Hepatitis C Seroprevalence and Risk Behaviors in Patients Attending Sexually Transmitted Disease Clinics

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Abstract
Hepatitis C virus (HCV) is a major global problem, transmitted primarily by percutaneous exposure to contaminated blood. The goal of the study was to determine the seroprevalence of and risk factors for HCV among patients attending two urban STD clinics in Alberta. Anonymous unlinked serosurveys were performed with use of leftover sera. Self-administered questionnaires collected information on demographics, sexual behaviors, and drug use. The seroprevalence of HCV was 3.4% (209 of 6668 patients). Univariate analysis revealed that infection was higher among nontherapeutic needle users (RR = 80.9), those coinfected with HIV (RR = 8.09), individuals over the age of 20 years (RR = 6.68), those of aboriginal ethnicity (RR = 5.54), those with a history of STD (RR = 3.43), men (RR = 2.2), and bisexuals (RR = 2.23). Not utilizing condoms and engaging in prostitution or exchanging money or drugs for sex were also risk factors. In multivariate analysis, nontherapeutic needle use remained highly significant (RR = 60.54–65.51). Other significant factors included sex, age, ethnicity, a history of STD, and HIV infection (RR = 1.72, 4.62, 3.18, 1.69, and 2.56, respectively). Sexual orientation and sexual practices were not significant without a history of drug use. Nontherapeutic needle use is the strongest predictor of HCV infection.