Prevalence of HIV/Hepatitis C Virus Co-Infection and Injection Risk Correlations in People Who Inject Drugs in Colombia: A Cross-Sectional Study Using Respondent Driven Sampling

Abstract

Background: In Colombia, an exponential growth of people who inject drugs (PWID) has been reported over the past decades. The main burden of disease in PWID is attributed to human immunodeficiency virus (HIV) and hepatitis C virus (HCV) and their co-infection is associated with poor prognosis, high morbidity and treatment related implications. Nevertheless, the prevalence of HIV/HCV co-infection in Colombian PWIDs is unknown. Objective: To determine the prevalence, demographic characteristics, and injecting behaviors of HIV/HCV co-infected PWID in Colombia. Methods: This was a cross-sectional study of 1,123 PWID recruited by respondent driven sampling in five Colombian cities between January and June of 2014. Each participant completed a quantitative survey, and blood samples for HIV and HCV antibody testing were obtained. A multinomial logistic regression was used for statistical analysis. Results: Average participant age was 26.3 ± 6.5 years, and the majority was male (86%). HIV or HCV mono-infection prevalence was 27.6%, while co-infection was 3.3%. Compared with PWID with mono-infection, co-infected PWID exhibited higher odds of: injecting ≥4 times daily (OR: 3.5; CI: 1.7–7.2; p < .001), cleaning needles and syringes with water (OR 3.2; CI: 1.6–6.3; p < .001), passing drug mix between syringes (OR: 2.7; CI: 1.3–5.3; p = .04), injecting on illegal indoor shooting galleries (OR: 2.4; CI: 1.0–5.3, p = .02), and getting injected by someone who charges for injecting (OR 2.3; CI: 1.0–5.2; p = .04). Conclusion: Prevalence of HIV/HCV co-infection among PWID in Colombia is lower than that reported in other countries. However, addressing the identified demographic characteristics and injection risk behaviors of co-infected PWID is essential for the implementation of broadly available harm reduction interventions as well as routine HIV/HCV testing and treatment strategies aiming to control the spread of both viruses and their associated morbidity and mortality.