Association between harm reduction intervention uptake and recent hepatitis C infection among people who inject drugs attending sites that provide sterile injecting equipment in Scotland

Elizabeth A. Allen, Norah Elizabeth Palmateer, Sharon Hutchinson, Sheila O. Cameron, David J. Goldberg, Avril Taylor

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Prevalence of the hepatitis C virus (HCV) among people who inject drugs (PWID) in Scotland is high. The Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among PWID. In evaluating the effectiveness of interventions, estimates of HCV incidence are essential. During 2008–2009, PWID were recruited from services providing sterile injecting equipment across mainland Scotland, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous anti-HCV and HCV-RNA testing. Recent infections were defined as anti-HCV negative and HCV-RNA positive. Logistic regression was undertaken to examine associations between recent HCV infection and self-reported uptake of methadone maintenance therapy (MMT) and injection equipment. Fifty-four percent (1367/2555) of participants were anti-HCV positive. We detected 24 recent HCV infections, yielding incidence rate estimates ranging from 10.8 to 21.9 per 100 person-years. After adjustment for confounders, those with high needle/syringe coverage had reduced odds of recent infection (adjusted odds ratio [AOR] 0.32, 95% CI 0.10–1.00, p = 0.050). In the Greater Glasgow & Clyde region only, we observed a reduced odds of recent infection among those currently receiving MMT, relative to those on MMT in the last six months but not currently (AOR 0.04, 95% CI 0.001–1.07, p = 0.055). The effect of combined uptake of MMT and high needle/syringe coverage was only significant in unadjusted analyses (OR 0.34, 95% CI 0.12–0.97, p = 0.043; AOR 0.48, 95% CI 0.16–1.48, p = 0.203). We report the first large-scale, national application of a novel method designed to determine incidence of HCV among PWID using a cross-sectional design. Subsequent sweeps of this survey will increase statistical power and allow us to gauge the impact of preventive interventions.
LanguageEnglish
Pages346-352
Number of pages7
JournalInternational Journal of Drug Policy
Volume23
Issue number6
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Harm Reduction
Scotland
Hepatitis C
Hepacivirus
Equipment and Supplies
Infection
Pharmaceutical Preparations
Methadone
Odds Ratio
Syringes
Virus Diseases
Needles
Incidence
RNA
Therapeutics
Logistic Models

Keywords

  • Hepatitis C virus
  • injection equipment
  • methadone
  • recent infection

Cite this

Allen, Elizabeth A. ; Palmateer, Norah Elizabeth ; Hutchinson, Sharon ; Cameron, Sheila O. ; Goldberg, David J. ; Taylor, Avril. / Association between harm reduction intervention uptake and recent hepatitis C infection among people who inject drugs attending sites that provide sterile injecting equipment in Scotland. In: International Journal of Drug Policy. 2012 ; Vol. 23, No. 6. pp. 346-352.
@article{0b2f39f8f2334c0ba8b810539a693906,
title = "Association between harm reduction intervention uptake and recent hepatitis C infection among people who inject drugs attending sites that provide sterile injecting equipment in Scotland",
abstract = "Prevalence of the hepatitis C virus (HCV) among people who inject drugs (PWID) in Scotland is high. The Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among PWID. In evaluating the effectiveness of interventions, estimates of HCV incidence are essential. During 2008–2009, PWID were recruited from services providing sterile injecting equipment across mainland Scotland, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous anti-HCV and HCV-RNA testing. Recent infections were defined as anti-HCV negative and HCV-RNA positive. Logistic regression was undertaken to examine associations between recent HCV infection and self-reported uptake of methadone maintenance therapy (MMT) and injection equipment. Fifty-four percent (1367/2555) of participants were anti-HCV positive. We detected 24 recent HCV infections, yielding incidence rate estimates ranging from 10.8 to 21.9 per 100 person-years. After adjustment for confounders, those with high needle/syringe coverage had reduced odds of recent infection (adjusted odds ratio [AOR] 0.32, 95{\%} CI 0.10–1.00, p = 0.050). In the Greater Glasgow & Clyde region only, we observed a reduced odds of recent infection among those currently receiving MMT, relative to those on MMT in the last six months but not currently (AOR 0.04, 95{\%} CI 0.001–1.07, p = 0.055). The effect of combined uptake of MMT and high needle/syringe coverage was only significant in unadjusted analyses (OR 0.34, 95{\%} CI 0.12–0.97, p = 0.043; AOR 0.48, 95{\%} CI 0.16–1.48, p = 0.203). We report the first large-scale, national application of a novel method designed to determine incidence of HCV among PWID using a cross-sectional design. Subsequent sweeps of this survey will increase statistical power and allow us to gauge the impact of preventive interventions.",
keywords = "Hepatitis C virus, injection equipment, methadone, recent infection",
author = "Allen, {Elizabeth A.} and Palmateer, {Norah Elizabeth} and Sharon Hutchinson and Cameron, {Sheila O.} and Goldberg, {David J.} and Avril Taylor",
year = "2012",
month = "9",
doi = "10.1016/j.drugpo.2012.07.006",
language = "English",
volume = "23",
pages = "346--352",
journal = "International Journal of Drug Policy",
issn = "0955-3959",
number = "6",

}

Association between harm reduction intervention uptake and recent hepatitis C infection among people who inject drugs attending sites that provide sterile injecting equipment in Scotland. / Allen, Elizabeth A.; Palmateer, Norah Elizabeth; Hutchinson, Sharon; Cameron, Sheila O.; Goldberg, David J.; Taylor, Avril.

In: International Journal of Drug Policy, Vol. 23, No. 6, 09.2012, p. 346-352.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between harm reduction intervention uptake and recent hepatitis C infection among people who inject drugs attending sites that provide sterile injecting equipment in Scotland

AU - Allen, Elizabeth A.

AU - Palmateer, Norah Elizabeth

AU - Hutchinson, Sharon

AU - Cameron, Sheila O.

AU - Goldberg, David J.

AU - Taylor, Avril

PY - 2012/9

Y1 - 2012/9

N2 - Prevalence of the hepatitis C virus (HCV) among people who inject drugs (PWID) in Scotland is high. The Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among PWID. In evaluating the effectiveness of interventions, estimates of HCV incidence are essential. During 2008–2009, PWID were recruited from services providing sterile injecting equipment across mainland Scotland, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous anti-HCV and HCV-RNA testing. Recent infections were defined as anti-HCV negative and HCV-RNA positive. Logistic regression was undertaken to examine associations between recent HCV infection and self-reported uptake of methadone maintenance therapy (MMT) and injection equipment. Fifty-four percent (1367/2555) of participants were anti-HCV positive. We detected 24 recent HCV infections, yielding incidence rate estimates ranging from 10.8 to 21.9 per 100 person-years. After adjustment for confounders, those with high needle/syringe coverage had reduced odds of recent infection (adjusted odds ratio [AOR] 0.32, 95% CI 0.10–1.00, p = 0.050). In the Greater Glasgow & Clyde region only, we observed a reduced odds of recent infection among those currently receiving MMT, relative to those on MMT in the last six months but not currently (AOR 0.04, 95% CI 0.001–1.07, p = 0.055). The effect of combined uptake of MMT and high needle/syringe coverage was only significant in unadjusted analyses (OR 0.34, 95% CI 0.12–0.97, p = 0.043; AOR 0.48, 95% CI 0.16–1.48, p = 0.203). We report the first large-scale, national application of a novel method designed to determine incidence of HCV among PWID using a cross-sectional design. Subsequent sweeps of this survey will increase statistical power and allow us to gauge the impact of preventive interventions.

AB - Prevalence of the hepatitis C virus (HCV) among people who inject drugs (PWID) in Scotland is high. The Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among PWID. In evaluating the effectiveness of interventions, estimates of HCV incidence are essential. During 2008–2009, PWID were recruited from services providing sterile injecting equipment across mainland Scotland, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous anti-HCV and HCV-RNA testing. Recent infections were defined as anti-HCV negative and HCV-RNA positive. Logistic regression was undertaken to examine associations between recent HCV infection and self-reported uptake of methadone maintenance therapy (MMT) and injection equipment. Fifty-four percent (1367/2555) of participants were anti-HCV positive. We detected 24 recent HCV infections, yielding incidence rate estimates ranging from 10.8 to 21.9 per 100 person-years. After adjustment for confounders, those with high needle/syringe coverage had reduced odds of recent infection (adjusted odds ratio [AOR] 0.32, 95% CI 0.10–1.00, p = 0.050). In the Greater Glasgow & Clyde region only, we observed a reduced odds of recent infection among those currently receiving MMT, relative to those on MMT in the last six months but not currently (AOR 0.04, 95% CI 0.001–1.07, p = 0.055). The effect of combined uptake of MMT and high needle/syringe coverage was only significant in unadjusted analyses (OR 0.34, 95% CI 0.12–0.97, p = 0.043; AOR 0.48, 95% CI 0.16–1.48, p = 0.203). We report the first large-scale, national application of a novel method designed to determine incidence of HCV among PWID using a cross-sectional design. Subsequent sweeps of this survey will increase statistical power and allow us to gauge the impact of preventive interventions.

KW - Hepatitis C virus

KW - injection equipment

KW - methadone

KW - recent infection

UR - http://www.scopus.com/inward/record.url?scp=84866145721&partnerID=8YFLogxK

U2 - 10.1016/j.drugpo.2012.07.006

DO - 10.1016/j.drugpo.2012.07.006

M3 - Article

VL - 23

SP - 346

EP - 352

JO - International Journal of Drug Policy

T2 - International Journal of Drug Policy

JF - International Journal of Drug Policy

SN - 0955-3959

IS - 6

ER -