Transitions from injecting to non-injecting drug use: Potential protection against HCV infection

• Published in: Journal of substance abuse treatment Vol. 46; no. 3; pp. 325 - 331
• Main Authors: Des Jarlais, Don C., Ph.D, McKnight, Courtney, M.P.H, Arasteh, Kamyar, Ph.D, Feelemyer, Jonathan, M.S, Perlman, David C., M.D, Hagan, Holly, Ph.D, Cooper, Hannah L.F., Sc.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2014; Elsevier; Elsevier Limited
• Subjects: Acquired Immunodeficiency Syndrome - epidemiology; Acquired Immunodeficiency Syndrome - prevention & control; Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Cross-Sectional Studies; Desintoxication. Drug withdrawal; Disease prevention; Drug abuse; Drug addiction; Drug use; Epidemics; Female; HCV; Hepatitis; Hepatitis C; Hepatitis C - prevention & control; HIV; Human immunodeficiency virus; Humans; Injecting drug use; Injections; Male; Medical sciences; Middle Aged; Miscellaneous; Non-injecting drug use; Prevalence; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Substance abuse; Substance abuse treatment; Substance Abuse, Intravenous - complications; Substance-Related Disorders - complications; Time Factors; Treatment; Treatments; United States > US; New York City New York; Non-injecting drug use; HCV; Substance abuse; Injecting drug use; HIV; Drug use; Intravenous administration; Hepatic disease; Prevention; Evolution; Protection; Public health; Viral hepatitis C; Consumption; Human; Drug; Immunopathology; Drug addiction; Use; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Addiction; Viral disease; Transition; Digestive diseases; Human immunodeficiency virus; Flaviviridae; Hepatitis C virus; Hepacivirus
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2013.09.004

Abstract Transitions from injecting to non-injecting drug use have been reported from many different areas, particularly in areas with large human immunodeficiency virus (HIV) epidemics. The extent to which such transitions actually protect against HIV and HCV has not been determined. A cross-sectional survey with HIV and hepatitis C (HCV) testing was conducted with 322 former injectors (persons who had injected illicit drugs but permanently transitioned to non-injecting use) and 801 current injectors recruited in New York City between 2007 and 2012. There were no differences in HIV prevalence, while HCV prevalence was significantly lower among former injectors compared to current injectors. Years injecting functioned as a mediating variable linking former injector status to lower HCV prevalence. Transitions have continued well beyond the reduction in the threat of AIDS to injectors in the city. New interventions to support transitions to non-injecting drug use should be developed and supported by both drug treatment and syringe exchange programs.