Individual and network factors associated with prevalent hepatitis C infection among rural Appalachian injection drug users.
Individual and network factors associated with prevalent hepatitis C infection among rural Appalachian injection drug users.
复制标题
DOI：
10.2105/ajph.2012.300874
复制
发表时间：
2013-01-01
影响因子：
12.7
通讯作者：
Crosby, Richard A
中科院分区：
文献类型：
--
作者：
Havens, Jennifer R;Lofwall, Michelle R;Crosby, Richard A
目的：我们确定了阿巴拉契亚山区吸毒者中与丙型肝炎 (HCV) 感染相关的因素。方法：本研究纳入了 394 名注射吸毒者 (IDU)，他们参与了肯塔基州阿巴拉契亚地区社交网络和传染病风险的研究。经过培训的工作人员进行了 HCV、HIV 和单纯疱疹 2 病毒 (HSV-2) 检测，并通过访谈者填写的问卷测量了自我报告的危险行为和社会计量网络特征。结果：农村注射吸毒者中 HCV 感染率为 54.6%。与 HCV 感染独立相关的终生因素包括 HSV-2、注射 5 年或以上、创伤后应激障碍、注射可卡因和注射处方阿片类药物。最近（过去 6 个月）HCV 感染的相关性包括共用注射器（调整后比值比 = 2.24；95% 置信区间 = 1.32、3.82）以及药物网络中更高水平的特征向量中心性。 结论：出现了一个可能是农村注射吸毒者所独有的因素：注射处方阿片类药物与 HCV 感染之间的关联。因此，防止向注射过渡，特别是在处方阿片类药物使用者中，可能会遏制传播，同时也会增加获得阿片类药物维持治疗、可卡因依赖的新疗法和注射器更换的机会。
OBJECTIVES: We determined the factors associated with hepatitis C (HCV) infection among rural Appalachian drug users.METHODS: This study included 394 injection drug users (IDUs) participating in a study of social networks and infectious disease risk in Appalachian Kentucky. Trained staff conducted HCV, HIV, and herpes simplex-2 virus (HSV-2) testing, and an interviewer-administered questionnaire measured self-reported risk behaviors and sociometric network characteristics.RESULTS: The prevalence of HCV infection was 54.6% among rural IDUs. Lifetime factors independently associated with HCV infection included HSV-2, injecting for 5 or more years, posttraumatic stress disorder, injection of cocaine, and injection of prescription opioids. Recent (past-6-month) correlates of HCV infection included sharing of syringes (adjusted odds ratio = 2.24; 95% confidence interval = 1.32, 3.82) and greater levels of eigenvector centrality in the drug network.CONCLUSIONS: One factor emerged that was potentially unique to rural IDUs: the association between injection of prescription opioids and HCV infection. Therefore, preventing transition to injection, especially among prescription opioid users, may curb transmission, as will increased access to opioid maintenance treatment, novel treatments for cocaine dependence, and syringe exchange.