High Prevalence and Incidence of HIV and HCV among New Injecting Drug Users with a Large Proportion of Migrants - Is Prevention Failing?

OBJECTIVES:

The aim of this study was to assess differences in the prevalence of HIV and HCV infection and associated risk factors between new (injecting for ≤5 years) and long-term injectors and to estimate HIV/HCV incidence among new injectors.

METHODS:

Cross-sectional study among people who inject drugs (PWID) who attended harm reduction centers in Catalonia in 2010-11. Anonymous questionnaires and oral fluid samples were collected. Poisson regression models were applied to determine the association between HIV/HCV infection and risk factors.

RESULTS:

Of the 761 participants, 21.4% were new injectors. New injectors were younger than long-term injectors (mean age = 31.6 vs. 37.8) and were more likely to be immigrants (59.0% vs. 33.4%). HIV and HCV prevalence was 20.6% and 59.4% among new injectors, and estimated HIV and HCV incidence 8.7 and 25.1 /100 person-years, respectively. Among new injectors, HIV infection was associated with homelessness and reporting a previous sexually transmitted infection. Reporting front/backloading and daily injection were risk-factors for HCV infection. For long-term injectors, HIV risk factors were: having shared syringes, having injected cocaine, reporting front/backloading and ever having been in prison.

CONCLUSION:

A large proportion of PWID in Catalonia are new injectors, a subgroup with a high level of both sexual and parenteral exposure and a high incidence rate of HIV/ HCV infections. It is important to improve early diagnosis of these infections among this group, in particular among migrants. To identify and address risk factors for homelessness PWID should be a priority.

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By:  Folch C1,2,3, Casabona J1,2,3,4, Espelt A2,5,6, Majó X7, Meroño M8, Gonzalez V1,2,9, Wiessing L10, Colom J7, Brugal MT2,5; REDAN Study Group.

• 1a Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agéncia de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya , Badalona , Spain.
• 2b CIBER Epidemiología y Salud Pública (CIBERESP) , Spain.
• 3c Fundació Institut d'Investigació Germans Trias i Pujol (IGTP) , Badalona , Spain.
• 4d Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Pública, Facultat de Medicina, Universitat Autònoma de Barcelona , Bellaterra (Cerdanyola del Vallés) , Spain.
• 5e Agéncia de Salut Pública de Barcelona , Spain.
• 6f Departament de Psicologia i Metodologia de les Ciéncies de la Salut, Universitat Autònoma de Barcelona , Bellaterra (Cerdanyola del Vallés) , Spain.
• 7g Subdirecció General de Drogodependéncies, Agéncia Salut Pública de Catalunya (ASPC), Departament de Salut de la Generalitat de Catalunya.
• 8h Ámbit Prevenció , Barcelona , Spain.
• 9i Microbiology Service, Hospital Universitari Germans Trias i Pujol , Badalona , Spain.
• 10j European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) , Lisbon , Portugal.
• Subst Use Misuse. 2016 Jan 28:1-11. 

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