Share your thoughts on this presentation with #IAS2019 Hepatitis C and HIV co-infection and related risk determinants among women who inject drugs in the capital city of Nepal Keshab Deuba Save the Children stationed at National Centre for AIDS and STD Control, Kathmandu, Nepal @Deuba4k Share your thoughts on this presentation with #IAS2019

Objectives and Methods Results Objectives and Methods Study aimed to assess the prevalence of HCV infection, co-morbidities, and related risk determinants among women who inject drugs in Nepal In this cross-sectional survey, 160 women at least 16 years of age who inject drugs were recruited between April 2016-August 2016 in Kathmandu valley using modified network sampling. Serum samples were taken and tested for antibodies against hepatitis C virus (anti-HCV), hepatitis B surface antigen (HBsAg) and HIV. For syphilis, Rapid Plasma Reagin test was used. All RPR reactive serum was confirmed using the specific Treponema pallidum Particle Agglutination (TPPA) test. Figure 1. Prevalence of HCV, HIV, HIV-HCV co- infection, syphilis and HBV among women who inject drugs in Nepal. HCV: Hepatitis C virus; HBV: Hepatitis B virus.

Results The prevalence of HCV was associated with: Table 1. Key characteristics of Women who Inject Drugs in the Kathmandu Valley, Nepal The prevalence of HCV was associated with: ≥24 years of age [odds ratio (OR), 6.3; 95% confidence interval (CI), 2.7-14.9] HIV seropositive status (OR 8.3, 95% CI 2.6-26.8) Cross-border movement (across the open border between India and Nepal) for the purpose of injecting drug use (OR 3.6, 95% CI 1.5-8.9) Visiting an outreach centre to get new syringes (OR 3.6, 95% CI 1.2-11) Visiting an HIV testing and counselling centre (HTC) (OR 3.1, 95% CI 1.7-8.6) Enrolling in opioid substitution therapy (OST) (OR 3.9, 95% CI 1.7-8.6). Variables (N = 160) N (%) Age in years (mean/range) 24 (17-39) Cross-border movement (across the open border between India and Nepal) for the purpose of injecting drug use Yes 25 (15.62) Knowledge of where to get an HIV test 148 (92.50) Ever had an HIV test 109 (68.12) Use of previously used syringes or needles in the past month   30 (18.7) Frequency of drug use in the past week 4-6 times/week Non use of condoms in last sexual contact with male partner 95 (59) Sexual intercourse in exchange for drugs or money in the past year 27 (17)

Conclusions The study found a high prevalence of HCV infection and other co-morbidities among women who inject drugs in Kathmandu valley but these women seem to be accessible for secondary prevention and treatment interventions since they also visit harm reduction centers to a higher degree than those women are uninfected. Thus, integrating diagnosis and treatment services for HCV within existing HIV (HTC) and OST services could help test, treat and retain high-risk women who inject drugs.