Traveling young injection drug users at high risk for acquisition and transmission of viral infections

Abstract

Background: Young injection drug users (IDU) are highly mobile. It is not known how mobility affects their risk of acquiring and transmitting viral infections. Methods:We conducted a cross-sectional study of young (under age 30) IDU in San Francisco (2004)(2005)(2006). Participants completed a semi-structured interview and testing for hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV infection. We examined whether travel was independently associated with drug, alcohol, sexual risk behaviors, and infection status, after adjusting for demographic characteristics and years injecting.Results: Two-thirds (62%) reported past (3 months) travel outside of San Francisco (n=355). Travelers, as compared to non-travelers, were more likely to be under age 20, female, and planned to leave San Francisco in the coming months. Travel was independently associated with heavy alcohol consumption, drinking alcohol until blackout, poly-substance use, more sexual and injecting partners, and receptive needle/syringe sharing, sharing drug preparation equipment, backloading syringes, and pooling money to buy drugs. In an analysis of interactions with travel, younger travelers were more likely to be HCV positive than younger non-travelers.Discussion: Traveling young IDU are at exceptionally high risk for acquiring and transmitting viral infections, while their mobility makes it challenging to effectively deliver interventions.

Review and meta-analysis of the association between self-reported sharing of needles/syringes and hepatitis C virus prevalence and incidence among people who inject drugs in Europe

“…Morissette, 2008; Thibault, Bara, Nefau, & Duplessy-Garson, 2011), and backloading or frontloading (using a N/S to prepare and divide drugs between other N/S) (Hahn, Page-Shafer, Ford, Paciorek, & Lum, 2008;Jose et al, 1993;Maher, Li, Jalaludin, Chant, & Kaldor, 2007;Platt et al, 2009). Many studies have investigated the association between sharing N/S and HCV but, despite this, only one study has reviewed/meta-analysed this association .…”

Predictors of Alcohol Use Among Rural Drug Users After.Disclosure of Hepatitis C Virus Status

“…In two independent studies, greater than 37% of young IDUs engaged in heavy or problem drinking (Campbell et al, 2006;Hahn et al, 2008), a troubling association given that alcohol increases the risk of initial HCV exposure progressing to chronic disease (Piasecki et al, 2004;Thomas et al, 2000). This is especially pertinent among IDUs, who already face elevated risk of chronic HCV infection.…”

HCV Infection Prevalence Lower Than Expected among 18–40-Year-Old Injection Drug Users in San Diego, CA

“…[1][2][3][4][5][6][7] Older age and longer injecting duration could account for the higher upper bounds of these estimates; however, two U.S. studies 8,9 reported finding 33 and 36 % of IDUs under 25 years old were HCV infected and several non-U.S. studies found a much higher prevalence even among IDUs in this age group. 10 In 2007, 48 % of individuals with incident HCV in the U.S. reported injection drug use, which continues to be the leading risk factor for infection.…”