Application of an area-based socioeconomic position index to assess disparities in the seroprevalence of hepatitis C in Puerto Rico

Surveillance data in the US have documented that African-Americans and Hispanics continue to be disproportionately affected by viral hepatitis. Seroprevalence of hepatitis C among Puerto Rican adults (2.3%) is higher than in the general US or Caucasian American populations, with injecting drug use as the most commonly identified risk factor for infection. We performed a secondary data analysis of data collected in a population-based sample from 2005 to 2008 to examine disparities in the seroprevalence of hepatitis C using an area-based socioeconomic position index. We used principal components to construct the socioeconomic position (SEP) index based on information available in the US Census 2000. Testing for antibody to hepatitis C was performed with a chemiluminiscent immunoassay and confirmation by recombinant immunoblot assay. Low SEP was associated with higher odds of hepatitis C seropositivity, although statistical significance was not achieved (OR=1.90, p=0.134). However, low SEP was significantly associated with hepatitis C seropositivity among males (OR= 3.36, 95% CI: 1.33-8.47) and adults that reported more than 10 sexual lifetime partners (OR= 3.09, 95% CI: 1.07-8.90). Further analysis of the extent and contributing factors to health disparities in hepatitis C in Hispanics living in Puerto Rico is needed to assist in the identification of target areas where public health interventions should be implemented.