Theme: Epidemiology & Public Health Research Year: 2018
Background:
Historically, people who inject image and performance enhancing drugs (IPEDs) were not
perceived as being at high risk of hepatitis C virus (HCV) infection. However, recent UK
studies indicate the HCV antibody prevalence in this group (around 5%) is about 10-times
that in the general population. Worryingly, the majority of HCV infections remain
undiagnosed. We examined HCV testing uptake using survey data.
Methods:
People who inject IPEDs, recruited from community settings and needle-syringe
programmes (NSPs) across England, Scotland and Wales during 2016, self-completed a
behavioural questionnaire. Factors associated with ever being HCV tested were examined
using multivariate analysis. Potential missed testing opportunities were also explored.
Results:
The participants’ (N=580; 24% NSP recruited) median age was 31 years, 97% were men,
4.4% identifying as lesbian, gay or bisexual (LGB), 17% had ever been imprisoned, and
5.7% had ever injected a psychoactive drug. Overall, 31% had ever been tested for HCV (for
60% their most recent test was during 2014-16). Testing was associated with identifying as
LGB (AOR=5.9, 95%CI 2.5-14); ever injecting a psychoactive drug (AOR=2.2, 95%CI 1.03-
5.0); NSP recruitment (AOR=3.1, 95%CI 2.0-4.7); injecting peptide-hormones and allied
drugs (AOR=2.0 95%CI 1.4-2.9); and ever imprisonment (AOR=2.2, 95%CI 1.4-3.6). Of
those never tested, 50% had used a health service during the preceding year where they
could have been tested (41% had used primary care). Overall, 14% had ever shared a drugs
vial (10% NSP recruited vs. 16% community recruited, p=0.084).
Conclusion:
Majority are untested, with testing associated with other risks: injecting psychoactive drugs
and imprisonment. Previous studies of this group have focused recruitment on NSPs,
potentially over-estimating testing uptake and the proportion aware of their HCV status.
Targeted HCV testing interventions, focused on those not using NSPs, or without a history of
psychoactive drug injection or imprisonment, are needed for those injecting IPEDs.
Disclosure of Interest Statement:
We have no disclosures.