Circumstances around First Drug Injection and Prevalence of HIV, Hepatitis B (HBV) and Hepatitis C (HCV) Among Participants of a Needle Exchange Program (NEP)

CIRCUMSTANCES AROUND FIRST DRUG INJECTION AND PREVALENCE OF HIV, HEPATITIS B (HBV) AND HEPATITIS C (HCV) AMONG PARTICIPANTS OF A NEEDLE EXCHANGE PROGRAM (NEP)

Alanko Blomé M 1, Isendahl P 1, Rigestam A 1, Quick S 1, Meijer B 1, Flamholc L 1, Björkman P 1, Widell A 2

1 Department of Clinical Sciences, Infectious Disease Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden; 2 Department of Translational Medicine, Clinical Virology, Lund University, Lund, Sweden.

Background: The NEP in Malmö, Sweden, was opened in 1987 and approximately 4700 persons have registered so far, 75% men. The baseline prevalence of HCV has remained high (60%), despite a prevalence of HIV (<1%). The objective of this study was to study if needle-sharing behaviour at the first injection related to self-perceived and objective signs of exposure to blood borne viruses. Methods: Interviews with 50 consecutive NEP visitors (28% women) about the circumstances of their first drug injection took place in 2014. Data was compared to the participants’ serological and self-perceived HIV, HBV and HCV status at NEP enrolment. Results: At NEP registration, 34/50 (68%) persons were anti-HCV positive and 36% had been exposed to HBV. One person was HIV positive. The median age among those HCV-positive (35 years) was significantly higher than for those anti-HCV negative (median 26 yrs, p<0.05, CI 1.61-11.77). Drug sort and age at first injection was similar for both groups; 80% had injected amphetamine at the median age of 20 years. Five (10%) persons (all male) had been alone when first injecting a drug. 35% of those anti-HCV positive had shared drug paraphernalia at first injection, compared to 25% of those anti-HCV negative. When asked who injected first, 5 persons (4 women) answered “the healthiest person”, while 12 persons (11 men) said it was “the one who owned the injection equipment”. 38% of those anti-HCV negative were aware of their HCV-status, compared to 68% of the anti-HCV positive. Conclusion: Sharing of drug injection paraphernalia was reported from 16/50 (32%) already at first injection. There was a difference between men and women in perception of the injection order, combined with an unawareness of current HCV status. Our findings indicate the specific need of information to persons at risk of starting injecting drugs and new injectors. Disclosure of Interest Statement: The authors have nothing to disclose.

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