"The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil

Maria De Lourdes Aguiar Oliveira,Mariana A Hacker,Clara Fumiko Tachibana Yoshida,Sabrina Alberti Nóbrega De Oliveira,Francisco I Bastos,Paulo Roberto Telles,Kycia Maria Rodrigues Do Ó

doi:10.1590/s0102-311x2006000400024

Maria De Lourdes Aguiar Oliveira, Mariana A Hacker + Show 5 more

Open Access

https://doi.org/10.1590/s0102-311x2006000400024

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Abstract

The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus) infection were investigated. Injection drug users (IDUs) (N = 606) were recruited in "drug scenes" (public places, bars) in Rio de Janeiro, Brazil, interviewed, and tested for HCV. Sharing of needles/syringes was more prevalent at the first injection (51.3%) than at the baseline interview (36.8%). Those who shared syringes/needles at first injection were more likely to be currently engaged in direct/indirect sharing practices. Among young injectors (< 30 years), those reporting sharing of needles/ syringes at the first injection were about four times more likely to have been infected by HCV. Hepatitis C virus prevalence among active IDUs (n = 272) was 11%. Prison history and longer duration of drug injection were identified as independent predictors of HCV infection. To effectively curb HCV transmission among IDUs and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs.

Highlights

The context of first drug injection and its association with ongoing injecting practices and hepatitis C virus (HCV) infection were investigated
Among young injectors (< 30 years), those reporting sharing of needles/ syringes at the first injection were about four times more likely to have been infected by HCV
To effectively curb HCV transmission among injection drug users (IDUs) and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs

Summary

Introduction

The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus) infection were investigated. Among young injectors (< 30 years), those reporting sharing of needles/ syringes at the first injection were about four times more likely to have been infected by HCV. A declining prevalence of blood-borne pathogens has been described among IDUs in some contexts, such as the United States, Spain, and Brazil [11,12,13,14] Despite such auspicious findings, the prevalence of HCV infection remains unacceptably high. The prevalence and predictors of HCV infection among active IDUs were discussed This information is pivotal to implement preventive strategies directed to young drug users who have not started to inject and/or to prevent harmful practices among those commencing to inject. The study was designed to provide policy- and decision-makers with comprehensive and reliable information for intervention development on injecting drug use and its health consequences by conducting rapid assessments linked with behavioral and seroprevalence (HIV, hepatitis B and C) surveys among injection drug users

Subjects and methods

Findings

Discussion