Tracy Daniel, Hahn Judith A, Fuller Lewis Crystal, Evans Jennifer, Briceño Alya, Morris Meghan D, Lum Paula J, Page Kimberly
Columbia University, Mailman School of Public Health, New York, New York, USA.
Department of Medicine, University of California San Francisco, School of Medicine, San Francisco, California, USA.
BMJ Open. 2014 May 29;4(5):e004988. doi: 10.1136/bmjopen-2014-004988.
Female injection drug users (IDUs) may report differences in injection behaviours that put them at greater risk for hepatitis C virus (HCV). Few studies have examined these in association with HCV incidence.
Longitudinal data from a cohort of 417 HCV-uninfected IDU aged 30 or younger were analysed. Cox proportional hazards was used to model female sex as a predictor of new HCV infection. General estimating equation (GEE) analysis was used to model female sex as a predictor of HCV-associated risk behaviour prospectively.
Women were significantly more likely than men to become infected with HCV during study follow-up (HR 1.4, p<0.05), and were also more likely than men to report high-risk injecting behaviours, especially in the context of sexual and injecting relationships. Sex differences in injecting behaviours appeared to explain the relationship between sex and HCV infection.
Young women's riskier injection practices lead to their higher rates of HCV infection. Further study on the impact of intimate partnership on women's risk behaviour is warranted.
女性注射吸毒者（IDU）可能报告注射行为存在差异，这使她们感染丙型肝炎病毒（HCV）的风险更高。很少有研究将这些行为与HCV发病率联系起来进行考察。
对一组417名30岁及以下未感染HCV的注射吸毒者的纵向数据进行分析。采用Cox比例风险模型将女性性别作为新感染HCV的预测因素。采用广义估计方程（GEE）分析将女性性别作为前瞻性HCV相关风险行为的预测因素。
在研究随访期间，女性感染HCV的可能性显著高于男性（风险比1.4，p<0.05），而且女性报告高风险注射行为的可能性也高于男性，尤其是在性和注射关系方面。注射行为的性别差异似乎解释了性别与HCV感染之间的关系。
年轻女性更危险的注射行为导致她们更高的HCV感染率。有必要进一步研究亲密伴侣关系对女性风险行为的影响。
