have been tested for HIV or HCV (85.1% and 80.6% respectively). Among those who were HIV-seropositive-only, 87.8% were under the recent care of a doctor and 74.2% were taking prescribed drugs for HIV. Among those HCV-seropositive-only, 45.5% were under the recent care of a doctor and 13.1% were taking prescribed drugs for HCV.
Conclusions Injecting and sexual risk behaviours were prevalent particularly among HCV-seropositive-only and seronegative IDU, respectively. Awareness of correct HIV infection status and frequency of HIV testing were lowest among seronegative IDU. These findings underscore the importance of routine and integrated HIV and HCV testing for at-risk IDU which may lead to higher levels of awareness for both HIV and HCV infections.
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