Background: Surveys of the prevalence of hepatitis C viral (HCV) infection in drug users have reported high prevalence rates (30% to 80%), which have been attributed to injecting use and the sharing of injection equipment.
Objectives: To examine predictors of injecting and sharing (direct and indirect) of injecting equipment in injecting drug users (IDUs) who participated in a randomized clinical trial of the effectiveness of enhanced prevention counseling in comparison with simple educational counseling in reducing HCV infection in seronegative IDU.
Methods: All HCV seronegative IDUs who participated in the randomized clinical trial and had taken part in the 12-month follow-up assessment of their HCV status were included. Statistical analyses were conducted to examine the differences in demographic characteristics and measures on the Injecting Risk Questionnaire at baseline, so as to identify any behaviors that may predict seroconversion. Binary logistic regression was conducted on the potential predictors of injecting status at 6-month follow-up.
Results: Eight out of 95 participants were seroconverted to HCV at 12-month follow-up, a seroconversion rate of 9.1 per 100 person-years. Of the sample, 12.9% reported direct sharing in the past 4 weeks, and this increased to 35.5% when participants were asked in the past 6 months. For indirect sharing practices, 27.4% and 64.5% of the sample reported indirect sharing practices in the past 4 weeks and 6 months, respectively. Those participants who seroconverted engaged in significantly higher levels of indirect sharing behavior in the past 4 weeks (P<0.05) than the nonseroconverters. Binary logistic regression analysis showed the Drug Injecting Confidence Questionnaire overall score and Addiction Severity Index-job satisfaction baseline scores to be significant predictors.
Conclusions: This study provides evidence of behaviors that can lead to the transmission of HCV and also factors that can reduce the likelihood of injecting. These findings have implications for the introduction of specific interventions for minimizing the risks for contracting HCV infection in drug users.