246814 Housing instability and hepatitis C seroconversion among injection drug users: A meta-analytic review

Tuesday, November 1, 2011: 9:05 AM

Enrique R. Pouget, PhD , Institute for AIDS Research, National Development and Research Institutes, New York, NY
Courtney McKnight, MPH , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Don C. Des Jarlais, PhD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Holly Hagan, PhD , College of Nursing, New York University, New York, NY
Background. Hepatitis C virus (HCV) infection is endemic among injection drug users (IDUs), and is transmitted through the sharing of injection and drug preparation equipment. Having a stable home may facilitate safer injecting and reduced exposure to contaminated blood. Methods. We conducted a systematic review of published and unpublished cohort or case-control studies that analyzed HCV seroincidence in relation to recent homelessness or unstable housing among IDUs, and meta-analyzed results from 8 studies, published between 2001 and 2009, using random effects models. Results. There was a trend towards a significant association: Pooled Relative Risk = 1.25, 95% Confidence Interval = 0.99, 1.59, p = 0.06. Heterogeneity, assessed by I-square and Q statistics was not significant; however, there was wide variability in the definition of housing instability used in the studies included in the analysis. The small number of studies limited the analysis of publication bias, but several studies that did not publish effect measures indicated that associations with housing instability were not significant. Conclusion. Stable housing may provide a safer setting for injection drug use in regard to HCV transmission, or may serve as an indicator of drug users' ability to plan and prepare for injecting safely. Further research is needed to assess potential publication bias in the observed associations.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Learning Objectives. 1. Evaluate the association between housing stability and hepatitis C seroconversion among injection drug users 2. Examine potential confounders of the association 3. Describe potential publication bias, and how best to evaluate it

Keywords: Hepatitis C, Housing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I collaborated on the development of the analysis, performed the analysis, and collaborated on the interpretation of the results.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Infectious Disease Epidemiology
See more of: Epidemiology