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Hepatitis-associated knowledge is low and risks are high among HIV-aware injection drug users in three US cities

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Abstract Aims

 Injection drug use is a major risk factor for HIV and hepatitis infections. Whereas programs to prevent new infections have focused on HIV, they have generally neglected hepatitis B and C. This study was designed to examine the interrelationships among HIV and hepatitis knowledge, risky drug preparation and injection practices, and participation in syringe exchange programs (SEPs). Design

Surveys of injection drug users (IDUs) collected data on socio-demographics, medical history, drug use and injection practices, and HIV- and hepatitis-related knowledge. Setting

Inner-city US neighborhoods in Chicago, IL, Hartford, CT and Oakland, CA. Participants

The study population was a convenience sample of 493 IDUs recruited using street outreach and snowball sampling strategies. Measurements

HIV and hepatitis knowledge, injection-related risks for virus transmission, associations between the two, and with SEP use. Findings

HIV knowledge was significantly higher than hepatitis knowledge among SEP customers and non-customers alike. Elevated hepatitis knowledge was associated with a history of substance abuse treatment, hepatitis infection, hepatitis B vaccination and injection practices that reduced contact with contaminated blood or water but not with SEP use. SEP customers were consistently less likely to engage in risk behaviors, with the notable exception of safely staunching blood postinjection. Conclusion

Increased hepatitis awareness among IDUs is necessary for reducing hepatitis transmissions. Although SEPs continue to effectively disseminate HIV prevention messages—as evidenced by lowered risk behaviors among their customers—they must do more to prevent hepatitis transmissions.

Keywords: AIDS; HIV; Injection; drug use; hepatitis; needle; syringe exchange

Document Type: Research Article


Affiliations: 1: Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 2: Hispanic Health Council, Hartford, CT 3: RAND Corporation, Santa Monica, CA and Charles Drew University of Medicine and Science, Los Angeles, CA 4: Center for Biomedical Ethics, Case Western Reserve University, Cleveland, OH, USA

Publication date: 2002-10-01

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