p. risk information were collected. Prevalence ratios and 95% confidence intervals were determined. Results Anti-HCV prevalence among IDUs (men and women) was between 47% and 57% at each site, with an overall prevalence of 51% (451/887). Of 1 1,699 non-IDU MSM, 26 (1.5%) tested anti-HCV positive, compared with Rabbit polyclonal to DDX5 126 (3.6%) of 3,455 other non-IDU men (prevalence percentage 0.42, 95% confidence interval 0.28, 0.64). Summary The low prevalence of anti-HCV among non-IDU MSM in urban public health clinics does not support routine HCV testing of all MSM. Hepatitis C disease (HCV) is the most common chronic blood-borne virus illness in the United States, with an estimated 3.2 to 4 million people chronically infected.1,2 Large or repeated percutaneous exposures to blood such as through transfusion from unscreened donors or injection drug use have been the primary sources of Nocodazole illness. Sexual transmission happens, but appears to be inefficient compared with additional sexually transmitted viruses.3 Multiple studies published in the 1990s have shown that men who have sex with men (MSM) without a history of injection drug use who are seen in sexually transmitted disease (STD) clinics or human being immunodeficiency disease (HIV) counseling and screening sites (CTS) have a prevalence of antibody to HCV (anti-HCV) that is no higher than additional men who deny injection drug use in these settings, or adult men in the general population.4C7 More recently, similar findings were reported among non-injection drug user (non-IDU) MSM seen in an STD clinic in San Diego8 and among a large cohort of MSM recruited for an HIV transmission study in Canada.9 The Centers for Disease Control and Prevention (CDC) recommends that people at increased risk for HCV infection be identified and offered counseling and testing.5 Such people generally include those with a high prevalence of infection, such as injection drug users (IDUs). Because non-IDU MSM without additional known risk factors for HCV illness are not Nocodazole at improved risk, HCV screening is not recommended regularly for this human population. Recent reports of improved HCV illness among HIV-positive non-IDU MSM have again raised issues of sexual transmission of HCV. As a result, some health-care companies and MSM advocates believe that all MSM should be tested regularly for HCV illness. 10C13 To further examine this problem, we compared anti-HCV prevalence between non-IDU MSM clients and additional non-IDU male clients in selected STD clinics and HIV CTS in three large cities. METHODS HCV Nocodazole counseling and screening was offered in selected STD clinics and HIV CTS in San Diego, New York City (NYC), and Seattle/King Region (SKC), Washington, as part of attempts to integrate viral hepatitis prevention services into general public health clinics providing people at high risk for illness.14,15 Hepatitis services, including testing and vaccination, were offered to all clients initially as part of routine clinic services, and data were collected on all clients as part of routine Nocodazole STD or HIV clinic protocol. During the CDC Institutional Review Table and human subjects review process, these solutions and the data collected for this study were identified to be part of system implementation and evaluation, and specific educated consent was not required Nocodazole by clients. From 1999C2003, all people seeking solutions in these settings were offered HCV counseling and screening for varying time periods. Risk behavior info, collected through interviews and self-administered questionnaires, included sexual and IDU history, as well as other known risk factors for HCV illness (e.g., blood transfusion before 1992). Although African American race offers been shown to be significantly associated with a higher prevalence of anti-HCV,1,4 race/ethnicity data were not systematically collected across sites for people receiving anti-HCV screening. However, sites were able to provide estimates.

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