Hepatitis C Virus Infection Among Young People Who Inject Drugs in Colombia: Prevalence, Demographics and Injection Risk Correlates.

Background: Latin America accounts for one of the largest populations of people who inject drugs (PWID) in the world, with Colombia reporting one of the fastest growing populations of young PWID in the region. Despite the previously reported association of injection drug use with hepatitis c virus (HCV) in other countries, studies on HCV prevalence in PWID in Colombia are lacking. The objective of this study was to determine the prevalence, demographics, and correlations of risky injection behaviors in HCV seropositive PWID in Colombia.

Methods: A cross sectional study was conducted between January and June of 2014. PWID (N=918) from four Colombian cities were recruited via Respondent Driven Sampling. An adapted version of the Behaviors of High Risk Drug Consumers Survey (CODAR by its Spanish acronym) was administered to each participant, and blood samples for HCV antibody testing were collected. Binary logistic regression and multivariate analyses were performed for statistical analysis.

Results: Average participant age was 26 years (SD 6.5) and 53.8% of the sample reported 4 or less years of injection drug use. Of all participants, 24.61% were HCV seropositive, of which 52% were 25 years old or younger. Increased risk of HCV infection was found for PWID that: had a history of injection drug use of 5 years or more (AOR: 3.1; CI: 1.2-7.8; p=0.01); used water to clean injection equipment (AOR: 2.9; CI: 1.4-5.7; p<0.01); had a higher injection frequency (4 or more times per day) (AOR: 2.3; CI: 1.3-4.2; p<0.01), and daily use of gifted, sold, or rented needles or syringes (AOR: 2.8; CI: 1.3-5.8; p<0.01). Moreover, the greatest association with risk of HCV seropositivity was being HIV seropositive (AOR: 10; CI: 2.9-34; p<0.001).

Conclusion: A high prevalence of HCV in PWID in Colombia is reported; however, it is lower than that reported for other countries. The described demographic characteristics and risky injection behaviors, in the context of a young and growing PWID population with a short injection drug use history, should be taken into account to guide efforts towards injection drug use prevention and risk reduction policies to avoid an epidemic growth of HCV infection and its associated morbidity among PWID in Colombia.