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Comparaison des séroprévalences du virus de l’hépatite C et du VIH, des profils sociodémographiques, des pratiques de consommation et de l’accès aux seringues chez les usagers de drogues en France selon les zones géographiques, enquête ANRS-Coquelicot 2011

Abstract : Background : People who use drugs (PWUDs) are at a high risk for hepatitis C virus (HCV) and human immunodeficiency virus (HIV), but they have different characteristics depending on the local context. In France, seroprevalence, sociodemographic, and behavior information have only been studied at a national level rather than at a local level. The Aim : of this study was to describe and examine profile and drug use practice differences in seven French cities and departments and to assess whether these differences can explain HCV and HIV seroprevalence variations between French geographical areas. Methods Data were collected from the cross-sectional ANRS-Coquelicot survey conducted for the second time in 2011 among drug users having injected or snorted drugs at least once in their life. Professional interviewers administrated a face-to-face questionnaire in six different areas in France: Paris, Marseille, Bordeaux, Lille, Strasbourg and the Seine-Saint-Denis department (Paris suburbs). Participants were asked to self-collect a fingerpick blood sample in order to search for the presence of anti-HIV and anti-HCV antibodies and to estimate seroprevalence in PWUDs. Results Overall, HCV and HIV seroprevalence was 44% [95% CI: 39.6–47.9] and 10% [95% CI: 7.5–12.6] respectively. The highest HCV seroprevalence was 56% in Marseille and the lowest was 24% in Bordeaux and for HIV the highest was 18% in Seine-Saint-Denis and the lowest was 0% in Lille. The population's age differed between areas and could mostly explain HCV seroprevalence variation but not exclusively. Profiles and practices, different in each area, can also explain this variation. In multivariate analysis, HCV seroprevalence was lower in Bordeaux (prevalence ratio [PR] = 0.64), Strasbourg (PR = 0.76), and Seine-Saint-Denis (PR = 0.8) than in Paris. Nearly one-third of injectors declared having had difficulties to obtain syringes in the 6 previous months, but disparities existed between areas. Conclusion HCV risk exposure in PWUDs remains high in France and varies between different areas. Innovative harm reduction strategies including educative programs about safe injecting and supervised consumption rooms need to be developed.
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https://hal-cnrs.archives-ouvertes.fr/hal-03479122
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Submitted on : Tuesday, December 14, 2021 - 11:14:00 AM
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L Weill-Barillet, J Pillonel, C Semaille, L Léon, y Le Strat, et al.. Comparaison des séroprévalences du virus de l’hépatite C et du VIH, des profils sociodémographiques, des pratiques de consommation et de l’accès aux seringues chez les usagers de drogues en France selon les zones géographiques, enquête ANRS-Coquelicot 2011. Epidemiology and Public Health / Revue d'Epidémiologie et de Santé Publique, Elsevier Masson, 2016, 64 (4), pp.301-312. ⟨10.1016/j.respe.2015.10.003⟩. ⟨hal-03479122⟩

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