Risk behaviours associated with hepatitis C infection: application of a syndemic effects framework in NHANES
Keywords:Hepatitis C Virus, Syndemic, Intravenous Drug Use, Risk, Disparity
Objectives: To apply syndemic theory to investigate the risk of hepatitis C virus (HCV) infection in the US population.
Methods: National representative data were from the National Health and Nutrition Examination Survey. We extracted and aggregated data on HCV antibody test, sociodemographic characteristics, alcohol and drug use, depression, sexual behaviour and sexually transmitted illnesses from 2005-2006 to 2011-2012. The study sample was restricted to men and women aged 20-59 years given the upper age limit of the risk factors used for the analysis.
Results: Overall, 11,593 people were included in the analysis (52.2% female). Higher prevalence of HCV, excessive alcohol consumption and drug use were found in men. Men also had higher odds of HCV in comparison to women among younger (20-39 years old) OR 1.37 (95%CI 1.36-1.37) and middle-aged adults (40-59 years old) OR 2.04 (95%CI 2.03-2.04). Among younger adults, non-Hispanic black and Hispanic people were found to have a lower likelihood of testing positive, OR 0.35 (95%CI 0.35-0.35) and OR 0.30 (95%CI 0.30-0.30), respectively. However, in the middle-aged adults non-Hispanic black people were found to have a higher likelihood of testing positive OR 1.45 (95%CI 1.45-1.46). Analysis showed that for each additional risk factor associated with HCV infection there is an additional increase in the risk OR 1.55 (95%CI 1.55-1.55).
Conclusions: For every additional risk factor for HCV a person is exposed to, the overall risk of HCV increases.
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