Correlates of the Hepatitis C Virus Among Injection Drug Users and their Sex Partners in Ciudad Juarez

Background: The drug using risk behaviors associated with injection drug use are a major public health issue due to the increased risk of contracting blood- borne pathogens such as the Hepatitis C Virus (HCV). Needle and syringe sharing is well established to be an efficient mode of transmission of HCV. The prevalence of HCV among injection drug users (IDUs) in Cd. Juarez is documented to be over 90%. However, the literature on the sexual transmission of HCV is minimal. Methods: The aim of this cross-sectional pilot study was to determine the prevalence and correlates of HCV and risk behaviors among IDUs and their non-injecting sex partners in Cd. Juarez. A mix of convenience sampling and snowball sampling was used for recruitment. The outreach workers interviewed 50 IDUs with their non-injecting sex partners (n=50 couples). The outreach workers administered a structured interview to assess demographics and sexual and drug using risk behaviors, conducted the rapid HCV test (OraQuick® HCV Rapid Antibody Test, OraSure Technologies, Inc.). Participants received an equivalent of $15 USD for their time. Univariate statistics were conducted for socio-demographic characteristics, sexual and drug behaviors, other HCV risks, and HCV status. Bivariate analyses were conducted for self-report sexual risk behaviors among the non-injecting sex partners by HCV status using Fisher Exact Tests. A p-value \u3c0.05 was considered to be statistically significant. Among the non-injecting sex partners, sex while under the influence of drugs or alcohol, unprotected vaginal or anal penile sex, traumatic anal sex, and having concurrent sexual partners were the exposure variables with HCV status as the outcome variable. Results: Among the IDUs and non-injecting sex partners, HCV prevalence was 96% and 18.4%, respectively. Those non-injecting sex partners who were HCV reactive also had IDU sex partners who were HCV reactive. Among those non-injecting sex partners who reported having sex, 42.9% of HCV reactive and 21.6% of HCV non-reactive reported having used drugs before, during, or after sex. This was not statistically significantly different based on the Fisher Exact Test (p=0.341). Among those non-injecting sex partners who reported having sex, 55.6% of HCV reactive and 80.0% of HCV non-reactive reported having used drugs before, during, or after sex, which was not statistically significantly different (Fisher Exact Test p=0.195). One non-injecting sex partner reported having traumatic anal sex and was HCV non-reactive. Among those non- injecting sex partners who reported having sex, 42.9% of HCV reactive and 8.1% of HCV reactive reported having concurrent sexual partners, which was statistically significantly different (Fisher Exact Test p=0.042). Conclusion: The findings suggested having concurrent sexual partners was associated with HCV reactivity. Future HCV prevention efforts (e.g., condom distribution, education