Theme: Epidemiology and Public Health Research Year: 2021
Background: People who inject drugs (PWID) are the population most concerned by the major public health issue of hepatitis C virus (HCV). A better understanding of the determinants of accessing HCV testing is needed to improve the HCV care cascade and consequently eliminate hepatitis C. Using data from the PrebupIV study, we aimed to identify factors associated with HCV testing in PWID. We also studied gender effect, as women who inject drugs access HCV screening and care less frequently than their male counterparts. Methods: The present study used self-reported data on HCV screening collected for 453 of the 557 PWID enrolled in PrebupIV, a cross-sectional community-based survey conducted between May and August 2015 in France, which assessed PWID acceptability of injectable buprenorphine. Data were collected using face-to-face interviews and online questionnaires. Factors associated with recent (i.e., in the previous 6 months) HCV testing were identified using a multivariable logistic regression model with gender-interaction effects. Results: Among the PWID included, 18% were women and 32% reported recent HCV testing. Multivariable analysis showed that participants who declared that they did not talk about their injecting practices with anyone, were less likely to report recent testing (adjusted OR [95% CI]: 0.22 [0.07-0.63], p=0.005). Moreover, employed men (0.39 [0.23-0.68], p=0.001) and unemployed women (0.49 [0.25-0.98], p=0.043) were less likely to report recent testing than unemployed men. Conclusion: Our findings highlight differences and similarities between both genders. In terms of the former, unemployed women (like employed men) were less likely to have access to HCV testing than unemployed men. For the latter, the taboo of injection was associated with no recent HCV testing for both genders. This shows the importance of developing injectable treatments for opioid use disorder to improve access to care for PWID. Keywords: injecting drug use; testing; hepatitis C; gender; denial Disclosure of interest: None
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