Stein Judith A, Nyamathi Adeline
Department of Psychology, 1282 Franz Hall, University of California, Los Angeles, CA 90095-1563, USA.
Drug Alcohol Depend. 2004 Jul 15;75(1):89-95. doi: 10.1016/j.drugalcdep.2004.02.002.
Homeless individuals are at risk for numerous health problems including Hepatitis C virus (HCV). HCV is primarily caused by sharing of equipment associated with injection drug use (IDU). In the current study, we assessed differences among HCV-negative and HCV-positive homeless men residing in Los Angeles (N = 198; about 50% HCV positive) on a number of risk factors and behaviors. Findings revealed several significant correlates of HCV-positive status. HCV-positivity was significantly and positively associated with a history of substance use (IDU and non-IDU), recent IDU-related behaviors including equipment sharing, other forms of sharing (e.g., toothbrushes, razors), homelessness severity, tattoos, sexually transmitted diseases, a jail/prison history, and greater age. Lifetime alcohol problems were not associated with HCV. Although associations of HCV with current IDU-related behaviors are not surprising, it is alarming that these behaviors were recent. Those who work among homeless populations should be aware not only of the high likelihood of HCV infection in this population but also of the transmission risk due to continued IDU sharing behaviors. Substance abuse treatment should be implemented to hinder the spread of HCV in this vulnerable population. Also, needle exchange and provision of clean ancillary IDU equipment should be encouraged in areas where homeless people are known to congregate.
无家可归者面临诸多健康问题的风险，包括丙型肝炎病毒（HCV）感染。HCV主要是由共用与注射吸毒（IDU）相关的设备引起的。在本研究中，我们评估了居住在洛杉矶的HCV阴性和HCV阳性无家可归男性（N = 198；约50%为HCV阳性）在一些风险因素和行为方面的差异。研究结果揭示了与HCV阳性状态相关的几个显著因素。HCV阳性与物质使用史（注射吸毒和非注射吸毒）、近期与注射吸毒相关的行为（包括设备共享）、其他形式的共享（如牙刷、剃须刀）、无家可归的严重程度、纹身、性传播疾病、入狱/服刑史以及年龄较大显著正相关。终生酒精问题与HCV无关。虽然HCV与当前注射吸毒相关行为之间的关联并不令人惊讶，但令人担忧的是这些行为是近期发生的。在无家可归人群中工作的人员不仅应意识到该人群中HCV感染的高可能性，还应意识到由于持续的注射吸毒共享行为导致的传播风险。应实施药物滥用治疗以阻止HCV在这一脆弱人群中的传播。此外，在已知无家可归者聚集的地区，应鼓励针头交换并提供清洁的注射吸毒辅助设备。
