Theme: Epidemiology and Public Health Research Year: 2021
Background: The Tracks survey of people who inject drugs (PWID) collected data in 14 sentinel sites across Canada (2017–2019). The prevalence of HIV and hepatitis C and associated risk behaviours were examined along with trends over time with previous survey rounds. Methods: Information regarding socio-demographics, social determinants of health, use of prevention services and testing, drug use, risk behaviours, and HIV and hepatitis C testing, care and treatment was collected through interviewer-administered questionnaires. Biological samples were tested for HIV, hepatitis C antibodies and hepatitis C ribonucleic acid (RNA). Descriptive statistics were calculated and trends over time were assessed. Results: Of the 2,383 participants, 65.6% were cisgender male, 42.2% were Indigenous, 48.0% completed high school or less, 62.6% lived in unstable housing and 75.7% had ever been incarcerated. Average age was 40.1 years. The majority experienced stigma and discrimination (88.7%) and physical, sexual and/or emotional abuse in childhood (85.0%) or with a sexual partner (75.9%). The majority reported use of a needle/syringe distribution program (90.1%) and tested for HIV (90.5%) and hepatitis C (90.9%). Among participants who ever had sex, 59.2% reported inconsistent condom use during vaginal and/or anal sex with a casual sex partner. Prevalence of HIV was 10.3% (82.9% were aware of infection status) and many (36.9%) were hepatitis C RNA-positive (50.1% were aware of infection status). Most surveillance indicators remained relatively stable compared with previous survey rounds. Changes were found in substances used, and improvements were noted related to HIV and hepatitis C prevalence and care cascade indicators. Conclusion: Improvements over time were shown in HIV and hepatitis C prevalence and care cascade indicators; however, many PWID in Canada were living in unstable housing and experienced high levels of stigma and discrimination. These findings contribute to the evidence base used to inform targeted prevention and control measures. Disclosure of Interest Statement: The authors have no conflicts of interest to disclose.
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