9261 HEPATITIS C REPORT GALLEY - North West Public Health ...

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• A previous positive result for hepatitis C did not appear to result in a change in sharing behaviour (Section 4.4). However, those who had presented for previous tests were more likely to be reformed sharers (i.e. not currently sharing). This may be because counselling received at the time of the test was successful in reducing subsequent risk behaviour regardless of the actual results of the test. However, it may relate to those asking for a test already having decided to protect their health. Further work should examine in more detail the links between hepatitis C testing and the identified reduction in sharing behaviour. • Sharing injecting equipment is more likely to occur in smaller groups of fellow users (Figure 4), possibly because the user feels safe among friends or with a partner. The high prevalence of hepatitis C in drug users in the North West means sharing with anyone carries a high risk of hepatitis C infection. Information about the risks of sharing should stress this includes close friends and sexual partners. Health information should also help users address the problems around refusing to share with a partner. A CKNOWLEDGMENTS We would like to thank staff at each drug unit for recruiting subjects and administering questionnaires and the drug unit clients for taking part in the survey. We thank Rod Thomson and the North West health authorities for supporting this study, Gerry Hale for his help in co-ordinating the project, and Nick Beeching (Infectious Disease Unit, University Hospital Aintree) and Diana Leighton (Public Health Sector, Liverpool John Moores University) for comments on the manuscript. Andrew Weild (PHLS Communicable Disease Surveillance Centre) and David Hillier (Prison Health Policy Unit) provided helpful information on current policy on hepatitis C education for prisoners. Finally, we thank Colin Heron for assistance with the production of this report. H EPATITIS C IN INJECTING DRUG USERS IN THE N ORTH W EST 5
C ONTENTS Summary 2 Aims 2 Key Findings and Recommendations 3 Acknowledgments 5 1 Introduction 8 1.1 Background 8 1.2 Transmission 8 1.3 Prisons 10 1.4 Drug use in the North West 11 1.5 Harm reduction policies 13 1.6 Screening 13 1.7 Tests for hepatitis C 14 1.8 Disease course and treatment 14 2 Aims and Objectives 16 3 Methods 17 3.1 Subjects 17 3.2 Questionnaire 17 3.3 Testing 18 3.4 Statistics 18 4 Results 19 4.1 Comparison of injectors and non injectors 19 4.2 Contact groups 21 4.3 Predictors of hepatitis C and hepatitis B infection 23 4.4 Previous hepatitis C test history 29 4.5 Predicting sharing behaviour 30 4.6 Blood donation 32 5 Discussion 33 5.1 Contact Groups 33 5.2 Co-infection between hepatitis B and hepatitis C 34 5.3 Risk factors 34 5.4 Effects of testing on risk behaviour 35 5.5 Sharing behaviour 36 5.6 Blood Donation 37 5.7 Further research 37 5.8 Conclusions and Recommendations 38 References 40 6 H EPATITIS C IN INJECTING DRUG USERS IN THE N ORTH W EST
Page 1 and 2: Hepatitis C in injecting drug users
Page 3 and 4: S UMMARY Viruses such as HIV, hepat
Page 5: • Those who are infected with hep
Page 9 and 10: 1. INTRODUCTION 1.1 Background Viru
Page 11 and 12: where sexual partners do get infect
Page 13 and 14: ehaviour at some stage in their dru
Page 15 and 16: likely to use a condom and less lik
Page 17 and 18: 2. AIMS AND O BJECTIVES Reviewing c
Page 19 and 20: 3.3 Testing Subjects gave blood and
Page 21 and 22: Table 1b: Basic results: behaviours
Page 23 and 24: Table 2: Hepatitis C and B status a
Page 25 and 26: Table 3: Effects of risk factors on
Page 27 and 28: Figure 3: Percentage of injecting d
Page 29 and 30: Table 5: Percentage (number) of sub
Page 31 and 32: 4.5 Predicting sharing behaviour Pe
Page 33 and 34: 4.6 Blood donation Of those who had
Page 35 and 36: 5.2 Co-infection between hepatitis
Page 37 and 38: sharers were significantly more lik
Page 39 and 40: 5.8 Conclusions and Recommendations
Page 41 and 42: R EFERENCES Allory Y, Charlotte F,
Page 43 and 44: Hepatitis Information Network (2000
Page 45 and 46: Tagger A, Donato F, Ribero ML, Chie

9261 HEPATITIS C REPORT GALLEY - North West Public Health ...

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