Hepatitis C virus infection and needle exchange use among young injection drug users in San Francisco

Hepatology. 2001 Jul;34(1):180-7. doi: 10.1053/jhep.2001.25759.


Young injection drug users (IDUs) in San Francisco may be at high risk for hepatitis C virus (HCV) infection despite access to several needle exchange venues. The authors conducted a cross-sectional study from 1997 to 1999 in San Francisco to estimate the prevalence and incidence of antibody to HCV (anti-HCV) among street-recruited IDUs under age 30, and to examine risk behaviors and sources of sterile needles. Among 308 participants, the prevalence of anti-HCV was 45%. Using statistical modeling, incidence of HCV infection was estimated to be 11 per 100 person years. Independent risk factors for anti-HCV included age (odds ratio [OR], 1.17 per year; 95% confidence interval [CI], 1.05-1.30), years injecting (OR, 1.21 per year; 95% CI, 1.10-1.34), years in San Francisco (OR, 1.06 per year; 95% CI, 1.00-1.14), first injected by a sex partner (OR, 4.06; 95% CI, 1.74-9.52), injected daily (OR, 3.85; 95% CI, 2.07-7.17), ever borrowed a needle (OR, 2.56; 95% CI, 1.18-5.53), bleached last time a needle was borrowed (OR, 0.50; 95% CI, 0.24-1.02), snorted or smoked drugs in the prior year (OR, 0.48; 95% CI, 0.26-0.89), and injected by someone else in the prior month (OR, 0.50; 95% CI, 0.25-0.99). In the prior month, 88% used at least 1 of several needle exchange venues, and 32% borrowed a needle. We conclude that anti-HCV prevalence is lower than in previous studies of older IDUs, but 11% incidence implies high risk of HCV infection in a long injecting career. Despite access to sterile needles, borrowing of needles persisted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Cocaine-Related Disorders / epidemiology
  • Cross-Sectional Studies
  • Female
  • Hepatitis C / epidemiology*
  • Hepatitis C Antibodies / blood
  • Heroin Dependence / epidemiology
  • Humans
  • Male
  • Methamphetamine / administration & dosage
  • Models, Statistical
  • Multivariate Analysis
  • Needle Sharing
  • Needle-Exchange Programs*
  • Risk Factors
  • San Francisco / epidemiology
  • Sexual Behavior
  • Sexual Partners
  • Substance Abuse, Intravenous*
  • Time Factors


  • Hepatitis C Antibodies
  • Methamphetamine