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Hepatitis B virus infection among street youths in Montreal

Élise Roy, MD, MSc^*, Nancy Haley, MD^*, Nicole Lemire, MA^*, Jean-François Boivin, MD, ScD, Pascale Leclerc, MSc^* and Jean Vincelette, MD, MSc

From *the Unité maladies infectieuses, Direction de la santé publique de Montréal-Centre, the Joint Department of Epidemiology, Biostatistics and Occupational Health, McGill University, and the Centre hospitalier de l'Université Montréal - campus Saint-Luc, Montreal, Que.

Abstract

Background: Street youths are at high risk for many health problems, including sexually transmitted diseases and bloodborne infections. The authors conducted a cross-sectional anonymous study from December 1995 to September 1996 involving street youths in Montreal to estimate the prevalence of risk behaviours for hepatitis B virus (HBV) infection and of markers of past and present HBV infection.

Methods: Participants were 437 youths aged 14 to 25 meeting specific criteria for itinerancy who were recruited in collaboration with the 20 major street youth agencies in Montreal. Sociodemographic and lifetime risk factor data were obtained during a structured interview, and a blood sample was taken to test for HBV markers (hepatitis B surface antigen and antibodies to the hepatitis B core antigen). Univariate analyses and multivariate logistic regressions were conducted.

Results: The mean age of the subjects was 19.5 years; 69.3% (303/437) were males. Many subjects had high-risk behaviours: 45.8% (200/437) had injected drugs, 24.5% (107/436) had engaged in prostitution, and 8.7% (38/437) reported having a sexual partner with a history of unspecified hepatitis. The prevalence rate for one or both HBV markers was 9.2% (40/434) (95% confidence interval [CI] 6.7%-12.3%). Multivariate logistic regression analysis showed that being over 18 years of age (adjusted odds ratio [OR] 4.5, 95% CI 1.8-11.7), having injected drugs (adjusted OR 3.5, 95% CI 1.5-8.3) and having had a sexual partner who had unspecified hepatitis (adjusted OR 3.2, 95% CI 1.3-7.5) were all associated with HBV infection.

Interpretation: Street youths are at high risk for HBV infection. Early and complete HBV vaccination among this vulnerable population is urgently needed.

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