Factors associated with HCV risk practices in methadone-maintained patients: the importance of considering the couple in prevention interventions

Substance Abuse Treatment, Prevention, and Policy

Patrizia M Carrieri³  Alain Morel⁵  Bruno Spire³  Fabienne Marcellin³  Jean-Pierre Daulouède⁴  Marion Mora³  Laurent Michel²  Caroline Lions³  Perrine Roux¹ 

[1] INSERM U912 – ORS PACA, 23 rue Stanislas Torrents, 13006 Marseille, France;Centre Pierre Nicole, Paris, France;ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France;Centre medico-social Bizia, Bayonne, France;Oppelia, Paris, France

关键词: Couples;    Sharing;    Cocaine;    Risk practices;    HCV transmission;    Methadone;   

Others  :  1136619
DOI  :  10.1186/1747-597X-9-37

 received in 2014-05-28, accepted in 2014-09-05,  发布年份 2014

【 摘 要 】

Background

One important public health issue associated with opioid use today is the risk of hepatitis C (HCV) infection. Although methadone maintenance may help to decrease HCV-related risk practices, HCV risk behaviors persist and are strongly associated with specific substance use patterns, mental status and social context. The ANRS-Methaville study gave us the opportunity to better disentangle the different relationships between these various factors and HCV risk practices.

Methods

The ANRS-Methaville multisite randomized trial was designed to assess the feasibility of initiating methadone in primary care by comparing it with methadone initiation in specialized centers. This study recruited 195 participants initiating methadone maintenance and followed up for 12 months. Longitudinal data from this trial was used to acquire a greater understanding of HCV risk practices and their pattern of correlates in this population. We selected 176 patients who had data on HCV risk practices at M0 and M12, accounting for 312 visits. HCV risk practices were defined as follows: sharing needles or syringes, sharing drug paraphernalia, getting a tattoo or having a piercing in a non-professional context, sharing toiletry items. To identify factors associated with HCV risk practices, we performed a mixed logistic regression analysis.

Results

HCV risk practices were reported by 19% and 15% of participants at baseline and M12, respectively. After adjustment for age, cocaine use and alcohol dependence as well as suicidal risk, living in a couple with a non-drug user and in a couple with a drug user were both independent predictors of HCV risk practices (OR[CI95%] = 4.16 [1.42-12.12]; OR[CI95%] = 9.85 [3.13-31.06], respectively).

Conclusions

Identifying individuals at risk of HCV transmission during methadone treatment such as stimulant users, alcohol dependent individuals, and those at suicidal risk is necessary to optimize response to treatment. Innovative prevention approaches tailored to couples are also urgently needed and could decrease HCV-risk in this population.

The trial is registered with the French Agency of Pharmaceutical Products (ANSM) under the number 2008-A0277-48, the European Union Drug Regulating Authorities Clinical Trials. Number Eudract 2008-001338-28, the ClinicalTrials.gov Identifier: NCT00657397 and the International Standard Randomised Controlled Trial Number Register ISRCTN31125511.

【 授权许可】

   
2014 Roux et al.; licensee BioMed Central Ltd.

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