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ID: HR19-194

Presenting author: Perrine Roux

Presenting author biography:

I am a pharmacist and public health researcher with expertise working in the fields of HIV, Hepatitis C, addictions, and harm reduction. I am currently researcher at INSERM U1252 - SESSTIM in Marseille working in several projects related to access to care and prevention for drug users and community-based research.

Correlates of self-reported HCV seropositivity among active people who inject opioids: the impact of prison experience

Perrine Roux, Salim Mezaache, Laelia Briand Madrid, nicolas khatmi, Khadim Ndiaye, Virginie Laporte, Gwenaelle Maradan, Stephane Morel, Daniela Rojas Castro, Patrizia Carrieri

Background
While opioid substitution treatments and syringe exchange programs (SEP) had significantly reduced HIV incidence among people who inject drugs (PWID), HCV prevalence remains high among this population. Injecting equipment sharing is known as the main route of HCV transmission, and more particularly when it is occurring in specific context (e.g. in prison, on the street). The objective of this analysis is to identify factor associated with self-reported HCV among people who inject opioids (PWIO).
Methodology
The prébupIV study consisted in a cross-sectional survey performed in 2015 among 557 PWIO. They all reported having injected opioids at least once during the last week. We collected socio-demographic and behavioral data on drug use practices and self-reported HCV status. For this analysis, we selected 552 participants who had data on HCV status and performed a multivariate logistic regression to assess factors associated with current or past HCV infection.
Results
Of the 552 participants, 164 (29,7%) reported current or past HCV infection and 41% reported having been incarcerated during their life. The main opioids injected were buprenorphine (53%), heroin (19%) and morphine sulfate (18%). After adjusting for known HCV risk factors, we found that participants who had experienced prison without injecting (adjusted Odds Ratio (aOR) [95% Confidence Interval (CI)] = 1.84 [1.14-2.97]) and those who injected in prison (aOR [95%CI] = 2.17 [1.17-4.02] were more likely to report HCV seropositivity.
Discussion
Our results indicate that PWIO who had experienced prison are at greater risk of HCV infection and especially those who reported injection during incarceration. Despite some recent laws encouraging access to prevention and care in prison, the gap is still important between prisoners and general population, especially regarding harm reduction services. Consequently, there is an urge to implement and promote SEP and access to testing and HCV care in prison.