ArticleThe International journal on drug policy2021
Drug use stigma and its association with active hepatitis C virus infection and injection drug use behaviors among community-based people who inject drugs in India.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- HIV, hepatitis B & C in people who inject drugs in India: A systematic review of regional heterogeneity & overview of opioid substitution treatment.The Indian journal of medical research · 2023Pooled it
- The Association Between HIV and Substance Use Stigma and Attitudes and Utilization of HIV Care Among Adults Who Use Injection Drugs: A Systematic Review.AIDS and behavior · 2026Article
- Factors influencing hepatitis C treatment initiation in a high-prevalence Brazilian state.Cadernos de saude publica · 2026Article
- Characterizing non-fatal overdose among people who inject drugs in India: prevalence and risk factor analysis, 2022-2024.The International journal on drug policy · 2026Article
- Drug-related stigma among people who inject drugs - development and validation of the drug use stigma scale (DUSS).PloS one · 2025Article
- The feasibility of respondent-driven sampling with people who use drugs in rural Western Cape, South Africa: A qualitative study.PLOS global public health · 2025Article
- How far are we? Assessing progress in hepatitis C response towards the WHO 2030 elimination goals by the civil society monitoring in 25 European countries, period 2020 to 2023.Harm reduction journal · 2024Article
- Need for integration of hepatitis C (HCV) services in community-based settings for people who inject drugs: results from a global values and preferences survey.Harm reduction journal · 2023Article
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAlthough drug use stigma is globally pervasive, quantitative evidence of its role in hepatitis C virus (HCV) transmission is limited. We evaluated the psychometric properties of a drug use stigma scale and examined the association between drug use stigma and active HCV infection among a community-based sample of people who inject drugs (PWID) in India.
methodsBetween 8/2016 and 5/2017, a cross-sectional sample of PWID was recruited from 12 Indian cities (~1000/city) using respondent-driven sampling. Participants were ≥18 years old and reported injection drug use (IDU) in the past 2 years. Multivariable logistic regression with a random-intercept for each city was used to estimate adjusted odds ratios (aOR) of active HCV infection (RNA>30 IU/mL). Analyses incorporated RDS-II weights.
resultsOf 11,663 participants, 73.1% reported IDU in the past 6 months and 33.8% had active HCV infection. Exploratory factor analysis yielded a four-factor solution of enacted, vicarious, felt normative and internalized drug use stigma with high internal consistency (Cronbach's α: 0.85-0.92). In analyses adjusted for age, gender, northeast region, education, homelessness, incarceration, alcohol dependence, HIV status, frequency of IDU, and ever sharing needles/syringes, PWID reporting any enacted stigma had greater odds of active HCV infection (aOR = 1.27 [95% CI = 1.13-1.43]) as did PWID with internalized stigma scores in the highest quartile (vs. lowest quartile; aOR = 1.69 [95% CI = 1.11-2.56]). Among PWID who reported IDU in the past 6 months, multiple forms of stigma were associated with higher frequency of IDU, sharing needles/syringes, having multiple injection partners, and IDU in public spaces.
conclusionUsing a multidimensional drug use stigma scale, various forms of stigma were significantly associated with active HCV infection and injection drug use-related risk behaviors. Collectively, these data suggest that drug use stigma may play a role in HCV transmission and impede efforts to achieve HCV elimination. Strategies to diminish drug use stigma are warranted.
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