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Most young patients with HCV located far from syringe programs

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April 17, 2017

The vast majority of young people with hepatitis C virus infection in the United States live more than 10 miles away from a syringe services program, researchers said.

The gap signifies a need for improved access to these programs (SSPs) to address increases in HCV infection between 2010 and 2014, particularly among people aged 20 to 29 years, they wrote in Clinical Infectious Diseases.

“Given that injection drug use is the primary cause of HCV infection among young people, better access to SSPs could have been a useful tool to prevent many of these HCV infections and reduced the risk of transmission to others,” they said.

The researchers assessed 29,382 patients aged 15 to 29 years who were infected with HCV. The patients were tested between July 2015 and June 2016 and included residents in all 50 states and Washington, D.C.

For each patient, the researchers calculated the distance between the center of the ZIP code in which he or she lived and the nearest SSP. A distance of 10 miles or less was considered near, whereas more than 10 miles was deemed far.

A home ZIP code was found for 86.8% of patients. Another 13.1% were assigned the ZIP code of the health care provider ordering the HCV test, and 0.1% were excluded from the study because no ZIP codes were available.

The researchers found that 23,494 of the patients (80%) lived far from an SSP. The median distance was 37 miles, with a range of zero to 667 miles.

The West had the highest proportion of patients living near an SSP, at 35.8%, and the South had the lowest, at 9.9% (P < .0001). In between were the Northeast and Midwest, with 29.9% and 15.3% living near SPPs, respectively.

In addition, as urbanicity of patients decreased, the proportion living far from an SSP increased. According to the researchers, 47% of patients living in the most urban areas were far from an SSP, compared with 98% of those in the most rural areas.

The researchers concluded that about 2,200 more SSPs would be needed to reach 95% of patients living far from such programs.

Such a deficit, they wrote, “points to the need for strategies to improve access to HCV preventive services, such as ... the mobilization of programs to reach dispersed populations and the utilization of existing infrastructure, such as local health departments and/or pharmacies.” – by Joe Green

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Disclosure: Canary reports serving in an unpaid role on the Atlanta Harm Reduction Coalition board of directors. Please see the full study for a list all other authors’ relevant financial disclosures.

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