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CMAJ • September 4, 2001; 165 (5)
© 2001 Canadian Medical Association or its licensors

Research
Recherche

Risk factors for hepatitis C virus infection among street youths

Élise Roy*§, Nancy Haley*{dagger}§, Pascale Leclerc*, Jean-François Boivin*§, Lyne Cédras* and Jean Vincelette{ddagger}

From *the Montreal Regional Public Health Department, {dagger}Centre hospitalier de l'Université de Montréal — Hôpital Sainte-Justine, {ddagger}Centre hospitalier de l'Université de Montréal — Hôpital Saint-Luc and §McGill University, Montreal, Que.

Correspondence to: Dr. Élise Roy, Infectious Diseases Unit, Montreal Regional Public Health Department, 1301 Sherbrooke St. E, Montréal QC H2L 1M3; fax 514 528-2452; eroy{at}santepub-mtl.qc.ca

Background: The relative contributions to risk of hepatitis C virus (HCV) infection resulting from unsafe sexual behaviours and exposures to blood (e.g., tattooing, body piercing and injection drug use) among youths at risk are not well known. We interviewed street youths about risk factors for HCV infection and documented their HCV antibody status.

Methods: From December 1995 to September 1996 we recruited 437 youths aged 14 to 25 years who met specific criteria for itinerancy. Data on sociodemographic characteristics and lifetime risk factors were obtained during a structured interview, and a venous blood sample was taken for HCV antibody testing.

Results: Many of the subjects reported behaviours that put them at risk for bloodborne diseases: 45.8% had injected drugs, 56.5% had at least 1 tattoo, and 78.3% had body piercing. The overall prevalence of HCV infection was 12.6% (95% confidence interval [CI] 9.7%–15.9%). In a multivariate logistic regression analysis, injecting drugs (adjusted odds ratio [OR] 28.4 [95% CI 6.6–121.4]), being over 18 years of age (adjusted OR 3.3 [95% CI 1.6–7.0]) and using crack cocaine (adjusted OR 2.3 [95% CI 1.0–5.3]) were independent risk factors for HCV infection. Having more than 1 tattoo (adjusted OR 1.8 [95% CI 0.95–3.6]) was marginally associated with HCV infection, and body piercing was not.

Interpretation: Drug injection was the factor most strongly associated with HCV infection among street youths. Given that injection drug users are the driving force of the HCV infection epidemic in Canada, increased intervention efforts to prevent initiation of drug injection are urgently needed to curb the epidemic.




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