Abstract：
Persons who inject drugs (PWID) have been experiencing a higher burden of new hepatitis C (HCV) due to the opioid epidemic. The greatest increases in injection have been in rural communities. However, less is known about the prevalence of HCV or its risk factors in rural compared to non-rural communities. This study compared HCV infection history, current infection, and associated behavioural and sociodemographic correlates among PWID recruited from rural and non-rural communities from Upstate New York (NY). This cross-sectional study recruited 309 PWID, using respondent-driven sampling. Blood samples were collected through finger stick for HCV antibody and RNA tests. A survey was also self-administered for HCV infection history, sociodemographics and behavioural correlates to compare by setting rurality. HCV seropositivity was significantly higher among PWID from rural than non-rural communities (71.0% vs. 46.8%), as was current infection (41.4% vs. 25.9%). High levels of past year syringe (44.4%) and equipment (62.2%) sharing were reported. Factors associated with infection history include syringe service program utilization, non-Hispanic white race, sharing needles and methamphetamine injection, which was higher in rural vs. non-rural communities (38.5% vs. 15.5%). HCV burden among PWID appears higher in rural than non-rural communities and may be increasing possibly due to greater levels of methamphetamine injection. On-going systematic surveillance of HCV prevalence and correlates is crucial to respond to the changing opioid epidemic landscape. Additionally, improving access to harm reduction services, especially with special focus on stimulants, may be important to reduce HCV prevalence among PWID in rural settings.
摘要：
注射药物（PWID）的人由于阿片类药物的流行而经历了更高的新丙型肝炎（HCV）负担。注射增加最多的是农村社区。然而,与非农村社区相比,农村地区对HCV患病率或其危险因素的了解较少.这项研究比较了HCV感染史，当前感染，以及从纽约州北部（NY）从农村和非农村社区招募的PWID之间的相关行为和社会人口统计学相关性。这项横断面研究招募了309名PWID，使用受访者驱动的抽样。通过手指针刺收集血样用于HCV抗体和RNA测试。还对HCV感染史进行了自我调查，社会人口统计学和行为相关性，通过设置乡村性来进行比较。农村地区的PWID患者的HCV血清阳性率显着高于非农村社区（71.0％vs.46.8%），目前的感染情况(41.4%vs.25.9%）。据报道，过去一年注射器（44.4%）和设备（62.2%）的共享水平很高。与感染史相关的因素包括注射器服务程序的使用，非西班牙裔白人种族,共用针头和注射甲基苯丙胺，在农村和农村中，这一比例更高。非农村社区(38.5%vs.15.5%）。PWID中的HCV负担在农村地区似乎高于非农村社区，并且可能由于甲基苯丙胺注射量增加而增加。HCV流行和相关的持续系统监测对于应对不断变化的阿片类药物流行格局至关重要。此外,改善获得减少伤害服务的机会，特别是特别关注兴奋剂，在农村地区，降低PWID人群中的HCV患病率可能很重要。
