November 4, 2013

“To share or not to share?” Serosorting by hepatitis C status in the sharing of drug injection equipment among NHBS-IDU2 participants

J Infect Dis. (2013) doi: 10.1093/infdis/jit520

First published online: October 16, 2013

Bryce D. Smith1,*, Amy Jewett2, Richard D. Burt3, Jon E. Zibbell1, Anthony K. Yartel4 and Elizabeth DiNenno5

+ Author Affiliations

  1. 1Centers for Disease Control and Prevention, Division of Viral Hepatitis, Atlanta, Georgia 30333
  2. 2Oak Ridge Institute for Science and Education, Oak Ridge, TN 37831
  3. 3Public Health Seattle and King County, Seattle, WA 98104
  4. 4Centers for Disease Control and Prevention Foundation, Atlanta, GA 30333
  5. 5Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA 30333
  1. *Corresponding author: 1600 Clifton Rd, MS G-37, Atlanta, GA 30333. Tel: 404-639-6277; Fax: 404-718-8595.


Background. Persons who inject drugs (PWID) are at high risk for acquiring hepatitis C virus (HCV) infection. CDC estimates there are 17,000 new infections per year, mainly among PWID. This study examines injection equipment serosorting – considering HCV serostatus when deciding whether and with whom to share injection equipment.

Objective. To examine whether injection equipment serosorting is occurring among PWID in selected cities.

Methods. Using data from the National HIV Behavioral Surveillance System-Injection Drug Users (NHBS-IDU2, 2009), we developed multivariate logistic regression models to examine the extent to which participants' self-reported HCV status is associated with their injection equipment serosorting behavior and knowledge of last injecting partner's HCV status.

Results. Participants who knew their HCV status were more likely to know the HCV status of their last injecting partner, compared to those who did not know their status (HCV+: aOR 4.1, 95%CI 3.4-4.9; HCV-: aOR 2.5, 95%CI 2.0-3.0). Participants who reported being HCV+, relative to those of unknown HCV status, were five times more likely to share injection equipment with a partner of HCV-positive status (aOR 4.8, 95%CI 3.9–6.0).

Conclusion. Our analysis suggests PWID are more likely to share injection equipment with persons of concordant HCV status.

Received April 23, 2013.
Revision received June 12, 2013.
Accepted June 13, 2013.

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