Abstract
BackgroundHomeless men are highly vulnerable to acquisition of the hepatitis C virus (HCV) compared to the general population. In Brazil, a country of continental dimensions, the extent of HCV infection in this population remains unknown. The objective of this study is to investigate the epidemiological profile of exposure to HCV in homeless men in Central Brazil.MethodsA Cross-sectional study was conducted in 481 men aged over 18 years attending therapeutic communities specialized in the recovery and reintegration of homeless people. Participants were tested for anti-HCV markers using rapid tests. Poisson regression analysis was used to verify the risk factors associated with exposure to HCV.ResultsThe prevalence of HCV exposure was 2.5% (95.0% CI: 1.4 to 4.3%) and was associated with age, absence of family life, injection drug use, number of sexual partners, and history of sexually transmitted infections (STI). Participants reported multiple risk behaviors, such as alcohol (78.9%), cocaine (37.1%) and/or crack use (53.1%), and inconsistent condom use (82.6%). Injection drug use was reported by 8.7% of participants.ConclusionsThe prevalence of HCV infection among homeless men was relatively high. Several risk behaviors were commonly reported, which shows the high vulnerability of this population. These findings emphasize the need for the development of specific strategies to reduce the risk of HCV among homeless men.
Highlights
Homeless men are highly vulnerable to acquisition of the hepatitis C virus (HCV) compared to the general population
In order to bridge the current gap in knowledge, this study aims to investigate the epidemiology of HCV exposure in homeless men in Central Brazil
Our findings show a high prevalence of HCV infection in homeless men and an association with age, lack of family life, injection drug use, number of sexual partners, and sexually transmitted infections (STI) history
Summary
Homeless men are highly vulnerable to acquisition of the hepatitis C virus (HCV) compared to the general population. In Brazil, the prevalence of HCV infection in the general population is 1.3%, with differences among Brazilian regions (from 0.68% in the Northeast to 2.1% in the North); in the Midwest, a prevalence of 1.6% is estimated among individuals over 20 years-old [4]. In addition to behavioral determinants, factors related to social and programmatic vulnerabilities, such as low income and education, discrimination based on social condition or sexual orientation, loss of family ties, and difficulty accessing health services may contribute indirectly to the spread of HCV, especially in key populations (non-injection and injection drug users, sex workers, men who have sex with men, and homeless people) [8, 9]
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