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Survival sex work involvement as a primary risk factor for hepatitis c virus acquisition in drug-using youths in a Canadian setting

British Columbia Centre for Excellence in HIV/AIDS

OBJECTIVE: To examine whether there were differential rates of hepatitis C virus (HCV) incidence in injecting drug-using youths who did and did not report involvement in survival sex work. DESIGN: Data were derived from 2 prospective cohort studies of injecting drug users (May 1, 1996, to July 31, 2007). Analyses were restricted to HCV antibody-negative youths who completed baseline and at least 1 follow-up assessment. SETTING: Vancouver, British Columbia, Canada. PARTICIPANTS: Of 3074 injecting drug users, 364 (11.8%) were youths (aged 14-24 years) with a median age of 21.3 years and a duration of injecting drug use of 3 years. Main Exposure Survival sex work involvement. MAIN OUTCOME MEASURE: The Kaplan-Meier method and Cox proportional hazards regression were used to compare HCV incidence among youths who did and did not report survival sex work. RESULTS: Baseline HCV prevalence was 51%, with youths involved in survival sex work significantly more likely to be HCV antibody positive (60% vs 44%; P = .002). In baseline HCV antibody-negative youths, the cumulative HCV incidence at 36 months was significantly higher in those involved in survival sex work (68.4% vs 38.8%; P < .001). The HCV incidence density was 36.8 (95% confidence interval [CI], 24.2-53.5) per 100 person-years in youths reporting survival sex work involvement at baseline compared with 14.1 (9.4-20.3) per 100 person-years in youths not reporting survival sex work. In multivariate Cox proportional hazards analyses, survival sex work was the strongest predictor of elevated HCV incidence (adjusted relative hazard, 2.30; 95% CI, 1.27-4.15). CONCLUSION: This study calls attention to the critical need for evidence-based social and structural HCV prevention efforts that target youths engaged in survival sex work.

Downtown-Eastside (Vancouver, B.C.)

Text

2017-01-21

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/59820

Shannon, K., Kerr, T., Marshall, B., Li, K., Zhang, R., Strathdee, S. A., … Wood, E. (2010). Survival sex work involvement as a primary risk factor for hepatitis c virus acquisition in drug-using youths in a Canadian setting. Archives of Pediatrics & Adolescent Medicine, 164(1), 61–65.

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http://creativecommons.org/licenses/by-nc-nd/4.0/