Integrated Studies of Infectious Disease Elimination ( InSIDE ): Hepatitis C Antibody and RNA Status of Persons Who Inject Drugs in New York State, 2021–2023

Hepatitis C virus (HCV) infection disproportionately impacts people who inject drugs (PWID). Understanding the prevalence and correlates of current and lifetime HCV infection is necessary to inform prevention, testing and treatment efforts among PWID to reduce HCV burden and achieve HCV elimination targets in this population From June 2021-December 2023, 751 PWID were recruited from syringe service harm reduction programs (SSP) and by referral from communities around New York State (NYS). Participants completed web-based surveys on risk factors and social determinants of health and were tested for HCV antibody and RNA to assess their current and lifetime HCV status (never infected, previously infected, or currently infected). Controlling for recruitment site as a fixed effect, a multivariate mixed logistic regression model was built to assess factors significantly associated with HCV status. Among PWID, 58% had a lifetime history of infection, and 29% were currently infected (50% among those with a lifetime history of infection). Daily/almost-daily injection, opioid injection, homelessness, and experience of abscess (all past-year) were significantly associated with current infection, as was younger age. Past-year SSP utilization was associated with a lifetime history of infection. PWID are a priority population to achieve HCV elimination in NYS. Our findings show that HCV burden is high among PWID utilizing SSPs. Expanding access to HCV care and treatment in harm reduction service settings while also providing services to address social determinants of health may be an effective strategy to progress towards reducing the burden of HCV among PWID.