Association between Hepatitis C Virus knowledge and drug use risk behaviors among people who inject drugs, Ciudad Juárez, Chihuahua, 2012
BACKGROUND: Needle sharing during injection drug use is the most common mode of transmission for the Hepatitis C Virus (HCV) in the U.S. The scientific literature on the relationship between knowledge and risk behaviors for HCV transmission among people who inject drugs (PWID) is minimal. Evidence-based and harm reduction programs (e.g., needle exchange programs; reducing needle and works sharing) exist to reduce the risks of HCV and other blood-borne pathogens, however these programs are not widely available. Solutions to reduce HCV transmission in the general population involve changes at the individual level as well as at the policy level. On the U.S.-Mexico border region, where drug trafficking, violence, and other structural factors have led to an increase in local drug consumption, residents are vulnerable for injection drug use, works and needle sharing, and thus HCV. AIMS: The study aims are to determine the: (1) level of HCV knowledge; (2) prevalence of HCV risk behaviors including needle and works sharing; and (3) association between HCV knowledge measures and HCV risk behaviors among HCV PWID living in Cd. Juárez, CHIH. METHODS: This study is a secondary data analysis from a cross-sectional study conducted in collaboration with Programa Compañeros, A.C. to assess the prevalence of HCV and HIV and risk behaviors among PWID and their non-injecting sex partners. Face to face interviews were conducted between March - May 2012. Measures collected include socio-demographic characteristics, drug use, needle and works sharing, HCV knowledge, and other HCV risk behaviors among 48 PWID who were HCV positive and living in Cd. Juárez. There are five outcome measures for HCV transmission risk behaviors: 1) injecting with others; 2) receptive syringe sharing; 3) receptive works sharing; 4) use of bleach water to clean the syringes; and 5) use of used water to clean syringes. The association between the HCV transmission risk behaviors (binary outcomes) and knowledge of HCV transmission and other measures will be determined using the Pearson Chi-Square Tests for categorical variables, t-tests for continuous variables, and non-parametric equivalent tests as needed. RESULTS: Overall, this was a sample of 48 PWID who were HCV reactive were primarily males (68.8%) with mean age 38 years of age, and injected an average of 65 times per month. The only factor statistically significantly associated with injecting with others was the belief in that they were at risk for becoming infected with HCV (p-value=0.027). For receptive syringe sharing, there were significant differences in frequency of distributive needle sharing after injecting (p-value=0.010); the mean number of new syringes used (p-value=0.031); the percent of new syringes used (p-value=0.011); the frequency of injection partner using rinse water or liquids to clean syringe by injection partner (p-value=0.010); and injection drug use in jail (p-value=0.048). The factors statistically significantly associated with the use of used bleach water to clean syringe were the use of used water by injection partner (reduce risk to others) (p-value=0.008) and the belief that someone can still be infected with HCV even though they don't have yellow skin or eyeballs (p-value=0.029). The use of used water to clean syringe before use is statistically significantly different for partners use of same rinse or liquids to clean the syringe (p-value=0.003) and the belief that a person who has HCV is also be at risk for HIV (p-value=0.034). DISCUSSION: Study findings indicate there are no significant associations between the HCV risk behavior outcomes and HCV transmission knowledge measures. However, there was indication that harm reduction messages have reached certain populations based on their needle sharing behaviors. In addition to the ongoing needle sharing HCV risk reduction and harm reduction efforts, there is a need to increase the emphasis on the risks of works sharing and address the structural factors, such as the lack of evidence based policy, that are fueling the epidemic.
Behavioral psychology|Public health|Criminology
Morgan, Leah Nicole, "Association between Hepatitis C Virus knowledge and drug use risk behaviors among people who inject drugs, Ciudad Juárez, Chihuahua, 2012" (2014). ETD Collection for University of Texas, El Paso. AAI1564689.