Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA.
Center for Collaborative HIV Research in Practice and Policy, University at Albany, Rensselaer, New York, USA.
J Viral Hepat. 2022 Nov;29(11):994-1003. doi: 10.1111/jvh.13735. Epub 2022 Aug 9.
Persons who inject drugs (PWID) have been experiencing a higher burden of new hepatitis C (HCV) due to the opioid epidemic. The greatest increases in injection have been in rural communities. However, less is known about the prevalence of HCV or its risk factors in rural compared to non-rural communities. This study compared HCV infection history, current infection, and associated behavioural and sociodemographic correlates among PWID recruited from rural and non-rural communities from Upstate New York (NY). This cross-sectional study recruited 309 PWID, using respondent-driven sampling. Blood samples were collected through finger stick for HCV antibody and RNA tests. A survey was also self-administered for HCV infection history, sociodemographics and behavioural correlates to compare by setting rurality. HCV seropositivity was significantly higher among PWID from rural than non-rural communities (71.0% vs. 46.8%), as was current infection (41.4% vs. 25.9%). High levels of past year syringe (44.4%) and equipment (62.2%) sharing were reported. Factors associated with infection history include syringe service program utilization, non-Hispanic white race, sharing needles and methamphetamine injection, which was higher in rural vs. non-rural communities (38.5% vs. 15.5%). HCV burden among PWID appears higher in rural than non-rural communities and may be increasing possibly due to greater levels of methamphetamine injection. On-going systematic surveillance of HCV prevalence and correlates is crucial to respond to the changing opioid epidemic landscape. Additionally, improving access to harm reduction services, especially with special focus on stimulants, may be important to reduce HCV prevalence among PWID in rural settings.
注射毒品者（PWID）由于阿片类药物流行，新丙型肝炎（HCV）的负担加重。注射量的最大增加发生在农村社区。然而，与非农村社区相比，农村社区中 HCV 的流行情况或其危险因素的了解较少。本研究比较了来自纽约州北部农村和非农村社区的 PWID 中 HCV 感染史、现感染以及与行为和社会人口统计学相关的因素。这项横断面研究使用响应驱动抽样招募了 309 名 PWID。通过指尖采集血样进行 HCV 抗体和 RNA 检测。还进行了一项调查，通过自我管理收集 HCV 感染史、社会人口统计学和行为相关性的信息，以按农村地区进行比较。与非农村社区相比，农村社区的 PWID 的 HCV 血清阳性率（71.0%对 46.8%）和现感染率（41.4%对 25.9%）均明显更高。报告了过去一年中注射器（44.4%）和设备（62.2%）共享的高比例。与感染史相关的因素包括使用注射器服务计划、非西班牙裔白人种族、共享针具和使用甲基苯丙胺，农村社区比非农村社区更高（38.5%对 15.5%）。与非农村社区相比，农村社区的 PWID 中的 HCV 负担似乎更高，并且可能由于使用甲基苯丙胺的水平更高而增加。对 HCV 流行率和相关因素的持续系统监测对于应对不断变化的阿片类药物流行情况至关重要。此外，改善减少伤害服务的可及性，特别是特别关注兴奋剂，可能对降低农村地区 PWID 中的 HCV 流行率很重要。
