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AJPH First Look, published online ahead of print Feb 12, 2009
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AJPH.2007.126383v1
99/S1/S173    most recent
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April 2009, Vol 99, No. S1 | American Journal of Public Health S173-S179
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.126383

RESEARCH AND PRACTICE

Risky Sexual Behavior, Bleeding Caused by Intimate Partner Violence, and Hepatitis C Virus Infection in Patients of a Sexually Transmitted Disease Clinic

Marcia Russell, PhD, Meng-Jinn Chen, PhD, Thomas H. Nochajski, PhD, Maria Testa, PhD, Scott J. Zimmerman, DrPH and Patricia S. Hughes, RN

At the time of the study, Marcia Russell, Meng-Jinn Chen, and Patricia S. Hughes were with the Pacific Institute for Research & Evaluation, Prevention Research Center, Berkeley, CA. Thomas H. Nochajski is with the School of Social Work, University at Buffalo, Buffalo, NY. Maria Testa is with the Research Institute on Addictions, University at Buffalo, Buffalo. Scott J. Zimmerman is with the Erie County Department of Public Health, Buffalo, and the University at Buffalo, Buffalo.

Correspondence: Requests for reprints should be sent to Marcia Russell, PhD, Prevention Research Center, 1995 University Ave, Suite 450, Berkeley, CA 94704 (e-mail: russell{at}prev.org).

Objectives. We sought to investigate independent contributions of risky sexual behaviors and bleeding caused by intimate partner violence to prediction of HCV infection.

Methods. We conducted a case–control study of risk factors among patients of a sexually transmitted disease clinic with and without HCV antibodies, group-matched by age.

Results. Multivariate analyses indicated that Black race (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.3, 4.4), injection drug use (OR = 20.3; 95% CI = 10.8, 37.8), sharing straws to snort drugs (OR = 1.8; 95% CI = 1.01, 3.0), sharing razors (OR = 7.8; 95% CI = 2.0, 31.0), and exposure to bleeding caused by intimate partner violence (OR = 5.5; 95% CI = 1.4, 22.8) contributed significantly to the prediction of HCV infection; risky sexual behavior and exposure to blood or sores during sexual intercourse did not.

Conclusions. HCV risk among patients of a sexually transmitted disease clinic can be explained by direct blood exposure, primarily through injection drug use. Exposure to bleeding caused by intimate partner violence may be a previously unrecognized mechanism for HCV transmission associated with risky sexual behavior.






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