Author: Bartholomew TS, Tookes HE, Feaster DJ

Theme: Epidemiology & Public Health Research Year: 2019

Background: Blood-borne viral infections, such as HIV and Hepatitis C (HCV), have been identified as
common infections among people who inject drugs (PWID). However, seroprevalence rates among this
population differ greatly between these two infections. This study aims to determine the prevalence of
HIV and HCV infection among PWID accessing a syringe services program (SSP) in Miami, FL, along with
baseline predictors of HIV and HCV infection.
Methods: Baseline behavioral enrollment assessments of 837 participants accessing a syringe exchange
program for the first time were analyzed. Patients self-reporting or testing HIV or HCV positive at the
enrollment visit were included in the present analysis. Socio-demographic, drug use and injectionrelated risk behaviors between HCV+/HCV- and HIV+/HIV- statuses were assessed. A multivariable
logistic regression model using backward selection was used to assess predictors of baseline HCV and
HIV infection independently.
Results: Overall prevalence rates for HCV and HIV infection were [47.4%] and [9.2%], respectively. After
adjusting for confounders, the most significant predictors of baseline HCV infection were lower
education (aOR=1.90; 95% CI: 1.32-2.72), homelessness (aOR=2.20; 95% CI: 1.51-3.20), years of injection
drug use (aOR=1.06; CI: 1.04-1.08), reusing syringes (aOR=1.76; 95% CI: 1.12-2.75) and sharing syringes
(aOR=2.17; CI: 1.50-3.16). The most significant predictors of baseline HIV infection were age (aOR=1.06;
CI: 1.03-1.09), self-reported Hispanic ethnicity (aOR=2.53; 95% CI: 1.19-5.36), self-reported Black race
(aOR=8.19; 95% CI: 2.77-24.23), gay or bisexual orientation (aOR=7.83; CI: 3.70-16.60) and
methamphetamine injection (aOR=5.59; CI: 2.50-12.47).
Conclusion: Baseline behavioral predictors differed between HIV infection and HCV infection among
participants accessing syringe services. Understanding the risk factors associated with each infection at
initial enrollment into SSPs should be considered and addressed when developing additional preventive
interventions among varying PWID populations seen at SSPs.
Disclosure of Interest Statement: This work was supported in part by grant funding through the
Frontlines of Communities in the United States (FOCUS), Gilead Sciences. The FOCUS program (a branch
of Gilead’s Government Affairs division) partners with health care providers, government agencies, and
community organizations to implement HIV and hepatitis C virus screening programs and develop
replicable models that embody best practices in screening and linkage to care. The program pays for
partial salary support for principal investigators to develop protocols and manage the screening
program, administrative staff to assist with data acquisition and linkage, and meeting-related travel

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