HIV and Hepatitis C Prevalence and Risk Behavior among People Who Inject or Inhale Drugs in Whitehorse, Yukon, Canada

INTRODUCTION:  People who use drugs are at increased risk for acquiring blood-borne infections such as HIV and hepatitis C virus (HCV) through the use of contaminated drug equipment.  Little is known about people who use drugs in Yukon, a territory in northern Canada, and the prevalence of HIV and HCV in this population.

METHODS:  An interviewer-administered questionnaire (part of I-Track Phase 3 enhanced surveillance in Canada) collected information on demographics, drug use, injection and non-injection risk behavior, sexual risk behavior and use of services among people who use drugs in Whitehorse, Yukon. A biological sample was collected and tested for HIV and HCV antibodies.  Chi-square/Fisher’s exact tests assessed differences in proportions with significance level set at p<0.05; logistic regression models assessed correlates for HCV seropositivity and sharing of used needles, syringes or equipment.  

RESULTS:  103 drug users (55 injectors, 48 non-injectors) were interviewed in Whitehorse.  Average age was 39 years and 62% were male.  HIV seropositivity was 6% (95% CI=2.2-12.5%).  Awareness of HIV seropositivity was 100%.  Lifetime exposure to HCV was 45% (95% CI=35.0-55.3%).  Most frequently injected drugs were cocaine (74%) and non-prescribed morphine (56%).   20% and 19% of injectors borrowed and lent used needles, respectively. 42% and 44% of injectors borrowed and lent used equipment, respectively. Condom use at last sex was 29% and 38% reported two or more sex partners.  90% of respondents ever used a needle exchange program. HCV seropositivity was associated with currently injecting (p=0.007) and time since first injection (p=0.007).  Sharing of used needles, syringes or equipment was associated with time since first injection (p=0.004) and most common drug partner (p=0.004).

CONCLUSIONS:  HIV prevalence and lifetime exposure to HCV are high among people who use drugs in Whitehorse.  The high proportion of users who share needles or equipment indicates ongoing opportunities for education and outreach.