Increased risk for hepatitis C associated with solvent use among Canadian Aboriginal injection drug users
1 Centre for Global Public Health, University of Manitoba, R070 Med Rehab Bldg 771 McDermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada
2 Department of Community Health Sciences, University of Manitoba S113 - 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada
3 School of Population and Public Health, University of British Columbia 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada
4 Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada 100 Eglantine Driveway-Tunney's Pasture, Ottawa, Ontario K1A 0K9, Canada
5 Department of Epidemiology and Community Medicine, University of Ottawa Room 3104-451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
6 Department of Medical Microbiology, University of Manitoba 745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
7 Cadham Provincial Laboratory, Manitoba Health 750 William Avenue, Winnipeg, Manitoba R3C 3Y1, Canada
Harm Reduction Journal 2010, 7:16 doi:10.1186/1477-7517-7-16Published: 19 July 2010
Solvent abuse is a particularly serious issue affecting Aboriginal people. Here we examine the association between solvent use and socio-demographic variables, drug-related risk factors, and pathogen prevalence in Aboriginal injection drug users (IDU) in Manitoba, Canada.
Data originated from a cross-sectional survey of IDU from December 2003 to September 2004. Associations between solvent use and variables of interest were assessed by multiple logistic regression.
A total of 266 Aboriginal IDU were included in the analysis of which 44 self-reported recent solvent use. Hepatitis C infection was 81% in solvent-users, compared to 55% in those reporting no solvent use. In multivariable models, solvent-users were younger and more likely to be infected with hepatitis C (AOR: 3.5; 95%CI: 1.3,14.7), to have shared needles in the last six months (AOR: 2.6; 95%CI:1.0,6.8), and to have injected talwin & Ritalin (AOR: 10.0; 95%CI: 3.8,26.3).
High hepatitis C prevalence, even after controlling for risky injection practices, suggests that solvent users may form closed networks of higher risk even amongst an already high-risk IDU population. Understanding the social-epidemiological context of initiation and maintenance of solvent use is necessary to address the inherent inequalities encountered by this subpopulation of substance users, and may inform prevention strategies for other marginalized populations.