Higher HCV antibody prevalence among Indigenous clients of needle and syringe programs

James Ward, Libby Topp, Jenny Iversen, Handan Wand, Snehal Akre, John Kaldor, Lisa Maher
Australian and New Zealand Journal of Public Health 2011, 35 (5): 421-6

OBJECTIVE: To compare prevalence of hepatitis C virus (HCV) antibody and associated risk behaviours among Indigenous and non-Indigenous participants in the Australian Needle and Syringe Program Survey.

METHODS: During 1 or 2 weeks each October from 1998 to 2008, clients of participating needle and syringe programs (NSPs) completed a self-administered questionnaire on demographics and risk behaviour and provided a capillary blood sample for HIV and HCV antibody testing. After de-duplication, 16,132 individuals participated during the 11 years, of whom 1,380 (8.6%) identified as Indigenous.

RESULTS: Higher proportions of Indigenous than non-Indigenous participants were HCV antibody positive (57% versus 51%, p<0.001). In an overall multivariable analysis, Indigenous status (OR 1.17; CI 1.03-1.32) and female gender (OR 1.25; CI 1.16-1.35) were independently associated with HCV antibody seropositivity. Indigenous participants also reported higher rates of risk behaviour, including receptive sharing of needle syringes (21% vs 16%; p<0.001), receptive sharing of ancillary injecting equipment (38% vs 33%; p<0.001), having been injected by others (18% vs 13%; p<0.001), and injecting in public (54% vs 49%; p<0.001).

CONCLUSION AND IMPLICATIONS: These results highlight the need for targeted, culturally appropriate programs to minimise risks for bloodborne viral transmission among Indigenous people who inject drugs.

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