The role of living context in prescription opioid injection and the associated risk of hepatitis C infection

Rachel Sacks-Davis, Mark DANIEL, Elise Roy, Yan Kestens, Geng Zang, Yuddy Ramos, Margaret Hellard, Didier Jutras-Aswad, Julie Burneau

Research output: Contribution to journalArticle

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Abstract

Background and aims: Prescription opioid injection (POI) is a leading risk factor for hepatitis C virus (HCV). Residential context relates to high-risk injection behaviour. This study assessed whether residence in the inner city (versus surrounding areas in Montréal Island) modified the effects of correlates of POI or the relationship between POI and HCV incidence. Design: Prospective cohort study. Setting: Montréal, Canada. Participants: A total of 854 people who inject drugs (18% female, 25% age < 30 years), living on Montréal Island, were interviewed every 3–6 months from 2004 to 2012. Measurements: Study visits included HCV antibody testing and an interviewer-administered questionnaire. Generalized estimating equations were used to test whether place of residence modified the effects of correlates of POI. Cox regression was used to test whether place of residence modified the relationship between POI and HCV incidence. Findings: At baseline, inner-city participants were more likely to report POI in the past month (40 versus 25%, P < 0.001). The association between POI and heroin injection, syringe sharing and sharing of injecting equipment varied according to place of residence and was greater in the inner city. The hazard of HCV infection associated with POI was greater among inner-city participants compared to those in the surrounding areas [adjusted hazard ratio (HR) = 3.38, 95% confidence interval (CI) = 1.88–6.07 versus HR = 1.26, 95% CI = 0.65–2.42, P = 0.025]. Conclusions: Among people who inject prescription opioids in Montréal, Canada, those who live in inner-city areas are more likely to engage in injecting-related risk behaviours and have a higher risk of hepatitis C virus infection than those who live in the suburbs
Original languageEnglish
Pages (from-to)1985-1996
Number of pages12
JournalAddiction
Volume111
Issue number11
DOIs
Publication statusPublished - 2016
Externally publishedYes

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Hepatitis C
Opioid Analgesics
Prescriptions
Injections
Infection
Hepacivirus
Virus Diseases
Risk-Taking
Islands
Canada
Needle Sharing
Confidence Intervals
Hepatitis C Antibodies
Heroin
Incidence
Cohort Studies
Prospective Studies
Interviews
Equipment and Supplies

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Sacks-Davis, R., DANIEL, M., Roy, E., Kestens, Y., Zang, G., Ramos, Y., ... Burneau, J. (2016). The role of living context in prescription opioid injection and the associated risk of hepatitis C infection. Addiction, 111(11), 1985-1996. https://doi.org/10.1111/add.13470
Sacks-Davis, Rachel ; DANIEL, Mark ; Roy, Elise ; Kestens, Yan ; Zang, Geng ; Ramos, Yuddy ; Hellard, Margaret ; Jutras-Aswad, Didier ; Burneau, Julie. / The role of living context in prescription opioid injection and the associated risk of hepatitis C infection. In: Addiction. 2016 ; Vol. 111, No. 11. pp. 1985-1996.
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title = "The role of living context in prescription opioid injection and the associated risk of hepatitis C infection",
abstract = "Background and aims: Prescription opioid injection (POI) is a leading risk factor for hepatitis C virus (HCV). Residential context relates to high-risk injection behaviour. This study assessed whether residence in the inner city (versus surrounding areas in Montr{\'e}al Island) modified the effects of correlates of POI or the relationship between POI and HCV incidence. Design: Prospective cohort study. Setting: Montr{\'e}al, Canada. Participants: A total of 854 people who inject drugs (18{\%} female, 25{\%} age < 30 years), living on Montr{\'e}al Island, were interviewed every 3–6 months from 2004 to 2012. Measurements: Study visits included HCV antibody testing and an interviewer-administered questionnaire. Generalized estimating equations were used to test whether place of residence modified the effects of correlates of POI. Cox regression was used to test whether place of residence modified the relationship between POI and HCV incidence. Findings: At baseline, inner-city participants were more likely to report POI in the past month (40 versus 25{\%}, P < 0.001). The association between POI and heroin injection, syringe sharing and sharing of injecting equipment varied according to place of residence and was greater in the inner city. The hazard of HCV infection associated with POI was greater among inner-city participants compared to those in the surrounding areas [adjusted hazard ratio (HR) = 3.38, 95{\%} confidence interval (CI) = 1.88–6.07 versus HR = 1.26, 95{\%} CI = 0.65–2.42, P = 0.025]. Conclusions: Among people who inject prescription opioids in Montr{\'e}al, Canada, those who live in inner-city areas are more likely to engage in injecting-related risk behaviours and have a higher risk of hepatitis C virus infection than those who live in the suburbs",
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Sacks-Davis, R, DANIEL, M, Roy, E, Kestens, Y, Zang, G, Ramos, Y, Hellard, M, Jutras-Aswad, D & Burneau, J 2016, 'The role of living context in prescription opioid injection and the associated risk of hepatitis C infection', Addiction, vol. 111, no. 11, pp. 1985-1996. https://doi.org/10.1111/add.13470

The role of living context in prescription opioid injection and the associated risk of hepatitis C infection. / Sacks-Davis, Rachel; DANIEL, Mark; Roy, Elise; Kestens, Yan; Zang, Geng; Ramos, Yuddy; Hellard, Margaret; Jutras-Aswad, Didier; Burneau, Julie.

In: Addiction, Vol. 111, No. 11, 2016, p. 1985-1996.

Research output: Contribution to journalArticle

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T1 - The role of living context in prescription opioid injection and the associated risk of hepatitis C infection

AU - Sacks-Davis, Rachel

AU - DANIEL, Mark

AU - Roy, Elise

AU - Kestens, Yan

AU - Zang, Geng

AU - Ramos, Yuddy

AU - Hellard, Margaret

AU - Jutras-Aswad, Didier

AU - Burneau, Julie

PY - 2016

Y1 - 2016

N2 - Background and aims: Prescription opioid injection (POI) is a leading risk factor for hepatitis C virus (HCV). Residential context relates to high-risk injection behaviour. This study assessed whether residence in the inner city (versus surrounding areas in Montréal Island) modified the effects of correlates of POI or the relationship between POI and HCV incidence. Design: Prospective cohort study. Setting: Montréal, Canada. Participants: A total of 854 people who inject drugs (18% female, 25% age < 30 years), living on Montréal Island, were interviewed every 3–6 months from 2004 to 2012. Measurements: Study visits included HCV antibody testing and an interviewer-administered questionnaire. Generalized estimating equations were used to test whether place of residence modified the effects of correlates of POI. Cox regression was used to test whether place of residence modified the relationship between POI and HCV incidence. Findings: At baseline, inner-city participants were more likely to report POI in the past month (40 versus 25%, P < 0.001). The association between POI and heroin injection, syringe sharing and sharing of injecting equipment varied according to place of residence and was greater in the inner city. The hazard of HCV infection associated with POI was greater among inner-city participants compared to those in the surrounding areas [adjusted hazard ratio (HR) = 3.38, 95% confidence interval (CI) = 1.88–6.07 versus HR = 1.26, 95% CI = 0.65–2.42, P = 0.025]. Conclusions: Among people who inject prescription opioids in Montréal, Canada, those who live in inner-city areas are more likely to engage in injecting-related risk behaviours and have a higher risk of hepatitis C virus infection than those who live in the suburbs

AB - Background and aims: Prescription opioid injection (POI) is a leading risk factor for hepatitis C virus (HCV). Residential context relates to high-risk injection behaviour. This study assessed whether residence in the inner city (versus surrounding areas in Montréal Island) modified the effects of correlates of POI or the relationship between POI and HCV incidence. Design: Prospective cohort study. Setting: Montréal, Canada. Participants: A total of 854 people who inject drugs (18% female, 25% age < 30 years), living on Montréal Island, were interviewed every 3–6 months from 2004 to 2012. Measurements: Study visits included HCV antibody testing and an interviewer-administered questionnaire. Generalized estimating equations were used to test whether place of residence modified the effects of correlates of POI. Cox regression was used to test whether place of residence modified the relationship between POI and HCV incidence. Findings: At baseline, inner-city participants were more likely to report POI in the past month (40 versus 25%, P < 0.001). The association between POI and heroin injection, syringe sharing and sharing of injecting equipment varied according to place of residence and was greater in the inner city. The hazard of HCV infection associated with POI was greater among inner-city participants compared to those in the surrounding areas [adjusted hazard ratio (HR) = 3.38, 95% confidence interval (CI) = 1.88–6.07 versus HR = 1.26, 95% CI = 0.65–2.42, P = 0.025]. Conclusions: Among people who inject prescription opioids in Montréal, Canada, those who live in inner-city areas are more likely to engage in injecting-related risk behaviours and have a higher risk of hepatitis C virus infection than those who live in the suburbs

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DO - 10.1111/add.13470

M3 - Article

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SP - 1985

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JO - British Journal of Addiction

JF - British Journal of Addiction

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