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Hepatitis C and HIV Prevalence Using Oral Mucosal Transudate, and Reported Drug Use and Sexual Behaviours of Youth in Custody in British Columbia

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Abstract

Background

Youth in custody have high-risk drug use and sexual behaviours. HIV prevalence in this population was assessed in British Columbia (BC) in 1994 but hepatitis C virus (HCV) prevalence has never been measured. We sought to determine: 1) the performance of the OraSure®, a non-invasive device for oral mucosal transudate (OMT) specimen collection, to detect HCV and HIV antibodies; 2) the prevalence of HCV and HIV among youth in custody; and 3) the factors associated with intravenous drug use and sex for trade.

Methods

OraSure® was validated in 110 adults with known HIV and HCV sero-status. Nurses administered an anonymous survey and collected OMT samples from youth aged 14–19 years in BC youth custody centres.

Results

Antibody detection in OMT had 96.4% sensitivity for HIV and 94.6% for HCV. 417 youth were enrolled; 22% were female; 48% reported Aboriginal ethnicity. Although 98.3% reported ever using drugs, <8% reported injection drug use (IDU). IDU was independently associated with age of first sexual intercourse (inverse association) and sex for trade (sex in exchange for money, drugs, food or shelter) (OR 4.28; 95% CI: 1.56-11.75). Females were >9 times more likely to report sex for trade. Five Aboriginal youth were identified with HCV; prevalence estimate 1.2% (95% CI: 0.53-2.77%); 3 reported injecting drugs, the other 2 reported using cocaine/crack and sharing non-injection drug paraphernalia. Two youth were identified with HIV, prevalence estimate 0.48% (95% CI: 0.14%-1.72%).

Conclusion

IDU, HCV and HIV prevalence remain low. Interventions are needed to prevent transition to IDU and further opportunities for prevention and harm reduction should be explored while the youth are in custody.

Résumé

Contexte

Les jeunes placés sous garde ont des comportements sexuels et d’utilisation de drogues à haut risque. La prévalence du VIH dans cette population a été évaluée en Colombie-Britannique (C.-B.) en 1994, mais la prévalence du virus de l’hépatite C (VHC) n’a jamais été évaluée. Nous avons cherché à déterminer: 1) le rendement d’OraSure®, un appareil non invasif pour le prélèvement du transsudat des muqueuses orales (TMO), afin de détecter les anticorps contre le VHC et le VIH; 2) la prévalence du VHC et du VIH chez les jeunes détenus; et 3) les facteurs associés à l’utilisation de drogues injectables et au commerce du sexe.

Méthode

OraSure® a été validé sur 110 adultes atteints d’une infection du VIH et du VHC. Les infirmières ont effectué des sondages anonymes et ont recueilli des échantillons de TMO chez des jeunes âgés entre 14 et 19 ans dans les centres de détention de la C.-B.

Résultats

La détection d’anticorps dans le TMO avait 96,4 % de sensibilité pour le VIH et 94,6 % pour le VHC. Ainsi, 417 jeunes ont été inscrits; 22 % étaient de sexe féminin; 48 % étaient d’origine autochtone. Bien que 98,3 % affirmaient avoir jamais consommé de drogues, <8 % affirmaient consommer des drogues injectables (DI). L’utilisation de DI était indépendamment associée à l’âge des premiers rapports sexuels (association inverse) et le commerce du sexe (sexe en échange d’argent, de drogues, de nourriture ou d’un abri) (r.c. = 4,28; 95 % i.c.: 1,56-11,75). Les filles étaient >9 fois plus susceptibles d’affirmer se livrer au commerce su sexe. Cinq jeunes Autochtones ont été diagnostiqués atteints du VHC; estimation de la prévalence 1,2 % (95 % i.c.: 0,53-2,77 %); 3 ont affirmé utiliser des DI, les 2 autres affirmaient consommer de la cocaïne/du crack et partager un attirail pour les drogues non injectables. Deux jeunes ont été diagnostiqués atteints du VIH, estimation de la prévalence 0,48 % (95 % i.c.: 0,14 %-1,72 %).

Conclusion

La prévalence de l’utilisation de DI, du VHC et du VIH demeure faible. Des interventions sont requises pour prévenir la transition à l’utilisation de DI, et d’autres possibilités de prévention et de réduction des préjudices devraient être examinées pendant que les jeunes sont détenus.

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Authors and Affiliations

  1. School of Population and Public Health, BC Centre for Disease Control, University of British Columbia, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada

    J. A. Buxton, M. Durigon & V. P. Remple

  2. British Columbia Centre for Disease Control, Vancouver, BC, Canada

    J. A. Buxton, M. Durigon, A. W. Tu, D. Cook & M. Krajden

  3. British Columbia Ministry of Children and Family Development, Victoria, BC, Canada

    D. Rothon

  4. Health Canada, First Nations and Inuit Health Branch, Ottawa, ON, Canada

    M. Lem

Authors
  1. J. A. Buxton
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  2. D. Rothon
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  3. M. Durigon
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  4. M. Lem
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  5. A. W. Tu
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  6. V. P. Remple
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  7. D. Cook
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  8. M. Krajden
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Corresponding author

Correspondence to J. A. Buxton.

Additional information

Financial support for this study was provided by Health Canada, First Nations and Inuit Health Branch.

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Buxton, J.A., Rothon, D., Durigon, M. et al. Hepatitis C and HIV Prevalence Using Oral Mucosal Transudate, and Reported Drug Use and Sexual Behaviours of Youth in Custody in British Columbia. Can J Public Health 100, 121–124 (2009). https://doi.org/10.1007/BF03405520

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  • DOI: https://doi.org/10.1007/BF03405520

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