Psychosocial predictors of risk of hepatitis C (HCV) reinfection in people who inject drugs on HCV treatment.

Author: Malaguti A, Sani F, Eriksen A, Power K, Dillon JF

Theme: Epidemiology & Public Health Research Year: 2019

Background: The risk of HCV reinfection in people who inject drugs (PWID) treated for HCV remains
high when sharing of injecting equipment continues to occur post-treatment. Literature suggests
psychosocial factors influence injecting risk behaviour, whilst social identity isolation is linked to
poor physical and mental health. This study investigates the role of psychosocial factors on risk
behaviour during HCV treatment.
Methods: This cross-sectional pilot study included 36 participants on treatment for HCV. Correlation
analyses informed the association of group identification, mental health and illness perception with
sharing injecting equipment. A multiple regression tested the model under investigation. Only
factors with a strong correlation to sharing behaviour were included.
Results: Participants injected 8.44 (mean; SE=1.63) times weekly. 72.2% were male, average age
37.8y (SE=1.19). When asked about sharing injecting equipment in the past 4-weeks, 19.4% reported
sharing with 1 or 2 people. Subsequently, asked about sharing specific injecting paraphernalia, 36.1%
reported sharing with between 1 and 4 people. A ceiling effect was observed for mental health
The regression model was a good fit for the data, F(3,26)=11.48, p<.001. Group identification with drug network (β= -0.06, p=0.07) and injecting frequency (β= -0.02, p=0.05) were the only baseline predictors used in the model and both approached significance level. The model explained 25% (R2 ) of variance in sharing behaviour. Conclusion: Reducing injecting risk behaviour in PWID is essential to improve HCV treatment costeffectiveness. Identification with a social group, usually associated with improved health, may pose health risks depending on the type of group identification. Interventions on social networks are recommended to influence sharing of injecting equipment. The results suggest a need to ask specific equipment questions when asking PWID about sharing behaviour. Recruitment is ongoing in order to increase the sample size and strengthen the power of the results. Disclosure of Interest Statement AM, FS, AE & KP declare no conflict of interest. JFD has received honoraria for lectures and research grants from Janssen-Cilag, Roche, Merck Sharp & Dohme, AbbVie, Bristol-Myers Squibb and Gilead Sciences

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