Risk Factors Associated with Prescription Opioid Use and Hepatitis C Infection among Young Persons who Inject Drugs in Rural Wisconsin Open Access

Ahmed, Farah (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/q811kj631?locale=en


Introduction: Recent research from the Centers for Disease Control suggest that the current increase of hepatitis C (HCV) cases in the United States is associated with the present opioid epidemic among young adults [1]. However, literature on the association between injecting prescription opioids (PO) and HCV infection is limited.

Methods:   This cross-sectional study collected survey data between 2014 and 2015 from 280 injection drug users between the ages of 18 to 29 who visited one of three different syringe service programs in rural Wisconsin.  Chi-square analyses were conducted to determine if there was a difference in the risk factors associated with injecting prescription opioids versus not. Logistic regression was conducted to examine the association between injecting prescription opioids and having a positive HCV test result after controlling for confounding variables.

Results: The majority of the study population were white (81.9%), had attained at least a high school diploma or GED (72.1%), and had a mean age of 23.4 years. Chi-square test results showed that race, sharing needles, number of lifetime injections,  average number of injections for a single dose, and syringe barrel size significantly differed by use of POs at the p=.05 level.  In bivariate analysis, using prescription opioids compared to not using prescription opioids, was found to be significantly associated with having a positive HCV test result at p<0.05 (OR=2.00, 95% CI: 1.20, 3.34) but was found to no longer be a significant predictor of HCV status when adjusted for other covariates (aOR=0.75, 95% CI: 0.37, 1.52).  Age (aOR=2.26, 95% CI: 1.19, 4.30), number of lifetime injections (100-1000 lifetime injections, aOR=5.19, 95% CI: 1.34, 20.03) (1000+ injections, (aOR=9.46, 95% CI: 2.29, 39.05), and number of times a participant had shared needles in the past (aOR=6.48, 95% CI: 2.46, 17.01) were all significant predictors of HCV status in the final model.

Discussion:  Although our analyses did not show that prescription opioid injection was associated with higher risk of HCV infection after adjusting for covariates, it is still important to understand the risk behaviors and characteristics of PO users in order to tailor HCV prevention strategies for this target population. 

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