Advertisement

 

 

A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia.

A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia.
Author Information (click to view)

Butt ZA, Shrestha N, Wong S, Kuo M, Gesink D, Gilbert M, Wong J, Yu A, Alvarez M, Samji H, Buxton JA, Johnston JC, Cook VJ, Roth D, Consolacion T, Murti M, Hottes TS, Ogilvie G, Balshaw R, Tyndall MW, Krajden M, Janjua NZ, ,


Butt ZA, Shrestha N, Wong S, Kuo M, Gesink D, Gilbert M, Wong J, Yu A, Alvarez M, Samji H, Buxton JA, Johnston JC, Cook VJ, Roth D, Consolacion T, Murti M, Hottes TS, Ogilvie G, Balshaw R, Tyndall MW, Krajden M, Janjua NZ, , (click to view)

Butt ZA, Shrestha N, Wong S, Kuo M, Gesink D, Gilbert M, Wong J, Yu A, Alvarez M, Samji H, Buxton JA, Johnston JC, Cook VJ, Roth D, Consolacion T, Murti M, Hottes TS, Ogilvie G, Balshaw R, Tyndall MW, Krajden M, Janjua NZ, ,

Advertisement

PloS one 2017 08 2212(8) e0183609 doi 10.1371/journal.pone.0183609

Abstract
BACKGROUND
Co-occurrence of social conditions and infections may affect HIV/HCV disease risk and progression. We examined the changes in relationship of these social conditions and infections on HIV and hepatitis C virus (HCV) infections over time in British Columbia during 1990-2013.

METHODS
The BC Hepatitis Testers Cohort (BC-HTC) includes ~1.5 million individuals tested for HIV or HCV, or reported as a case of HCV, HIV, HBV, or tuberculosis linked to administrative healthcare databases. We classified HCV and HIV infection status into five combinations: HIV-/HCV-, HIV+monoinfected, HIV-/HCV+seroconverters, HIV-/HCV+prevalent, and HIV+/HCV+.

RESULTS
Of 1.37 million eligible individuals, 4.1% were HIV-/HCV+prevalent, 0.5% HIV+monoinfected, 0.3% HIV+/HCV+ co-infected and 0.5% HIV-/HCV+seroconverters. Overall, HIV+monoinfected individuals lived in urban areas (92%), had low injection drug use (IDU) (4%), problematic alcohol use (4%) and were materially more privileged than other groups. HIV+/HCV+ co-infected and HIV-/HCV+seroconverters were materially most deprived (37%, 32%), had higher IDU (28%, 49%), problematic alcohol use (14%, 17%) and major mental illnesses (12%, 21%). IDU, opioid substitution therapy, and material deprivation increased in HIV-/HCV+seroconverters over time. In multivariable multinomial regression models, over time, the odds of IDU declined among HIV-/HCV+prevalent and HIV+monoinfected individuals but not in HIV-/HCV+seroconverters. Declines in odds of problematic alcohol use were observed in HIV-/HCV+seroconverters and coinfected individuals over time.

CONCLUSIONS
These results highlight need for designing prevention, care and support services for HIV and HCV infected populations based on the evolving syndemics of infections and social conditions which vary across groups.

Submit a Comment

Your email address will not be published. Required fields are marked *

six − 5 =

[ HIDE/SHOW ]