Linkage to hepatitis C virus care in a binational cohort study of People who inject drugs on the U.S.-Mexico border

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-06-19 DOI:10.1016/j.drugpo.2025.104899

Bo Shan Go , Daniela Abramovitz , Irina Artamonova , Alicia Harvey-Vera , Natasha Martin , Gudelia Rangel , Christian B. Ramers , Samantha Tweeten , Winston Tilghman , Steffanie A. Strathdee , Robert G. Deiss

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引用次数: 0

Abstract

Background

People who inject drugs (PWID) experience high rates of Hepatitis C Virus (HCV) infection in the U.S.-Mexico border region, but their care continuum is poorly characterized.

Methods

We analysed the HCV care continuum (linkage to care, initiation and completion of treatment) in a cohort of PWID in Tijuana, Mexico and San Diego. We also used multivariable Poisson regression to identify factors associated with linkage to HCV care among PWID in San Diego and Tijuana who reported prior HCV diagnosis.

Results

Among 133 PWID with active HCV infection in San Diego, 50.4 %, 16 % and 14.3 % reported prior awareness of their diagnosis; linkage to care and treatment completion; corresponding proportions for 21 PWID in Tijuana were 19 %, 14.3 % and 0 %. In multivariable analysis, factors independently associated with increased linkage to HCV care included receiving medication for opioid use disorder (MOUD) (Adjusted Prevalence Ratio [adjPR] 1.38; 95 % CI: 1.23–1.54) and HIV-seropositivity (adjPR 1.87 (95 %CI: 1.32–2.66). Tijuana residency (adjPR: 0.73; 95 % CI: 0.70–0.75) and younger age (adjPR 0.94 per 5-year age decrease; 95 % CI: 0.89–0.99) were independently associated with decreased linkage to care. Among PWID with a prior HCV diagnosis, 52.6 % and 40.7 % reported linkage to care in San Diego and Tijuana respectively.

Conclusions

Our study shows poor linkage to HCV-related care among PWID in both San Diego and Tijuana, along with low treatment completion. MOUD programs could be an efficient touchpoint to improve access to HCV care.

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在美墨边境注射毒品人群的两国队列研究中与丙型肝炎病毒护理的联系

背景注射吸毒者（PWID）在美墨边境地区丙型肝炎病毒（HCV）感染率很高，但他们的护理连续性特征不明显。方法：我们分析了墨西哥蒂华纳和圣地亚哥PWID队列的HCV治疗连续体（与治疗、开始和完成治疗的联系）。我们还使用多变量泊松回归来确定圣地亚哥和蒂华纳报告有HCV诊断的PWID患者中与HCV治疗相关的因素。结果在圣地亚哥133例HCV活动性感染的PWID患者中，50.4%、16%和14.3%的患者表示对自己的诊断知情；与完成护理和治疗的联系；蒂华纳21例PWID相应比例分别为19%、14.3%和0%。在多变量分析中，与HCV治疗相关性增加独立相关的因素包括接受阿片类药物使用障碍（mod）治疗(调整患病率比[adjPR] 1.38；95% CI: 1.23-1.54)和hiv血清阳性(adjPR: 1.87 （95% CI: 1.32-2.66）。蒂华纳居住地(adjPR: 0.73；95% CI: 0.70-0.75)和更年轻(每5年减少0.94；95% CI: 0.89-0.99)与护理相关性降低独立相关。在先前诊断为HCV的PWID中，分别有52.6%和40.7%报告与圣地亚哥和蒂华纳的护理有关。结论我们的研究显示圣地亚哥和蒂华纳的PWID患者与hcv相关护理的相关性较差，且治疗完成率较低。mod项目可以成为改善丙型肝炎病毒治疗可及性的有效接触点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.