Availability of body art facilities and body art piercing do not predict hepatitis C acquisition among injection drug users in Montreal, Canada: Results from a cohort study

Bruneau, Julie; Daniel, Mark; Kestens, Yan; Abrahamowicz, Michal; Zang, Geng

doi:10.1016/j.drugpo.2010.05.001

« Previous Next »International Journal of Drug Policy
Volume 21, Issue 6 , Pages 477-484, November 2010

Availability of body art facilities and body art piercing do not predict hepatitis C acquisition among injection drug users in Montreal, Canada: Results from a cohort study

Julie Bruneau
- CRCHUM, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Family Medicine, Université de Montréal, Montréal, Québec, Canada
- Corresponding author at: CRCHUM, Centre Hospitalier de l’Université de Montréal, 264 René-Lévesque est, Room 312, Montreal, Québec, Canada H2X 1P1. Tel.: +1 514 890 8000x35882; fax: +1 514 412 7280.
Mark Daniel
- CRCHUM, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada
- School of Health Sciences, University of South Australia, Adelaide, Australia
Yan Kestens
- CRCHUM, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada
Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
Geng Zang
- CRCHUM, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada

Received 6 February 2010; received in revised form 11 May 2010; accepted 12 May 2010. published online 14 June 2010.

Abstract

Background

Cross-sectional associations suggest that body art piercing (BAP) is a risk factor for hepatitis C (HCV) infection among injection drug users. The temporal basis of the relationship has not been established.

Methods

Associations between HCV seropositivity, HCV incidence, recent BAP and BAP facility availability were evaluated among IDUs followed biannually between 2004 and 2008 in Montreal, Canada. A geographic information system was used to determine the availability of BAP facilities for each participant. Statistical models included individual and neighbourhood covariates. Logistic regression was used for analysis of HCV seropositivity. Cox proportional hazards regression was used for analysis of HCV incidence.

Results

Of 784 IDUs, 73% were seropositive for HCV. In multivariable logistic regression, HCV seropositivity was associated with BAP availability (OR: 1.32 95% confidence interval (CI): 1.1, 1.6) but not recent BAP. Of 145 initially HCV-negative participants, 52 seroconverted to HCV for an incidence of 27.7/100 person-years (95%CI: 20.9, 36.0). Crude hazard ratios (HR) for the association between HCV infection and BAP variables were: recent BAP, HR 0.98 (95%CI: 0.4, 2.7) and BAP facilities availability, HR 1.43 (95%CI: 1.1, 1.9). After accounting for individual and neighbourhood factors, crude associations between HCV infection and recent BAP and BAP facilities availability were: HR recent BAP, 0.96, 95%CI: 0.3, 2.7; and HR BAP facility availability, 1.21, 95%CI: 0.9, 1.7.

Conclusion

BAP facility availability is a marker of neighbourhood disadvantage associated with HCV seropositivity. Longitudinal analyses accounting for behaviour risk factors and neighbourhood characteristics do not support a temporal association between BAP acquisition, BAP facility availability, and HCV infection among IDUs.

Keywords: Body piercing, Epidemiology, HCV, Incidence, Injection drug use