High Burden of Blood-Borne Viral Infections (HCV, HIV, HBV) and Sexually Transmitted Infections Among People Experiencing Homelessness – First Results From a Pilot Study in Berlin, Germany


Author: Christoph Weber Navina Sarma Gyde Steffen Caoimhe Cawley Astrid Leicht Sascha Heidrich Katja Kajikhina Claudia Hövener Klaus Jansen Stefan Kröger Ruth Zimmermann Viviane Bremer Klaus

Theme: Epidemiology & Public Health Research Year: 2022

Background:
People experiencing homelessness (PEH) are at increased risk of infection with blood-borne viral
infections (BBV) and sexually transmitted infections (STI), due to precarious living conditions and
associated risk factors (e.g. drug/alcohol use, sexual risk behavior, incarceration). In Germany, there
are app. 417.000 PEH, however, there is little data available on the burden of these infections
among this group. We conducted a pilot study in Berlin in order to assess prevalence of BBV and STI
in this population.
Methods:
A multicentre cross-sectional pilot study was conducted between April and June 2021. Data were
collected by means of a questionnaire-based interview, serological testing for HIV, hepatitis B,
hepatitis C (if seropositive corresponding RNA determinations) and syphilis and Nucleic Acid
Amplification Tests (NAAT) from urine for gonococcal and chlamydia.
Results:
216 participants were included in the analysis. Mean age: 41 years (range 19-68). Male: 191 (88.4 %),
female: 24 (11.5 %) and gender diverse: 1 (0.5 %). 57 (26.8 %) participants were born in Germany.
Reported homelessness <1 year was 29.4 %, for about 1-5 years: 42.5 %, more than 6 to over 10
years: 27.1 %. Drug use: 154 (71.6%) and 153 (71.5 %) were at least once incarcerated. 123 (56.9 %)
had no health insurance. HCV-RNA was found in 34 (16.0%), 4 (1.9%) were HBsAg positive. HIV was
detected in 6 (2.8%). Active syphilis was found in 3 (1.4%), while gonococcal infections were seen in
4 (2,0%) and chlamydial infections in 6 (3,0%).
Conclusion:
PEH in Berlin have a high prevalence of BBV and STI. There is a need to improve awareness, access to
treatment and care for this population and to include them in national elimination strategies for
HCV, HBV and HIV. As more data is needed, a nationwide expansion of the POINT study is planned.
Disclosure of Interest Statement:
None

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