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Abstract Details
Factors associated with hepatitis C and HIV testing uptake among men who inject image and performance enhancing drugs
Drug Alcohol Rev. 2020 Nov 8. doi: 10.1111/dar.13198. Online ahead of print.
Vivian D Hope1, James McVeigh2, Emma Begley1, Rachel Glass3, Claire Edmundson3, Ellen Heinsbroek3, Joseph Kean4, John Campbell5, Mark Whitfield1, Gareth Morgan6, Dean Acreman7, Josie Smith7
Author information
1Public Health Institute, Liverpool John Moores University, Liverpool, UK.
2Department of Sociology, Manchester Metropolitan University, Manchester, UK.
3National Infection Service, Public Health England, London, UK.
4NHS Greater Glasgow and Clyde, National Health Service Scotland, Glasgow, UK.
5Change Grow Live, Bradford, UK.
6Commissioning Team, Cardiff and Vale University Health Board, Cardiff, UK.
7Substance Misuse Programme, Public Health Wales, Cardiff, UK.
Abstract
Introduction and aims: Historically, people who inject image and performance enhancing drugs (IPED) were not perceived as being at high risk of HIV or hepatitis C virus (HCV) infection. However, recent studies indicate HCV and HIV prevalences are elevated, with many HCV infections undiagnosed.
Design and methods: Men who inject IPEDs recruited from community settings and specialist services, including needle-syringe programs, across UK during 2016 self-completed a questionnaire. Multivariate analyses examined factors associated with HCV/HIV testing.
Results: The participants' (n=562; 24% service recruited) median age was 31 years, 4% identified as gay or bisexual, 18% had ever been imprisoned and 6% had ever injected a psychoactive drug. Those community recruited more often reported sharing drugs vials (16% vs. 8%, P=0.021) and, among those with 2+ sexual partners, poor condom use (50% vs. 36%, P=0.063), than those service recruited. Overall, one-third had ever been tested for HCV (31%) and/or HIV (34%). Testing uptake was associated with other risk factors for HCV/HIV, being recruited through services and having received metabolic tests. Participants' motivations for using IPEDs were associated with recruitment setting and HIV/HCV testing uptake.
Discussion and conclusions: The majority were untested for HCV/HIV. HCV/HIV testing and risks were associated with recruitment through services. Previous needle and syringe program-based studies have potentially overestimated testing uptake and underestimated risk. Targeted interventions are needed, particularly for those not accessing services. The association between HCV/HIV testing uptake and receipt of metabolic tests suggests that developing a combined offer of these tests as part of health monitoring could improve uptake.