Recorded presentation

Steffanie A. Strathdee, PhD, Division of International Health and Cross Cultural Medicine, University of California, San Diego, 9500 Gilman Drive, Ash Building, La Jolla, CA 92093-0622, Holly Hagan, PhD, NDRI, 71 West 23rd, 8th floor, New York, NY 10010, David Vlahov, PhD, Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, Sharon M. Hudson, PhD, Health Research Association, 1111 N. Las Palmas Avenue, Hollywood, CA 90038, SL Bailey, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, 2121 W. Taylor, Chicago, IL 60612, Peter O'Driscoll, MS, Epidemiology, Johns Hopkins School of Public health, 615 N. Wolfe Street, baltimore, MD 21205, and Richard Garfein, PhD, Division of HIV/AIDS Prevention, Centers for Disease Control, 1600 Clifton Road, MS E-45, Atlanta, GA 30333, 404-639-6175, rlg6@cdc.gov.

Background: The opportunity to prevent blood-borne viral infections among injection drug users (IDUs) – particularly hepatitis C virus (HCV) – is assumed brief and new injectors may be at elevated risk. We examined HIV, HCV and HBV prevalence in relation to duration of drug injection in a cross-sectional sample of young IDUs in 5 US cities.

Methods: IDUs aged 15-30 years who had injected >once in the past 6 months were recruited for a risk behavior interview and serologic testing for antibodies to HIV, HCV, and HBV.

Results: To date, of 2806 IDUs, 64% were white, 70% male. Median age and age at first injection was 23 and 19; 40% injected daily; 28% injected 4+ times/day; 44% reported recent receptive syringe sharing. Prevalence increased steadily in relation to duration of injection: HCV-prevalence was 15% (injecting 2 years), 28% (4 yrs), 32% (6 yrs) and 54% (10 yrs); HBV-prevalence was 13% (2 yrs), 18% (4 yrs), 23% (6 yrs) and 36% (10 yrs). HIV increased slowly: 1%, 2%, 3% and 6%, respectively. Among those injecting 4+ times/day, HCV-prevalence >1 year of injection was 15% vs. 4% in less frequent injectors.

Conclusion: Despite frequent syringe-sharing, HCV prevalence was relatively low several years after onset of injection. A subgroup of frequent injectors acquired HCV (but not HIV) infection sooner than others, suggesting that individual behaviors and lower prevalence of these viral infections in one’s social networks may be protective. Vaccination in new injectors and in those at risk of initiating injection may prevent acquisition of HBV.

Learning Objectives:

• To understand the relationship between injection drug use duration and acquisition of HIV, HCV and HBV.
• To understand risk factors for acquisition of blood borne infections among young drug users.

Keywords: Drug Injectors, Adolescents

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.

Recorded presentation