Juan C. Reyes, EdD¹, Rafaela R. Robles, EdD¹, Héctor M. Colón, PhD¹, C. Amalia Marrero, MPH¹, Eddy Rios, PhD, MPH², Tomás D. Matos, MS¹, José M. Calderón, MS¹, and Elizabeth W. Shepard, PA-C, MPH¹. (1) Center for Addiction Studies, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamón, PR 00960-6032, 787-288-0200, jcreyes@uccaribe.edu, (2) Internal Medicine Department, Retrovirus Research Center, Universidad Central del Caribe, Call Box 60327, Bayamón, PR 00960-6032

Background: Injection drug users (IDUs) worldwide are at high risk for hepatitis C virus (HCV) infection. This study aimed to estimate HCV seroprevalence and identify risk factors associated with HCV infection among IDUs in Puerto Rico. Methods: The sample was drawn from a target population of injection drug users not in treatment, living in the San Juan metropolitan area of Puerto Rico. A total of 400 IDUs were recruited using a variety of outreach strategies. HCV and HIV infection were detected by enzyme-linked immunosorbent assay and/or polymerase chain reaction. Information on sociodemographics, drug use patterns, and risk behaviors was obtained by interview. Bivariate analysis and logistic regression were used in the analysis. Results: The sample was predominantly male (77.8%) and over one-third of subjects were age 25 to 34 years old (39%). The overall prevalence of HCV infection was 89%. Among HCV-infected subjects, almost 15%were co-infected with HIV. After controlling for sociodemographic characteristics, HCV infection was positively associated with increasing years of injection, needle sharing, injecting in a shooting gallery, and self-reported STD infection (herpes simplex virus, syphilis, and gonorrhea). Notably, body piercing or tattooing in prison was the most important risk factor associated with HCV infection (OR=4.1, 95%CI=1.5, 10.9). Conclusions: Results of this study indicate that more aggressive educational programs are urgently needed to reduce the spread of HCV infection among IDUs in Puerto Rico, especially in the incarcerated population.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe the prevalence of HCV infection and HIV-HCV co-infection among street-recruited injection drug users in Puerto Rico, and compare with other populations.
• Identify risk factors associated with HCV infection among injection drug users in Puerto Rico.
• Discuss three implications of these findings for drug use prevention and treatment programs.

Keywords: Hepatitis C, Injection Drug Users

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.