Infectious Disease
Getting to Full Disclosure: HCV testing and status disclosure behaviors among PWID and their injecting partners Maia Scarpetta* Maia Scarpetta Rachel Kanner Neia Prata Menezes Claire C. McDonell Julie Bruneau Kimberly Page Meghan D. Morris
Background: Hepatitis C virus (HCV) is primarily transmitted through injection drug use. While HCV testing access has improved for people who inject drugs (PWID), little is known about whether people share their results with people they inject with. Understanding the dynamics of HCV disclosure among primary injecting partners fosters informed public health decision-making and prevention strategies.
Methods: From 2017-2019, PWID and their primary injecting partners in Montreal, Canada, and San Francisco, USA (SF), underwent HCV screening and participated in a quantitative socio-behavioral survey. Using dyadic data, we estimated HCV-status disclosure prevalence, overall and by partnership HCV status. Statistical analyses included Kruskal-Wallis tests for nonparametric variables and Pearson chi-squared/Fisher exact tests for categorical variables.
Results: Overall, 91% received an HCV test, representing 162 individuals and 131 partnerships; most (57%) were positive for HCV infection (Montreal: 64%; SF: 43%). Most were male-male partnerships (Montreal: 63%, SF: 51%), and currently living together (Montreal: 57%, SF: 60%), but most Montreal partnerships were both over 30 (71%), while most SF partnerships were both were under 30 (71%). Overall, 90% (n=118) individuals disclosed their HCV result to their primary injecting partner; in 81% of partnerships results were mutually disclosed. Mutual disclosure was highest (41%) among seropositive (+/+) partnerships, less common (32%) in seronegative partnerships, and rarest (17%) in serodiscordant (+/-) partnerships. Neither member disclosed in 5% partnerships. None of the comparisons were significantly different (Figure 1).
Conclusions: Results highlight a high prevalence of HCV testing and disclosure within injecting partnerships. Encouraging result sharing, regardless of serostatus, and involving injecting partners in the HCV continuum can provide support for positive diagnoses and prevention strategies for negative diagnoses.
