Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort

Tracy, Daniel; Hahn, Judith A.; Lewis, Crystal Fuller; Evans, Jennifer L.; Briceño, Alya; Morris, Meghan D.; Lum, Paula J.; Page, Kimberly

doi:10.1136/bmjopen-2014-004988

Cited by 63 publications

(48 citation statements)

References 34 publications

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“…A number of studies conducted among young PWID have reported female gender as an independent predictor of exposure to HIV and/or HCV 22–24 . Prospective cohort studies that have included recruitment of young WWID have documented HIV incidence of 5.3 per 100 person years (PY) 25 and high HCV incidence in the 35–42 per 100 PY range 26,27 among this population.…”

Section: Hiv and Hepatitis C Virus Infectionmentioning

confidence: 99%

“…WWID are more likely to have a sexual partner who injects drugs, more likely to be initiated into injection drug use by male sex partners and more likely to be injected by others, including male partners 20,28 . Further, women whose injecting partner is also a sexual partner have an elevated risk of incident HCV infection compared to women and men without overlapping partnerships 24,29 .…”

Section: Hiv and Hepatitis C Virus Infectionmentioning

confidence: 99%

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HIV, HCV, and Health-Related Harms Among Women Who Inject Drugs

Iversen¹,

Page

Madden

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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143

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Introduction While an estimated 3.5 million women inject drugs globally, women are outnumbered four to one by men who inject drugs and are often ignored or overlooked in the development and delivery of prevention and treatment services for this population. The current study aimed to identify key comorbidities prevalent among women who inject drugs (WWID), consider factors that contribute to vulnerability of this population and examine implications for prevention and treatment. Methods The literature was reviewed to examine the specific challenges and needs of WWID. We searched health-related bibliographic databases and grey literature to identify studies conducted among WWID, studies conducted among people who inject drugs (PWID) where results were disaggregated by gender and policies/guidelines/reports relevant to WWID. Results WWID face a range of unique, gender-specific and often additional challenges and barriers. The lack of a targeted focus on WWID by prevention and treatment services and harm reduction programs increases women’s vulnerability to a range of health-related harms including blood borne viral and sexually transmitted infections, injection-related injuries, mental health issues, physical and sexual violence, poor sexual and reproductive health, issues in relation to child bearing and child care and pervasive stigma and discrimination. Conclusions There is a need to improve the collection and reporting of gender-disaggregated data on prevalence of key infections and prevention and treatment service access and program coverage. Women-focussed services and integrating gender equity and human rights into the harm reduction programming is a prerequisite if improvements in the health, safety and well-being of this often invisible and highly vulnerable population are to be achieved.

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Section: Hiv and Hepatitis C Virus Infectionmentioning

confidence: 99%

Section: Hiv and Hepatitis C Virus Infectionmentioning

confidence: 99%

HIV, HCV, and Health-Related Harms Among Women Who Inject Drugs

Iversen¹,

Page

Madden

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

143

View full text Add to dashboard Cite

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“…Young women who inject drugs (WWID) experience higher rates of both HIV and hepatitis C virus (HCV) infection compared to their male counterparts (Des Jarlais, Feelemyer, Modi, Arasteh, & Hagan, 2012; Esmaeili et al, 2017; Miller et al, 2002; Tracy et al, 2014). Compared to men, WWID are more likely to have overlapping sexual and drug use networks, thus placing the mat higher risk for sexually transmitted and blood-transmitted infections (Bourgois, Prince, & Moss, 2004; Latkin, Forman, Knowlton, & Sherman, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…WWID are also more likely to have a sexual partner who injects drugs and more often report being injected by their partner compared to men who inject drugs (Choi, Cheung, & Chen, 2006; Evans et al, 2003; Frajzyngier, Neaigus, Gyarmathy, Miller, & Friedman, 2007; Montgomery et al, 2002). Additionally, WWID in close relationships, such as sexual relationship or who live with their injecting partner are at greater risk for risky injecting behaviors and experience higher incidence of hepatitis C virus than those not in close injecting relationships (Morris et al, 2014; Tracy et al, 2014). Ethnographic reports of victimization, marginalization, and resource scarcity demonstrate the “everyday violence” WWID experience resulting in high vulnerability to HIV and HCV in young WWID (Scheper-Hughes & Bourgois, 2003).…”

Section: Introductionmentioning

confidence: 99%

A Study of Sexual Relationship Power among Young Women Who Inject Drugs and Their Sexual Partners

Morris

Montgomery

Briceño

et al. 2017

Substance Use & Misuse

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Background To date, research applying the Sexual Relationship Power Scale (SRPS) has been limited to sexual risk behaviors. Objective We measured levels of sexual relationship power and examined associations between sexual relationship power and injecting and sexual behaviors that place women at increased risk for blood borne infections. Methods Using data from a cross-sectional study of young women who inject drugs (WWID) in San Francisco, USA, logistic regression analysis identified independent associations between SRPS and subscale scores (relationship control [RC] and decision making dominance [DMD]) and injecting and sexual behaviors. Results Of the 68 young WWID, 24 (34%) reported receptive syringe sharing, 38 (56%) reused/shared a cooker to prepare drugs, and 25 (37%) injected someone else’s drug residue during the three-months prior to enrollment. Most (60, 88%) reported condomless sex with main sex-partner, 8 (12%) reported transactional sex, and 36 (53%) had two or more recent sex partners. The median SRPS score was 2.98 (IQR: 2.65, 3.18), 3.23 (IQR: 3.23, 3.57) for RC and 2.40 (IQR: 2.20, 2.60) for DMD. No significant associations were detected between SRPS or DMD and injecting or sexual risk behaviors. After adjusting for gender and years injecting, for every one-point increase in RC, women had a 6.70 lower odds of recent condomless sex (95% CI: 0.92, 50.00, p = 0.06), and a 3.90 lower odds of recent transactional sex (95%CI: 1.22, 12.50, p = 0.02). Conclusion Our study findings suggest that some components of sexual relationship power may play a role in sexual risk, but not in injecting risk.

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“…WWID report higher rates than men for both injecting and sexual HIV risk behaviors (10–12). Thus, the risk of infection with blood-borne viruses including HIV and HCV is likely increased among WWID (1, 12, 44). …”

Section: Introductionmentioning

confidence: 99%

Biomedical HIV Prevention Including Pre-exposure Prophylaxis and Opiate Agonist Therapy for Women Who Inject Drugs

Page

Tsui

Maher³

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Women who inject drugs are at higher risk of HIV compared to their male counterparts as a result of multiple factors including biological, behavioral and socio-structural, yet comparatively little effort has been invested in testing and delivering prevention methods that directly target this group. In this paper, we discuss the need for expanded prevention interventions for women who inject drugs, focusing on two safe, effective, and approved, yet underutilized biomedical prevention methods: opiate agonist therapy (OAT) and oral pre-exposure prophylaxis (PrEP). While both interventions are well researched they have not been well examined in the context of gender. We discuss the drivers of women injectors’ higher HIV risk, review the effectiveness of OAT and PrEP interventions among women, and explain why these new HIV prevention tools should be prioritized for women who inject drugs. There is substantial potential for impact of OAT and PrEP programs for women who inject drugs in the context of broader gender-responsive HIV prevention initiatives. While awaiting efficacy data on other biomedical approaches in the HIV prevention research ‘pipeline’, we propose that the scale up and implementation of these proven, safe, and effective interventions are needed now.

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Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort

Cited by 63 publications

References 34 publications

HIV, HCV, and Health-Related Harms Among Women Who Inject Drugs

HIV, HCV, and Health-Related Harms Among Women Who Inject Drugs

A Study of Sexual Relationship Power among Young Women Who Inject Drugs and Their Sexual Partners

Biomedical HIV Prevention Including Pre-exposure Prophylaxis and Opiate Agonist Therapy for Women Who Inject Drugs

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