Skip to main content

Advertisement

SpringerLink
Log in

Prevalence and Correlates of Hepatitis C Virus Infection among Street-Recruited Injection Drug Users in San Juan, Puerto Rico

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Throughout the world, injection drug users (IDUs) are the group at highest risk for hepatitis C virus (HCV) infection. IDUs residing in the island of Puerto Rico and Puerto Rican IDUs residing in the U.S. mainland have been shown to be at very high risk of infection with HIV. However, the extent to which HCV infection has spread among IDUs in Puerto Rico is not yet known. The aims of this study were to estimate seroprevalence of HCV and to identify the correlates associated with HCV transmission. The sample was drawn through street outreach strategies and was comprised of 400 injection drug users not in treatment, living in the San Juan metropolitan area. HCV and HIV infection were detected by enzyme-linked immunosorbent assay and the results were confirmed by Western blot. Information on sociodemographics, drug use patterns, and risk behaviors was obtained through structured interviews. Bivariate analyses and multivariate logistic regression were used to assess covariates of infection with HCV. The prevalence of HCV infection was 89%. After controlling for sociodemographic characteristics, HCV infection was positively associated with increasing years of injection, injecting in a shooting gallery, tattooing in prison, and self-reported STD infection. Notably, IDUs who had initiated drug injection within the year prior to the study interview had an HCV infection rate of 57%. This study indicates that more aggressive educational programs are urgently needed to reduce the spread of HCV infection among IDUs in Puerto Rico.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Roy K, Hay G, Andragetti R, Taylor A, Goldberg D, Wiessing L. Monitoring hepatitis C virus infection among injecting drug users in the European Union: a review of the literature. Epidemiol Infect. 2002;129(3):577–585.

    Article  PubMed  CAS  Google Scholar 

  2. Abdala N, Carney J, Durante A, et al. Estimating the prevalence of syringe-borne and sexually transmitted diseases among injection drug users in St Petersburg, Russia. Int J STD AIDS. 2003;14(10):697–703.

    Article  PubMed  Google Scholar 

  3. Alter M. Hepatitis C virus infection in the United States. J Hepatol. 1999;31(Suppl 1):88–91.

    Article  PubMed  Google Scholar 

  4. Garten R, Lai S, Zhang J, et al. Rapid transmission of hepatitis C virus among young injecting heroin users in Southern China. Int J Epidemiol. 2004;33(1):182–188.

    Article  PubMed  Google Scholar 

  5. Trepo C, Pradat P. Hepatitis C virus infection in Western Europe. J Hepatol. 1999; 31(Suppl 1):80–83.

    Article  PubMed  Google Scholar 

  6. Weissenbacher M, D R, Radulich G, et al. High seroprevalence of bloodborne viruses among street-recruited injection drug users from Buenos Aires, Argentina. Clin Infect Dis. 2003;15(37 Suppl 5):S348–352.

    Article  Google Scholar 

  7. Alter M, Moyer L. The importance of preventing hepatitis C virus infection among injection drug users in the United States. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18(Suppl 1):S6–10.

    PubMed  Google Scholar 

  8. Diaz T, Buehler J, Castro K, Ward J. AIDS trends among Hispanics in the United States. Am J Public Health. 1993;83(4):504–509.

    PubMed  CAS  Google Scholar 

  9. Selik R, Castro K, Pappaioanou M. Racial/ethnic differences in the risk of AIDS in the United States. Am J Public Health. Dec 1988;78(12):1539–1545.

    PubMed  CAS  Google Scholar 

  10. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report. 2003;13(2).

  11. Deren S, Robles R, Andia J, Colon H, Kang S, Perlis T. Trends in HIV seroprevalence and needle sharing among Puerto Rican drug injectors in Puerto Rico and New York. J Acquir Immune Defic Syndr Hum Retrovirol. 1 Feb 2001;26(2):164–169.

    CAS  Google Scholar 

  12. Deren S, Kang S, Colon H, Andia J, Robles R. HIV incidence among high-risk Puerto Rican drug users: a comparison of East Harlem, New York, and Bayamón, Puerto Rico. J Acquir Immune Defic Syndr. 15 Aug 2004;36(5):1067–1074.

    PubMed  Google Scholar 

  13. Colon H, Robles R, Deren S, et al. Between-city variation in frequency of injection among Puerto Rican injection drug users: East Harlem, New York, and Bayamón, Puerto Rico. J Acquir Immune Defic Syndr Hum Retrovirol. 2001;27(4):405–413.

    CAS  Google Scholar 

  14. Finlinson H, Colon H, Lopez M, Robles R, Cant J. Injecting shared drugs: an observational study of the process of drug acquisition, preparation, and injection by Puerto Rican drug users. J Psychoactive Drugs. 2005;37:37–49.

    PubMed  Google Scholar 

  15. Montoya I, Bell D, Richard A, Carlson J, Trevino R. Estimated HIV risk among Hispanics in a national sample of drug users. J Acquir Immune Defic Syndr Hum Retrovirol. 1999;21(1):42–50.

    CAS  Google Scholar 

  16. Cagle H, Fisher D, Senter T, Thurmond R, AJ K. Classifying skin lesions of injection drug users: a method for corroborating disease risk. DHHS Pub. No. (SMA) 03-3771. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration. 2002.

  17. Robles R, Colón H, Freeman D. Copping areas as sampling and recruitment sites for out-of-treatment crack and injection drug users. Drugs and Society. 1993;7:91–105.

    Article  Google Scholar 

  18. Fisher D, Needle R, Weatherby N, Brown B, Booth R, Williams M. Reliability of drug user self report. In: Abstract Book, IX International Conference on AIDS, June 6–11, 1993; Berlin, Germany, Abstract no. PO-C35-3355.

  19. Needle R, Weatherby N, Chitwood D, et al. Reliability of self-reported HIV risk behaviors of drug users. Psychol Addictive Behaviors. 1995;9:242–250.

    Article  Google Scholar 

  20. Robles R, Colón H, Sahai H, Matos T, Marrero C, Reyes J. Behavioral risk factors and human immunodeficiency virus (HIV) prevalence among intravenous drug users in Puerto Rico. Am J Epidemiol. 1992;135:531–540.

    PubMed  CAS  Google Scholar 

  21. Habib S, Lovejoy F, Aspin C. Hepatitis C prevalence and risk behavior of injecting drug users in Sydney: a continuing concern. Southeast Asian J Trop Med Public Health. 2001;32(4):823–834.

    PubMed  CAS  Google Scholar 

  22. Oliveira M, Bastos F, Telles P, et al. Prevalence and risk factors for HBV, HCV and HDV infections among injecting drug users from Rio de Janeiro, Brazil. Braz J Med Biol Res. 1999;32(9):1107–1114.

    Article  PubMed  CAS  Google Scholar 

  23. Quaglio G, Lugoboni F, Pajusco B, et al. Hepatitis C virus infection: prevalence, predictor variables and prevention opportunities among drug users in Italy. J Viral Hepatitis. 2003;10(5):394–400.

    Article  CAS  Google Scholar 

  24. Diaz T, Des Jarlais D, Vlahov D, et al. Factors associated with prevalent hepatitis C: differences among young adult injection drug users in lower and upper Manhattan, New York City. Am J Public Health. 2001;91(1):23–30.

    PubMed  CAS  Google Scholar 

  25. Garfein R, Vlahov D, Galai N, Doherty M, Nelson KE. Viral infections in short-term injection drug users: the prevalence of hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health 1996;86:655–661.

    Article  PubMed  CAS  Google Scholar 

  26. Hahn J, Page-Shafer K, Lum P, Ochoa K, Moss AR. Hepatitis C virus infection and needle exchange use among young injection drug users in San Francisco. Hepatology. 2001;34(1):180–187.

    Article  PubMed  CAS  Google Scholar 

  27. Thorpe L, Ouellet L, Hershow R, et al. Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment. Am J Epidemiol. 2002; 155(7):645–653.

    Article  PubMed  Google Scholar 

  28. Reyes J, Robles R, Colón H, Freeman D, Sahai H, Matos TD. Risk factors for shooting gallery use among drug injectors in Puerto Rico. Puerto Rico Health Sci J. 1996;15:227–231.

    CAS  Google Scholar 

  29. Robles R, Marrero C, Reyes J, et al. Risk behaviors, HIV seropositivity and TB infection among IDUs who operate shooting galleries in Puerto Rico. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17:477–483.

    PubMed  CAS  Google Scholar 

  30. Battjes R, Pickens R, Haverkos H, Sloboda Z. HIV risk factors among injecting drug users in five U.S. cities. AIDS. May 1994;8(5):681–687.

    Article  PubMed  CAS  Google Scholar 

  31. Hien N, Giang L, Binh P, Wolffers I. The social context of HIV risk behaviour by drug injectors in Ho Chi Minh City, Vietnam. AIDS Care. Aug 2000;12(4):483–495.

    Article  PubMed  CAS  Google Scholar 

  32. Strathdee S, Galai N, Safaiean M, et al. Sex differences in risk factors for HIV seroconversion among injection drug users: a 10-year perspective. Arch Intern Med. 28 May 2001;161(10):1281–1288.

    Article  PubMed  CAS  Google Scholar 

  33. Thorpe L, Ouellet L, Levy J, Williams I, Monterroso ER. Hepatitis C virus infection: prevalence, risk factors, and prevention opportunities among young injection drug users in Chicago, 1997–1999. J Infect Dis. 2000; 182(6):1588–1594.

    Article  PubMed  CAS  Google Scholar 

  34. Villano S, Vlahov D, Nelson K, Lyles C, Cohn S, Thomas DL. Incidence and risk factors for hepatitis C among injection drug users in Baltimore, Maryland. J Clin Microbiol. 1997;35(12):3274–3277.

    PubMed  CAS  Google Scholar 

  35. Champion J, Taylor A, Hutchinson S, et al. Incidence of hepatitis C virus infection and associated risk factors among Scottish prison inmates: a cohort study. Am J Epidemiol. 2004;159(5):514–519.

    Article  PubMed  CAS  Google Scholar 

  36. Pallas J, Farinas-Alvarez C, Prieto D, Llorca J, Delgado-Rodriguez M. Risk factors for monoinfections and coinfections with HIV, hepatitis B and hepatitis C viruses in northern Spanish prisoners. Epidemiol Infect. 1999;123(1):95–102.

    Article  PubMed  CAS  Google Scholar 

  37. Esteban J, Lopez-Talavera J, Genesca J, et al. High rate of infectivity and liver disease in blood donors with antibodies to hepatitis C virus. Ann Intern Med. 1991;115(6):443–449.

    PubMed  CAS  Google Scholar 

  38. Meyer R, Gordon S. Epidemiology of hepatitis C virus infection in a suburban Detroit community. Am J Gastroenterol. 1991;86(9):1224–1226.

    PubMed  CAS  Google Scholar 

  39. Samuel M, Doherty P, Bulterys M, Jenison SA. Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA. Epidemiol Infect. Dec 2001;127(3):475–484.

    Article  PubMed  CAS  Google Scholar 

  40. Iwamura K, Pronai L, Nishioka K, Watanabe J. Incidence of hepatitis C in chronic liver diseases following tattooing. Orv Hetil. 1992;133(15):923–925.

    PubMed  CAS  Google Scholar 

  41. Entz A, Ruffolo V, Chinveschakitvanich V, Soskolne V, van Griensven GJ. HIV-1 prevalence, HIV-1 subtypes and risk factors among fishermen in the Gulf of Thailand and the Andaman Sea. AIDS. 2000;14(8):1027–1034.

    Article  PubMed  CAS  Google Scholar 

  42. Romanowski B, Preiksaitis J, Campbell P, Fenton J. Hepatitis C seroprevalence and risk behaviors in patients attending sexually transmitted disease clinics. Sex Transm Dis. Jan 2003;30(1):33–38.

    PubMed  Google Scholar 

  43. Segurado A, Braga P, Etzel A, Cardoso MR. Hepatitis C virus coinfection in a cohort of HIV-infected individuals from Santos, Brazil: seroprevalence and associated factors. AIDS Patient Care STDs. Mar 2004;18(3):135–143.

    Article  PubMed  Google Scholar 

  44. Zhou F, Ma Z, Hu W, et al. Study on the relationship between hepatitis C virus infection and sharing injection equipment, sexual behavior among injecting drug users. Zhonghua Liu Xing Bing Xue Za Zhi. Apr 2004;25(4):329–332.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Addiction Studies, Institute of Addiction, Universidad Central del Caribe, PO Box 60327, Bayamón, 00960, Puerto Rico

    Juan C. Reyes

Authors
  1. Juan C. Reyes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Héctor M. Colón
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rafael R. Robles
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eddy Rios
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tomás D. Matos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Juan Negrón
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carmen Amalia Marrero
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. José M. Calderón
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Elizabeth Shepard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juan C. Reyes.

Additional information

Reyes, Colón, Robles, Matos, Negrón, Marrero, Calderón, and Shepard are with the Center for Addiction Studies, Institute of Addiction, Universidad Central del Caribe, Bayamón, Puerto Rico; Robles and Shepard are with the Caribbean Basin and Hispanic Addiction Technology Transfer Center, Institute of Addiction, Universidad Central del Caribe, Bayamón, Puerto Rico; Rios is with the Retrovirus Research Center, School of Medicine, Universidad Central del Caribe, Bayamón, Puerto Rico.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reyes, J.C., Colón, H.M., Robles, R.R. et al. Prevalence and Correlates of Hepatitis C Virus Infection among Street-Recruited Injection Drug Users in San Juan, Puerto Rico. J Urban Health 83, 1105–1113 (2006). https://doi.org/10.1007/s11524-006-9109-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-006-9109-7

Keywords

Search

Navigation