SOCIAL AND HEALTH VULNERABILITY ANALYSIS AMONG PEOPLE WHO INJECT DRUGS IN ARMENIA, COLOMBIA

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.101967

Javier Enrique Hernandez Blanco , Juan Ignacio Marin Zuluaga , Ismael de Jesús Yepes Barreto , Diana Chávez Bejarano , Alfredo Spath , Sara Milena Ramos Jaraba , Dedsy Yajaira Berbesí Fernández

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Abstract

Introduction and Objectives

People who inject drugs (PWID) face significant barriers to accessing healthcare, which increases their vulnerability to infections such as hepatitis C virus (HCV). Stigmatization, marginalization, and unsafe injection practices further elevate the risk of infection and hinder opportunities for timely diagnosis and treatment.

Objective

To characterize social and health vulnerability among PWID in Armenia, Colombia, and to determine the prevalence of HCV infection according to vulnerability levels.

Materials and Methods

A cross-sectional study was conducted using Respondent Driven Sampling (RDS) among 205 PWID between may 2024 and october 2024. Sociodemographic, drug use, and health condition data were collected through structured interviews. Rapid anti-HCV testing was performed, with confirmatory HCV RNA testing. A social vulnerability index was constructed using K-means cluster analysis to classify participants into low, medium, and high vulnerability groups.

Results

The HCV antibody testing was positive in 84% (172/205 cases).

The overall prevalence of HCV (with detectable viremia by quantitative measurement of HCV RNA) was 54.15% (111/205 cases).

High vulnerability was observed in 44.88% of participants and was significantly associated with higher HCV prevalence (29.35%; p=0.025). Key vulnerability factors included a history of incarceration (43.9%) and homelessness (40.49%). Most participants had low educational attainment (48.29% completed only primary education) and reported low monthly income levels.

Conclusions

There is a high burden of HCV infection among PWID in Armenia, particularly among those with higher social vulnerability. These findings highlight the urgent need for harm reduction strategies, systematic screening, and expanded access to antiviral treatment for highly marginalized populations.

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亚美尼亚、哥伦比亚注射吸毒者的社会和健康脆弱性分析

简介和目标注射吸毒者在获得医疗保健方面面临重大障碍，这增加了他们感染丙型肝炎病毒（HCV）等感染的脆弱性。污名化、边缘化和不安全的注射做法进一步提高了感染风险，阻碍了及时诊断和治疗的机会。目的了解亚美尼亚和哥伦比亚PWID人群的社会和健康脆弱性特征，并根据脆弱性水平确定HCV感染的流行情况。材料与方法采用问卷调查驱动抽样（RDS）方法，于2024年5月至2024年10月对205名PWID进行了横断面调查。通过结构化访谈收集社会人口统计、药物使用和健康状况数据。进行快速抗丙型肝炎病毒检测，并进行丙型肝炎病毒RNA确认检测。采用k -均值聚类分析构建社会脆弱性指数，将参与者划分为低、中、高脆弱性群体。结果HCV抗体检测阳性率为84%（172/205）。总体HCV患病率为54.15%（111/205例）（通过定量检测HCV RNA可检测到病毒血症）。44.88%的参与者存在高易感性，并与较高的HCV患病率显著相关（29.35%;p=0.025）。主要的脆弱性因素包括监禁史（43.9%）和无家可归（40.49%）。大多数参与者受教育程度较低（48.29%仅完成初等教育），月收入水平较低。结论亚美尼亚PWID患者的HCV感染负担较高，特别是在社会易感性较高的人群中。这些发现突出表明，迫切需要为高度边缘化人群制定减少危害战略、系统筛查和扩大抗病毒治疗的可及性。

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

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.