RESUMO
Monitoring injecting drug users' (IDUs) health is challenging because IDUs form a difficult to reach population. We examined the impact of recruitment setting on hepatitis C prevalence. Individual datasets from 12 studies were merged. Predictors of HCV positivity were sought through a multilevel analysis using a mixed-effects logistic model, with study identifier as random intercept. HCV prevalence ranged from 21% to 86% across the studies. Overall, HCV prevalence was higher in IDUs recruited in drug treatment centres compared to those recruited in low-threshold settings (74% and 42%, respectively, P < 0·001). Recruitment setting remained significantly associated with HCV prevalence after adjustment for duration of injecting and recent injection (adjusted odds ratio 0·7, 95% confidence interval 0·6-0·8, P = 0·05). Recruitment setting may have an impact on HCV prevalence estimates of IDUs in Europe. Assessing the impact of mixed recruitment strategies, including respondent-driven sampling, on HCV prevalence estimates, would be valuable.
Assuntos
Hepatite C/epidemiologia , Programas de Troca de Agulhas , Seleção de Pacientes , Centros de Tratamento de Abuso de Substâncias , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Projetos de Pesquisa , Viés de Seleção , Estudos SoroepidemiológicosRESUMO
Limited data on HIV prevalence and related risks among men who have sex with men (MSM) exist in the Republic of Moldova. In Chisinau and Balti, 188 and 209, respectively, men who reported having anal or oral sex in the last six months with another man, aged ≥16 years were recruited into a study in 2010 using respondent-driven sampling methods. MSM reported having multiple male and female partners and inconsistent condom use. In Chisinau, 2% of MSM were HIV seropositive, 3.7% had antibodies to hepatitis C (HCV), 5.7% had antibodies to hepatitis B (HBV) and 12.1% had syphilis. In Balti, less than 1% of MSM were HIV seropositive, 1.2% had antibodies to HCV, 3.2% had antibodies to HBV and only 0.5% had syphilis. MSM who used a condom at last anal sex with a man were less likely to reside in Chisinau, to have casual sex partners and to have had an HIV test in the last year and were more likely to know where to get an HIV test. Although HIV prevalence was low, MSM practice a number of risky sexual behaviours that may heighten the risk of further HIV transmission in this population and to the wider population.