Marcia Russell ^1*, Meng-Jinn Chen ¹, Thomas H. Nochajski ², Maria Testa ³, Scott J. Zimmerman ⁴, Patricia S. Hughes ¹

¹ Pacific Institute for Research & Evaluation
² University of Buffalo
³ Research Institute on Addictions
⁴ Erie County Public Health Laboratory

^* To whom correspondence should be addressed. E-mail: russell{at}prev.org.

	Abstract

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.

Key Words: Epidemiology, Hepatitis, Injury/Emergency Care/Violence, African Americans/Blacks, Sexual Health, Drugs