Trends in Hepatitis B Virus,Hepatitis C Virus,and Human Immunodeficiency Virus Prevalence,Risk Behaviors,and Preventive Measures among Seattle Injection Drug Users Aged 18–30 Years, 1994–2004 |
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Authors: | Richard D Burt Holly Hagan Richard S Garfein Keith Sabin Cindy Weinbaum Hanne Thiede |
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Institution: | (1) Public Health—Seattle and King County, Seattle, WA, USA |
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Abstract: | Injection drug users (IDUs) are at risk for infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency
virus (HIV). Information on time trends in prevalence of these viruses among IDUs and in behaviors influencing their transmission
can help define the status of these epidemics and of public health efforts to control them. We conducted a secondary data
analysis combining cross-sectional data from IDUs aged 18–30 years enrolled in four Seattle-area studies from 1994 to 2004.
Participants in all four studies were tested for antibody to HIV (anti-HIV), hepatitis B core antigen (anti-HBc), and HCV
(anti-HCV), and completed behavioral risk assessments. Logistic regression was used to investigate trends in prevalence over
time after controlling for sociodemographic, drug use, and sexual behavior variables. Between 1994 and 2004, anti-HBc prevalence
declined from 43 to 15% (p < 0.001), anti-HCV prevalence fell from 68 to 32% (p < 0.001) and anti-HIV prevalence remained constant at 2–3%. Declines in anti-HBc and anti-HCV prevalence were observed within
the individual studies, although not all these declines were statistically significant. The declines in anti-HBc and anti-HCV
prevalence remained significant after control for confounding. Although we did not observe coincident declines in injection
equipment sharing practices, there were increases in self-reported needle-exchange use, condom use, and hepatitis B vaccination.
We conclude that there has been a substantial and sustained reduction in prevalence rates for HBV and HCV infection among
young Seattle IDUs, while HIV rates have remained low and stable.
Burt and Thiede are with Public Health—Seattle and King County, Seattle, WA, USA; Hagan is with the National Development and
Research Institutes, New York, NY, USA; Garfein and Sabin were with the Division of HIV/AIDS Prevention, Centers for Disease
Control and Prevention, Atlanta, GA, USA; Garfein is currently with the School of Medicine, University of California at San
Diego, San Diego, CA, USA; Sabin is currently with the Global AIDS Program, CDC, Atlanta, GA, USA; Weinbaum is with the Division
of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, USA. |
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Keywords: | HIV Hepatitis B Hepatitis C Injection drug users Adolescents Needle sharing Needle exchange Hepatitis B vaccination |
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