Sector News

  1. How does a Positive or Negative Hepatitis C Virus Test Impact Behavior?

    Background

    • Worldwide, Hepatitis C virus (HCV) prevalence among injection drug users is estimated between 50% and 90%.
    • HCV testing and counselling can be used as an opportunity to influence behaviour and transmission of HCV at the time of test notification. For example, a study conducted in Montreal showed a decrease in syringe sharing after participants were made aware of both positive and negative HCV test results in an addition to a reduction of alcohol use. However the results were limited due to a small sample size.

    Approach

    • The authors used data from the International Collaboration of Incident HIV and HCV Infection in Injecting Cohorts (InC3 Study), which is a multicohort study of pooled data from prospective studies of people who inject drugs (PWID) in Canada, USA, The Netherlands, and Australia. Participants were recruited and followed between 1985 and 2011. The sample included 829 people who inject drugs.

    Findings

    • Notification of a HCV test result showed a reduction in recent injection drug use and recent syringe sharing for both those who received a positive and negative HCV test result (5% and 3% reduction, respectively). There were no significant differences between the two groups.
    • Recent Australian and Canadian data show some sustained behavioural changes associated with the notification process.
    • The proportion of participants using alcohol increased among those who received a positive HCV test
    • Younger (under 25 years) PWID populations who received a positive HCV test significantly increased alcohol consumption in comparison to the HCV-negative group.

    Conclusion

    Timely notification of HCV test results is a key opportunity for risk behavior reduction counseling. In addition, there is need to expand post-test counseling services and monitoring in order to address post-diagnosis alcohol use.

    Spelman, T., Morris, M.D., and Zang, G. (2015). A longitudinal study of hepatitis C virus testing and infection status notification on behavior change in people who inject drugs. J Epidemiol Community Health. 69(8): 745–752.