High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing

Enkelmann, Julia; Gassowski, Martyna; Nielsen, Stine; Wenz, Benjamin; Roß, Stefan; Marcus, Ulrich; Bremer, Viviane; Zimmermann, Ruth

doi:10.1186/s12954-019-0338-y

Harm Reduction Journal

Table 1 Sociodemographic characteristics, drug injection behaviour and HCV-status, awareness and testing experience of PWID participating in the German DRUCK-study 2011–2014 by duration of injection drug use

From: High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing

	Injecting drugs < 5 years (N = 232)		Injecting drugs ≥ 5 years (N = 1827)		p
	n	Proportion^k (%)	n	Proportion^k (%)	p
Sociodemographic characteristics
Female	73	31.5	403	22.1	0.001^**
Age ≤ 25 years	71	30.6	62	3.4	< 0.001^***
2nd-generation migrant^a	26	11.2	273	14.9	0.128
1st-generation migrant^b	63	27.2	393	21.5	0.051
Did not graduate from school	46	19.8	250	13.7	0.012*
A-level	23	9.9	182	10.0	0.982
Main place of residence in the last 12 months (max 2 entries)
Own flat	111	48.1	1040	57.5	0.006^**
With family or friends	57	24.7	297	16.4	0.002^**
Homeless, staying in shelters	50	21.7	258	14.3	0.003^**
Ever homeless^c	132	57.1	1226	67.3	0.002^**
Ever in prison	143	61.9	1518	83.3	< 0.001^***
Released from prison in the last 12 months^d	37	24.3	332	24.2	0.965
Sources of income in the last 12 months
Job (including unemployment benefit I)	61	26.4	384	21.2	0.069
State benefits	171	74.0	1548	85.3	< 0.001^***
Selling newspapers, begging, dealing	110	47.6	673	37.1	0.002^**
Sex work	17	7.4	60	3.3	0.002^**
Injection behavior
Age at first injection < 18 years	19	8.2	623	34.1	< 0.001^***
Injecting daily in the last 30 days	63	34.2	452	30.1	0.244
Substance injected in the last 30 days^f
Heroin	130	56.0	1109	60.8	0.165
Cocaine	73	31.5	752	41.2	0.004^**
Crack	10	4.3	98	5.4	0.504
Speed (amphetamines)	11	4.7	60	3.3	0.254
Crystal (metamphetamines) ^g	17	7.4	64	3.5	0.005^**
Substance consumed in the last 30 days
Heroin	180	77.6	1355	74.3	0.217
Cocaine	95	41.0	908	49.8	0.011^*
Crack	54	23.4	461	25.3	0.534
Speed (amphetamines)	49	21.1	234	12.8	0.001^**
Crystal (metamphetamines)^g	23	10.0	97	5.3	0.005^**
Most common setting of drug injection in the last 30 days^h
Alone at home^e	76	42.2	678	45.4	0.425
In consumption room^e,i	24	27.6	195	31.9	0421
With good acquaintances^e	75	41.2	484	32.4	0.017^*
With steady partner^e	24	13.3	241	16.1	0.317
With hardly known or unknown people^e	15	8.3	125	8.4	0.984
Unsafe use in the last 30 day^h
Used used needles or syringes	19	10.4	133	8.8	0.482
Used water from a shared container	45	24.7	316	21.4	0.302
Used used spoons or filters	40	22.1	280	18.7	0.268
Source for sterile needles and syringes in the last 30 days^h
Low threshold services	115	62.2	1069	70.2	0.025^*
Syringe vending machine^j	48	52.8	290	37.9	0.006^**
Pharmacy (bought)	67	38.2	656	44.1	0.142
Access to addiction therapy
Ever in detoxification	143	61.6	1517	83.2	< 0.001^***
Ever in weaning/rehabilitation program	80	34.5	1004	55.1	< 0.001^***
Ever in outpatient substitution therapy	126	54.3	1532	84.0	< 0.001^***
Currently in outpatient substitution therapy	68	29.3	945	51.8	< 0.001^***
HCV status, awareness and testing experience
HCV positive	83	35.8	1270	69.5	< 0.001^***
Detectable HCV-RNA	63	27.2	836	45.8	< 0.001^***
Of HCV positive: Unaware of HCV positive status	33	40.7	157	12.6	< 0.001^***
Ever tested for HCV	153	73.2	1653	93.6	< 0.001^***
Report negative HCV test, last test > 12 months ago	32	36.8	135	38.8	0.730

^aBorn in Germany, mother and/or father born abroad
^bBorn outside of Germany
^cDefined as reporting living on the streets or in homeless shelters as main residence in the last 12 months
^dNot asked in Berlin, Essen
^eLast 30 days
^fSubstance consumed in last 30 days and most common mode of consumption injection
^gMethamphethamine use was concentrated in Leipzig (East Germany) and to a lower extent in Munich (South Germany), while it played almost no role in other study cities
^hOnly answered if participants injected drugs in the last 30 days
ⁱInformation available for Essen, Berlin, Hamburg; reported use of drug consumption rooms varied widely between cities: highest use in Hamburg (> 60% reported by NI and LI), lowest use in Berlin (< 10% reported by NI and LI)
^jExist in Berlin, Essen, Cologne, Munich
^kof responding participants
^*p < 0.05
^**p < 0.01
^***p < 0.001

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ISSN: 1477-7517

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