People Who Inject Drugs Have Inequitable Chance To Be HCV Tested

Author: Novak I., Sazonova I., Dumchev K.

Theme: Epidemiology & Public Health Research Year: 2018

Background There is no HCV medical record system in Ukraine. The reliable data on HCV testing is available for subpopulations such as program data for clients of harm reduction programs, surveillance studies for key populations and medical records for people living with HIV (PLHIV). People who inject drugs (PWID) have the highest HCV prevalence according to bio-behavioral survey (63,9%). We measured HCV prevalence among HIV patients (and particularly among PWID) and examined factors associated with (1) being HCV tested and (2) HCV positive test result. Methods We extracted the data from medical records system used in 18 regions of Ukraine in HIV clinics for patients diagnosed with HIV in 2010-2014 (27829 patients). We used multivariate logistic regression to measure the factors associated with (1) being HCV tested and (2) HCV positive test result. Predictors included in the model: sex, age, mode of HIV transmission, year of linkage to HIV care. The analysis was performed in SPSS. Results The coverage with HCV testing among HIV patients is 48,9%. HCV prevalence among those who was tested is 57%. Patients with suspected heterosexual HIV transmission had 27% of HCV positive results; men who have sex with men (MSM) – 13,2%; PWID – 86,5%. According to logistic regression, PWID have higher odds to have HCV positive results (AOR 15,33; 95% CI: 13.6-17.2). However, PWID have lower odds to be HCV tested comparing to HIV patients with heterosexual HIV transmission (AOR 0.84; 95%CI: 0.79-0.89). Conclusions Despite PWID have the highest HCV prevalence comparing to other HCV key populations, they have been tested in HIV medical facilities less often than others. Since HCV and HIV have the shared modes of transmission, HIV medical providers should scale up HCV testing for HIV patients with the suspected parenteral mode of transmission. National public health program should support integrated HCV/HIV services. Disclosure of Interest Statement: Iuliia Novak and co-authors don’t have conflicts of interest to present this data.

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