Seroprevalence and risk factors associated with hepatitis C: a cross-sectional study of persons who inject drugs in Puerto Rico, 2018

Background People Who Inject Drugs (PWID) are at a higher risk of acquiring bloodborne infections.

We aimed to estimate the seroprevalence of the Hepatitis C Virus (HCV) in PWID and identify correlates and risk factors using data from the Puerto Rico National HIV Behavioral Surveillance System, PWID cycle 5, conducted in 2018.

Methods A total of 502 San Juan Metropolitan Statistical Area participants were recruited through the Respondent Driven Sampling method.

Sociodemographic, health-related, and behavioral characteristics were assessed.

Testing for HCV antibodies was completed after the face-to-face survey.

Descriptive and logistic regression analyses were performed.

Results Overall seroprevalence of HCV was 76.5% (95% CI: 70.8-81.4%).

A significantly (p < 0.05) higher HCV seroprevalence was observed among PWID with the following characteristics: heterosexuals (78.5%), high school graduates (81.3%), tested for sexually transmitted infections (STI) in the past 12 months (86.1%), frequent speedball injection (79.4%), and knowing the HCV serostatus of the last sharing partner (95.4%).

Adjusted logistic regression models showed that having completed high school and reported STI testing in the past 12 months were significantly associated with HCV infection (OR_a = 2.23; 95% CI: 1.06–4.69; OR_a = 2.14; 95% CI: 1.06–4.30, respectively).

Conclusions We report a high seroprevalence of HCV infection in PWID.

Social health disparities and potential missed opportunities validate the continuing call for local action for public health and prevention strategies.