Prevalence Rates of HIV and HCV and Correlates of HCV Infection Among Young Opioid Injectors in New York City

Aim: To document the prevalence rates of HIV and hepatitis C virus (HCV) and examine risk factors associated with HCV infection among young opioid injectors, most of whom transitioned from oral use of prescription opioids to heroin injection.

Methods: New York City young adults (N=459) were recruited via respondent-driven sampling for an ongoing epidemiological survey to assess drug use patterns, overdose experiences and HCV and HIV prevalence.  Eligible participants were ages 18-29 and had used POs nonmedically and/or heroin in the past 30 days.   Participants were tested on-site for HIV and HCV antibodies.  This analysis is restricted to the 63% (291/459) of the total sample who reported at least one month of regular heroin injection (“regular” defined as having injected 3 or more times a week). Correlates of HCV positive status were examined in SPSS with t-tests for continuous variables and chi-square for categorical variables

Results: Participants were 35% female, 19% Latino, 81% White and 14% other races (mean age=24.4 years). Regarding education, 19% did not complete high school, 38% received a high school diploma/GED and 42% attended or graduated college.  Thirty-three percent tested positive for HCV antibodies; .7% tested positive for HIV. HCV prevalence by years of regular heroin injection is as follows: up to 1 year: 16%; 2 years: 28%; 3 years: 34%; 4 years: 28 %; 5 years 54%.  The following variables were significantly associated with HCV-positive status at p ≤ .01 (unless indicated otherwise): household income while growing up (p=.018); younger age when first injected drugs; ever homeless (lifetime); injecting with a syringe used by someone else in the past 12 months (p=.016); having ever injected prescription opioids (lifetime); sharing syringes and cookers with a greater number of people in the past 12 months; having ever overdosed (lifetime); using crack regularly; using ketamine regularly; using speedballs regularly (3 or more times a week for at least one month); older age of person who injected the participant for the first time (p=.013); having injected drugs with more people in the past 3 months ( p=.015); encouraging fellow users to get tested for HCV (p=.002); telling fellow users that injection is a risk factor for HCV.

Conclusions: Drug injection among young opioid users in New York City carries a serious risk of HCV infection. HCV is widespread among them, and HIV may spread. There is a pressing need to develop innovative prevention programs to help young PO-initiated injectors to engage in safe injection practices to avoid blood-born infections.

Supported by NIDA grant# R01DA035146