Low knowledge and perceived Hepatitis C risk despite high risk behaviour among injection drug users in Kathmandu,Nepal |
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| Institution: | 1. School of Materials Science and Engineering, School of Life Sciences, Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Collaborative Innovation Center of Chemical Science and Engineering, Tianjin University, Tianjin, P.R. China;2. Department of Radiology, Second Affiliated Hospital of Tianjin Medical University, Tianjin, P.R. China;1. Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, USA;2. Department of Internal Medicine, University of Michigan Medical School, USA;3. Department of Epidemiology, University of Michigan, USA;4. Institute for Healthcare Policy and Innovation, University of Michigan, USA;1. Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea;2. Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea;3. Department of Biomedical Engineering, Keimyung University School of Medicine, Daegu, Republic of Korea;4. Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA |
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| Abstract: | BackgroundIn Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at 50% and knowledge of the virus is low. Rehabilitation and harm reduction attendees constitute populations to whom health care providers can deliver services. As such, characterizing their drug use and risk profiles is important for developing targeted service delivery. We measured drug use and risk patterns of IDUs participating in residential rehabilitation as well as those contacted through needle exchanges to identify correlates of drug use frequency, risky injection practices as well as HCV testing, knowledge and perceived risk.MethodsWe collected cross-sectional data from one-on-one structured interviews of IDUs contacted through needle-exchange outreach workers (n = 202) and those attending rehabilitation centres (behaviour immediately prior to joining rehabilitation) (n = 167).ResultsRoughly half of participants reported injecting at least 30 times in the past 30 days and individuals with previous residential rehabilitation experience reported frequent injection far more than those without it. About one in fourteen respondents reported past week risky injection practices. Participants were over three times as likely to report risky injection if they consumed alcohol daily (17.2%) than if they did not (5.0%) (p = 0.002). Those who reported injecting daily reported risky injection practices (11.9%) significantly more than non-daily injectors (1.8%) (p < 0.001). Respondents reported high HCV infection rates, low perceived risk, testing history and knowledge. HCV knowledge was not associated with differences in risky injecting.ConclusionTreatment centres should highlight the link between heavy drinking, frequent injection and risky injecting practices. The link between rehabilitation attendance and frequent injection may suggest IDUs with more severe use patterns are more likely to attend rehabilitation. Rehabilitation centres and needle exchanges should provide testing and education for HCV. Education alone may not be sufficient to initiate change since knowledge did not predict lower risk. |
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| Keywords: | Hepatitis C risk Addiction Residential drug rehabilitation Needle exchange centres Harm reduction Nepal South Asia Injecting drug use |
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