Knowledge of status and assessment of personal health consequences with hepatitis C are not enough to change risk behaviour among injecting drug users in Stockholm County, Sweden

Abstract

This was a multicentre study with risk perception as the theoretical framework, investigating if risk behaviours change when injecting drug users (IDUs) are aware of their hepatitis C virus (HCV) status and had assessed the health consequences with HCV infection. Two hundred and thirteen participants aged 15-40 y were analysed. Sharing of needles and of other injecting equipment were common both among participants who reported HCV-positive status (74%, 95% confidence interval (CI) 65.3-80.1%) and among those who reported HCV status unknown (68%, 95% CI 56.0-78.4%). Participants associating very severe health consequences with HCV infection and those who did not know of any health consequences with HCV infection shared needles at almost the same rate (78%, 95% CI 62.5-87.7 vs 69%, 95% CI 8.0-78.9, respectively). Sharing of other injecting equipment was most common among participants with verified HCV-positive status (adjusted risk ratio 5.64, 95% CI 2.64-12.07). Knowledge of HCV status and assessment of health consequences with HCV infection were not enough to change injecting risk behaviours. Sharing of other injecting equipment was a more important risk factor than sharing needles for participants with verified HCV-positive status. It is suggested that professionals engage IDUs in risk analysis and open a dialogue about assessment in order to identify, quantify and characterize risks.

High-risk behaviors after release from incarceration among people who inject drugs in St. Petersburg, Russia

“…While incarceration is often a setting where inmates can learn of their disease status, previous studies in the US, Canada, and Scandinavia suggest that risky injection behaviors may not change after a positive diagnosis for viral hepatitis (Hagan et al, 2006; Kwiatkowski et al, 2002; Norden et al, 2009; Ompad et al, 2002) or increase after becoming aware of one’s disease status (Vidal-Trecan et al, 2000). The findings on injection behaviors following HIV diagnosis are less clear, with conflicting reports of no change or risk reductions (Brogly et al, 2002) and persistence of injection-related risk behaviors after receipt of a positive HIV diagnosis (Metsch et al, 1998).…”

Preference, acceptability and implications of the rapid hepatitis C screening test among high-risk young people who inject drugs

“…Some studies suggest that PWID who know their serostatus may reduce some high-risk injection-related behaviors [25-27], however others have not observed this [22,24,28]. Young PWID may also engage in seroadaptive practices, based on their perception of their partners’ HCV status [18,29], although others have not observed this [22,24,28,30,31]. Finally, identifying HCV infections among PWID is critical for ensuring referrals to appropriate care and treatment.…”

Injection behaviors among injection drug users in treatment: The role of hepatitis C awareness

“…HCV-aware IDUs may also “sero-sort,” or preferentially engage in risky injection behaviors with others they know to be similarly HCV-infected (Burt, Thiede, & Hagan, 2009). Other studies, however, suggest that HCV awareness is insufficient to change injection risk behaviors (Norden, et al, 2009). Little is known about the influence of HCV awareness on IDUs engaged in substance use treatment—information that might improve HCV prevention services in addiction treatment settings.…”