Developing evidence based HCV prevention Program for injecting drug users (IDUs) and assessing needs for prevention in this population

Injecting drug users belong to the most at risk population for HCV infection. In the countries with high medical care standards the IDUs make up main group determining the dynamic of HCV epidemic.

The local studies conducted in 2004-2005 in 14 localities in Poland showed high prevalence of HCV infection among IDUs. The average prevalence was 65%, much higher than HIV prevalence. The HCV prevalence was significantly higher among IDUs with low socio-economic status and particularly high among IDUs from the most  marginalized groups. For instance 77% of IDUs who were ever homeless and 72% with imprisonment experiences were HCV infected. High prevalence was noted not only among older IDUs with long drug use career but also among young IDUs, below 25 years old (50% infected).

Marginalized groups, especially IDUs are underrepresented in general population studies and they have usually limited access to prevention and treatment services. The specific infection routes and high intensity of risk factors prompt to adopting a special prevention approach to this group. Moreover IDUs are particularly difficult population to cover by prevention measures due to limited access to them (hidden population), lack of trust and specific system of norms and values characteristic for this population. Hence there is a need to develop special prevention strategy for IDUs population and to tailor a specific program.

The prevention strategy means a set of institutional solutions on the national level facilitating access of IDUs to health care services dealing with HCV problem and a prevention program means evidence based procedure focused on reaching IDUs with prevention messages in the way which is acceptable by target population and assure impact of prevention messages on health behaviors of recipients.