High Prevalence and Incidence of HIV and HCV Among New Injecting Drug Users With a Large Proportion of Migrants-Is Prevention Failing?
Por:
Folch, C, Casabona, J, Espelt, A, Majo, X, Merono, M, Gonzalez, V, Wiessing, L, Colom, J, Brugal, MT
Publicada:
28 ene 2016
Resumen:
Objectives: The aim of this study was to assess differences in the prevalence of HIV and HCV infection and associated risk factors between new (injecting for <= 5years) and long-term injectors and to estimate HIV/HCV incidence among new injectors. Methods: Cross-sectional study among people who inject drugs (PWID) who attended harm reduction centers in Catalonia in 2010-11. Anonymous questionnaires and oral fluid samples were collected. Poisson regression models were applied to determine the association between HIV/HCV infection and risk factors. Results: Of the 761 participants, 21.4% were new injectors. New injectors were younger than long-term injectors (mean age = 31.6vs. 37.8) and were more likely to be immigrants (59.0% vs. 33.4%). HIV and HCV prevalence was 20.6% and 59.4% among new injectors, and estimated HIV and HCV incidence 8.7 and 25.1 /100 person-years, respectively. Among new injectors, HIV infection was associated with homelessness (PR = 3.10) and reporting a previous sexually transmitted infection (PR = 1.79). Reporting front/backloading (PR = 1.33) and daily injection (PR = 1.35) were risk-factors for HCV infection. For long-term injectors, HIV risk factors were: having shared syringes (PR = 1.85), having injected cocaine (PR = 1.38), reporting front/backloading (PR = 1.30) and ever having been in prison (PR = 2.03). Conclusion: A large proportion of PWID in Catalonia are new injectors, a subgroup with a high level of both sexual and parenteral exposure and a high incidence rate of HIV/ HCV infections. It is important to improve early diagnosis of these infections among this group, in particular among migrants. To identify and address risk factors for homelessness PWID should be a priority.
Filiaciones:
Folch, C:
Agencia Salut Publ Catalunya, Ctr Estudis Epidemiol Infecc Transmiss Sexual & S, Gen Catalunya, Badalona, Spain
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Fundacio Inst Invest Germans Trias i Pujol IGTP, Badalona, Spain
Casabona, J:
Agencia Salut Publ Catalunya, Ctr Estudis Epidemiol Infecc Transmiss Sexual & S, Gen Catalunya, Badalona, Spain
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Fundacio Inst Invest Germans Trias i Pujol IGTP, Badalona, Spain
Univ Autonoma Barcelona, Dept Pediat Obstet & Ginecol Med Prevent & Salut, Fac Med, Bellaterra, Cerdanyola Del, Spain
Espelt, A:
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Agencia Salut Publ Barcelona, Barcelona, Spain
Univ Autonoma Barcelona, Dept Psicol & Metodol Ciencies Salut, Bellaterra, Cerdanyola Del, Spain
Majo, X:
Agencia Salut Publ Catalunya, Subdireccio Gen Drogodependencies, Dept Salut Generalitat Catalunya, Badalona, Spain
Merono, M:
Ambit Prevenc, Barcelona, Spain
Gonzalez, V:
Agencia Salut Publ Catalunya, Ctr Estudis Epidemiol Infecc Transmiss Sexual & S, Gen Catalunya, Badalona, Spain
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Microbiol Serv, Barcelona, Spain
Wiessing, L:
European Monitoring Ctr Drugs & Drug Addict, Lisbon, Portugal
Colom, J:
Agencia Salut Publ Catalunya, Subdireccio Gen Drogodependencies, Dept Salut Generalitat Catalunya, Badalona, Spain
Brugal, MT:
CIBER Epidemiol & Salud Publ, Barcelona, Spain
Agencia Salut Publ Barcelona, Barcelona, Spain
|