Factors associated with hepatitis C and HIV testing uptake among men who inject image and performance enhancing drugs

Hope, Vivian, McVeigh, James ORCID: https://orcid.org/0000-0001-5319-6885, Begley, Emma, Glass, Rachel, Edmundsen, Claire, Heinsbroek, Ellen, Kean, Joseph, Campbell, John, Whitfield, Mark, Morgan, Gareth, Acreman, Dean and Smith, Josie (2021) Factors associated with hepatitis C and HIV testing uptake among men who inject image and performance enhancing drugs. Drug and Alcohol Review, 40 (4). pp. 586-596. ISSN 0959-5236

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Abstract

Introduction and Aims: Historically, people who inject image and performance enhancing drugs (IPED) were not perceived as being at high risk of HIV or hepatitis C virus (HCV) infection. However, recent studies indicate HCV and HIV prevalences are elevated, with many HCV infections undiagnosed. Design and Methods: Men who inject IPEDs recruited from community settings and specialist services, including needle-syringe programs, across UK during 2016 self-completed a questionnaire. Multivariate analyses examined factors associated with HCV/HIV testing. Results: The participants' (n=562; 24% service recruited) median age was 31 years, 4% identified as gay or bisexual, 18% had ever been imprisoned and 6% had ever injected a psychoactive drug. Those community recruited more often reported sharing drugs vials (16% vs. 8%, P=0.021) and, among those with 2+ sexual partners, poor condom use (50% vs. 36%, P=0.063), than those service recruited. Overall, one-third had ever been tested for HCV (31%) and/or HIV (34%). Testing uptake was associated with other risk factors for HCV/HIV, being recruited through services and having received metabolic tests. Participants' motivations for using IPEDs were associated with recruitment setting and HIV/HCV testing uptake. Discussion and Conclusions: The majority were untested for HCV/HIV. HCV/HIV testing and risks were associated with recruitment through services. Previous needle and syringe program-based studies have potentially overestimated testing uptake and underestimated risk. Targeted interventions are needed, particularly for those not accessing services. The association between HCV/HIV testing uptake and receipt of metabolic tests suggests that developing a combined offer of these tests as part of health monitoring could improve uptake.