Opioid and other drug use and drug-related mortality as indicators of Hepatitis C and Human Immunodeficiency Virus in Oklahoma

Aaron M Wendelboe; Ozair H Naqvi; Mary Williams; Heather Hollen; Kaitlin McGrew; Peng Li; Terrainia Harris; Ann F Chou

doi:10.1371/journal.pone.0301442

Opioid and other drug use and drug-related mortality as indicators of Hepatitis C and Human Immunodeficiency Virus in Oklahoma

PLoS One. 2024 May 9;19(5):e0301442. doi: 10.1371/journal.pone.0301442. eCollection 2024.

Authors

Aaron M Wendelboe¹, Ozair H Naqvi¹, Mary Williams¹, Heather Hollen¹, Kaitlin McGrew², Peng Li², Terrainia Harris², Ann F Chou³

Affiliations

¹ Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America.
² The Oklahoma State Department of Health, Sexual Health & Harm Reduction Service, Oklahoma City, OK, United States of America.
³ Department of Family and Preventive Medicine, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America.

Abstract

Objectives: Outbreaks of injection drug use (IDU)-associated infections have become major public health concerns in the era of the opioid epidemic. This study aimed to (1) identify county-level characteristics associated with acute HCV infection and newly diagnosed IDU-associated HIV in Oklahoma and (2) develop a vulnerability index using these metrics.

Methods: This study employs a county-level ecological design to examine those diagnosed with acute or chronic HCV or newly diagnosed IDU-associated HIV. Poisson regression was used to estimate the association between indicators and the number of new infections in each county. Primary outcomes were acute HCV and newly diagnosed IDU-associated HIV. A sensitivity analysis included all HCV (acute and chronic) cases. Three models were run using variations of these outcomes. Stepwise backward Poisson regression predicted new infection rates and 95% confidence intervals for each county from the final multivariable model, which served as the metric for vulnerability scores.

Results: Predictors for HIV-IDU cases and acute HCV cases differed. The percentage of the county population aged 18-24 years with less than a high school education and population density were predictive of new HIV-IDU cases, whereas the percentage of the population that was male, white, Pacific Islander, two or more races, and people aged 18-24 years with less than a high school education were predictors of acute HCV infection. Counties with the highest predicted rates of HIV-IDU tended to be located in central Oklahoma and have higher population density than the counties with the highest predicted rates of acute HCV infection.

Conclusions: There is high variability in county-level factors predictive of new IDU-associated HIV infection and acute HCV infection, suggesting that different public health interventions need to be tailored to these two case populations.

Copyright: © 2024 Wendelboe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adult
Female
HIV Infections* / complications
HIV Infections* / epidemiology
HIV Infections* / mortality
Hepatitis C* / epidemiology
Humans
Male
Middle Aged
Oklahoma / epidemiology
Substance Abuse, Intravenous / complications
Substance Abuse, Intravenous / epidemiology
Young Adult

Grants and funding

These efforts are supported by funding from the Centers for Disease Control and Prevention (CDC-RFA-PS17-1703: Strengthening Surveillance in Jurisdictions with High Incidence of Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) Infections). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.