Gender differences in hepatitis C antibody prevalence and risk behaviours amongst people who inject drugs in Australia 1998–2008

Iversen, Jenny; Wand, Handan; Gonnermann, Andrea; Maher, Lisa; on behalf of the collaboration of Australian Needle and Syringe Programs,

doi:10.1016/j.drugpo.2010.04.004

« Previous Next »International Journal of Drug Policy
Volume 21, Issue 6 , Pages 471-476, November 2010

Gender differences in hepatitis C antibody prevalence and risk behaviours amongst people who inject drugs in Australia 1998–2008

Jenny Iversen
- Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Australia
Handan Wand
- Biostatistics and Databases Program, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Australia
Andrea Gonnermann
- Human and Health Sciences, University of Bremen, Germany
Lisa Maher
- Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Australia
- Corresponding author at: Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Australia. Tel.: +61 2 9385 0900; fax: +61 2 9385 0920.
on behalf of the collaboration of Australian Needle and Syringe Programs
- The collaboration of Australian Needle and Syringe Programs (2009): ACON Hunter; Albury CHC; Barwon Health Service; Biala NSP; Cairns NSP; Central Access Service; Central Coast Harm Reduction Services; Clarence CHC; DASSA; Directions ACT; First Step Program; Health ConneXions; Health Information Exchange; Hindmarsh Centre; Hunter Harm Reduction Services; Inner Space; Kirketon Road Centre; Kobi House; Northcote NSP; North Coast Harm Reduction Services; North Richmond CHC; Northern Territory AIDS Council; NUAA; Nunkuwarrin Yunti CHC; QUIHN NSP Services; REPIDU; Salvation Army Launceston; SAVIVE CNP Services; SHARPS; Sydney West NSP Services; TasCHARD NSP Services; Townsville ATODS; WA AIDS Council; WASUA and West Moreton NSP.

Received 3 December 2009; received in revised form 7 April 2010; accepted 20 April 2010. published online 17 May 2010.

Abstract

Background

Global prevalence of hepatitis C virus (HCV) is estimated to be around 3% with approximately 170 million people affected. In Australia, and in many other resource rich countries, injecting drug use is the single most important risk factor for acquiring HCV, with around a third of diagnoses occurring in women. This study aims to assess gender differences in hepatitis C antibody prevalence and associated risk behaviours amongst a large sample of PWID in Australia.

Methods

During a one to two week period in October, PWID attending selected NSP sites are invited to participate in the Australian NSP Survey. Between 1998 and 2008, approximately 16,000 individuals completed a self-administered questionnaire and provided a capillary blood sample for HIV and HCV antibody testing. We stratified our sample by time since onset of injecting and analysed the demographic characteristics, injecting behaviours and antibody test results to determine gender differences.

Results

Women were found to be at increased risk of exposure to hepatitis C in all duration of injection categories except those injecting for 17 or more years. In the early years of injecting, women also reported higher rates of receptive sharing of needles and syringe and ancillary equipment when compared to men. Last injecting heroin, methadone or buprenorphine was significantly associated with HCV antibody prevalence amongst both males and females injecting for less than 5 years.

Conclusion

Findings indicate that women are at greater risk than men of HCV infection during the early years of injection through higher rates of receptive sharing of needles and syringes and/or ancillary equipment. Our results suggest that women who are new to injecting, and Indigenous women in particular, should be identified as priority populations when developing and implementing harm reduction strategies that target people who inject illicit drugs.

Keywords: Hepatitis C virus (HCV), Injection drug use (IDU), Gender