Hepatitis C Screening Among Young People Who Inject Drugs

Abstract and Introduction

Abstract

Background: People who inject drugs (PWID) are at highest risk for hepatitis C virus (HCV) infection, yet many remain unaware of their infection status. New anti-HCV rapid testing has high potential to impact this.

Methods: Young adult (<30 years) active PWID were offered either the rapid OraQuick® or standard anti-HCV test involving phlebotomy, then asked to complete a short questionnaire about testing perceptions and preferences. Sample characteristics, service utilization, and injection risk exposures are assessed with the HCV testing choice as the outcome, testing preferences, and reasons for preference.

Results: Of 129 participants: 82.9% (n = 107) chose the rapid test. There were no significant differences between those who chose rapid vs. standard testing. A majority (60.2%) chose the rapid test for quick results; most (60.9%) felt the rapid test was accurate, and less painful (53.3%) than the tests involving venipuncture.

Conclusions: OraQuick® anti-HCV rapid test was widely accepted among young PWID. Our results substantiate the valuable potential of anti-HCV rapid testing for HCV screening in this high risk population.

Table 1. Characteristics of UFO study participants participating in the Rapid HCV testing study: (1) overall; and (2) in association with having chosen the rapid HCV test
Characteristic	Overall (N = 129)	Rapid test (N = 107)	Standard blood draw (N = 22)	P-value¹
N	N (%)	N (%)
Median age (range, IQR)[yrs]	25 (23–27)	25 (23–27)	25 (23–27)	0.75
Gender
Male	88	72 (81.8)	16 (18.2)	0.80
Female	40	34 (85.0)	6 (15.0)
Ethnicity
Non-white	55	48 (87.3)	7 (12.7)	0.35
White	74	59 (79.7)	15 (20.3)
Ethnicity
Asian, Asian-American	1	1 (100)	0 (0)	0.56
African American	5	4 (80.0)	1 (20.0)
Filipino	1	1 (100)	0 (0)
Latino/Hispanic	7	6 (85.7)	1 (14.3)
Native American	5	3 (60.0)	2 (40.0)
Caucasian	74	59 (79.7)	15 (20.3)
Other	9	8 (88.9)	1 (11.1)
Mixed	27	25 (92.6)	2 (7.4)
Previously tested for HIV
Yes	105	86 (81.9)	19 (18.1)	1.00
No	21	18 (85.7)	3 (14.3)
Missing^*	3		3
Self report anti-HIV results
Negative	101	83 (82.2)	18 (17.8)	1.00
Positive	5	4 (80.0)	1 (20.0)
Homeless, last 3 months
Yes	101	82 (81.2)	19 (18.8)	0.40
No	28	25 (89.3)	3 (10.7)
Completed grade 12
Yes	93	78 (83.9)	15 (16.1)	0.79
No	36	29 (80.6)	7 (19.4)
Seen health provider, last 3 months
Yes	64	52 (81.3)	12 (18.8)	0.82
No	64	54 (84.4)	10 (15.6)
Missing^*	1		1
Obtained new needles from NEP, last 3 months
Yes	95	77 (81.1)	18 (19)	0.43
No	33	29 (87.9)	4 (12.1)
Missing^*	1		1
Median years injecting (range, IQR)[yrs]	4.2 (1.7–7.5)	4 (1.5–7.7)	4.9 (2.1–6.5)	0.51
Inject every day in past 30 days
Yes	37	29 (78.4)	8 (21.6)	0.44
No	91	77 (84.6)	14 (15.4)
Missing^*	1		1

Table 1. Characteristics of UFO study participants participating in the Rapid HCV testing study: (1) overall; and (2) in association with having chosen the rapid HCV test

Characteristic

Overall (N = 129)

Rapid test (N = 107)

Standard blood draw (N = 22)

P-value¹

N (%)

Median age (range, IQR)[yrs]

25 (23–27)

0.75

Gender

Male

72 (81.8)

16 (18.2)

0.80

Female

34 (85.0)

6 (15.0)

Ethnicity

Non-white

48 (87.3)

7 (12.7)

0.35

White

59 (79.7)

15 (20.3)

Ethnicity

Asian, Asian-American

1 (100)

0 (0)

0.56

African American

4 (80.0)

1 (20.0)

Filipino

1 (100)

0 (0)

Latino/Hispanic

6 (85.7)

1 (14.3)

Native American

3 (60.0)

2 (40.0)

Caucasian

59 (79.7)

15 (20.3)

Other

8 (88.9)

1 (11.1)

Mixed

25 (92.6)

2 (7.4)

Previously tested for HIV

Yes

105

86 (81.9)

19 (18.1)

1.00

18 (85.7)

3 (14.3)

Missing^*

Self report anti-HIV results

Negative

101

83 (82.2)

18 (17.8)

1.00

Positive

4 (80.0)

1 (20.0)

Homeless, last 3 months

Yes

101

82 (81.2)

19 (18.8)

0.40

25 (89.3)

3 (10.7)

Completed grade 12

Yes

78 (83.9)

15 (16.1)

0.79

29 (80.6)

7 (19.4)

Seen health provider, last 3 months

Yes

52 (81.3)

12 (18.8)

0.82

54 (84.4)

10 (15.6)

Missing^*

Obtained new needles from NEP, last 3 months

Yes

77 (81.1)

18 (19)

0.43

29 (87.9)

4 (12.1)

Missing^*

Median years injecting (range, IQR)[yrs]

4.2 (1.7–7.5)

4 (1.5–7.7)

4.9 (2.1–6.5)

0.51

Inject every day in past 30 days

Yes

29 (78.4)

8 (21.6)

0.44

77 (84.6)

14 (15.4)

Missing^*

Table 2. Perceptions about HCV rapid test among young people who inject drugs in the UFO Study
Variable	N (%)
*Among all participants (N = 129)*
Belief in accuracy of rapid vs. Standard anti-HCV test
Much less accurate	3 (2.3)
Somewhat accurate	14 (10.9)
Just as accurate	70 (54.7)
More accurate	5 (3.9)
Much more accurate	3 (2.3)
Don't know	33 (25.8)
*Among HCV Rapid Test takers (N = 107)*
Main reason for choosing rapid anti-HCV test: (n = 83)*
1. Wanted fast results	50 (60.2)
2. Rapid test is more convenient	10 (12.1)
3. I am afraid of needles or blood draws	1 (1.2)
4. I have bad veins	3 (3.6)
5. Rapid test is less painful	4 (4.8)
6. Rapid test requires less blood	6 (7.2)
7. Rapid test is less stressful	4 (4.8)
8. Rapid test is newer	1 (1.2)
9. I trust the research staff experience	2 (2.4)
10. I was concerned I wouldn't get paid	2 (2.4)
Compared to standard blood draw, getting a finger prick was: (n = 99)
Much more painful	4 (4.0)
More painful	9 (9.1)
About the same amount of pain	33 (33.3)
Less painful	29 (29.3)
Much less painful	24 (24.2)
'I have tested for HCV in the past and I prefer receiving my results the same day' (n = 96)
Strongly agree	30 (31.3)
Agree	51 (53.1)
Disagree	13 (13.5)
Strongly disagree	2 (2.1)
'It would have been better to wait a week' (n = 97)
Strongly agree	0 (0)
Agree	3 (3.1)
Disagree	66 (68.0)
Strongly disagree	28 (28.9)
'I understand the results of my test' (n = 96)
Strongly agree	50 (52.1)
Agree	44 (45.8)
Disagree	1 (1)
Strongly disagree	1 (1)
'I would recommend rapid test to a friend' (n = 98)
Strongly agree	42 (42.9)
Agree	50 (51)
Disagree	2 (2)
Strongly disagree	4 (4.1)

Table 2. Perceptions about HCV rapid test among young people who inject drugs in the UFO Study

Variable

N (%)

Among all participants (N = 129)

Belief in accuracy of rapid vs. Standard anti-HCV test

Much less accurate

3 (2.3)

Somewhat accurate

14 (10.9)

Just as accurate

70 (54.7)

More accurate

5 (3.9)

Much more accurate

3 (2.3)

Don't know

33 (25.8)

Among HCV Rapid Test takers (N = 107)

Main reason for choosing rapid anti-HCV test: (n = 83)*

1. Wanted fast results

50 (60.2)

2. Rapid test is more convenient

10 (12.1)

3. I am afraid of needles or blood draws

1 (1.2)

4. I have bad veins

3 (3.6)

5. Rapid test is less painful

4 (4.8)

6. Rapid test requires less blood

6 (7.2)

7. Rapid test is less stressful

4 (4.8)

8. Rapid test is newer

1 (1.2)

9. I trust the research staff experience

2 (2.4)

10. I was concerned I wouldn't get paid

2 (2.4)

Compared to standard blood draw, getting a finger prick was: (n = 99)

Much more painful

4 (4.0)

More painful

9 (9.1)

About the same amount of pain

33 (33.3)

Less painful

29 (29.3)

Much less painful

24 (24.2)

'I have tested for HCV in the past and I prefer receiving my results the same day' (n = 96)

Strongly agree

30 (31.3)

Agree

51 (53.1)

Disagree

13 (13.5)

Strongly disagree

2 (2.1)

'It would have been better to wait a week' (n = 97)

Strongly agree

0 (0)

Agree

3 (3.1)

Disagree

66 (68.0)

Strongly disagree

28 (28.9)

'I understand the results of my test' (n = 96)

Strongly agree

50 (52.1)

Agree

44 (45.8)

Disagree

1 (1)

Strongly disagree

1 (1)

'I would recommend rapid test to a friend' (n = 98)

Strongly agree

42 (42.9)

Agree

50 (51)

Disagree

2 (2)

Strongly disagree

4 (4.1)

Preference, Acceptability and Implications of the Rapid Hepatitis C Screening Test Among High-Risk Young People Who Inject Drugs

Abstract and Introduction

Abstract

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

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