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

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.