August 13, 2002
Injection drug users (IDUs) account for more than 60 percent of all new hepatitis C virus (HCV) infections in the United States. Fifty to eighty percent of new IDUs are infected within 6 to 12 months of initial injection. Current treatment regimens are not highly effective, and no vaccine against HCV is available.
Studies suggest that drug treatment and syringe exchange programs play a role in reducing HCV infection among participants by promoting drug abstinence or safer injection practices among those who continue to use drugs. The New York City Department of Health conducted a survey of local drug treatment and syringe exchange programs to determine whether their HCV screening and counseling practices were carried out, as recommended in recent federal guidelines.
In March 1999, 141 agency directors (all 132 drug treatment programs listed in the state drug services directory, nine syringe exchange programs and eight unaffiliated drug treatment programs) received a survey asking about client characteristics, hepatitis screening (based on laboratory testing or client self-report), HCV education and counseling and barriers to offering HCV services. Seventy percent of the programs (99) and four syringe exchange programs responded. The analysis of data was based on 113 questionnaires completed by 109 programs and the four syringe exchange programs.
This survey, among others, found that despite enrollment in treatment programs, many clients continue to use illicit drugs and engage in practices that place them at risk for HCV infection. Because drug treatment programs and syringe exchange programs provide access to the highest-risk population for HCV, targeted screening at these facilities would prove to be cost-effective, especially among younger clients who may have the highest incidence of HCV. Facilities should be provided with adequate resources to initiate and expand their HCV screening and education programs, the authors concluded.
American Journal of Public Health
08.02; Vol. 92; No. 8:1254-1256; Chi-Chi N. Udeagu Pratt, M.P.H.; Denise Paone, Ed.D.; Rosalind J. Carter, Ph.D.; Marcelle C. Layton, M.D.