Risk behaviors and prevalence of hepatitis B and C among people who inject drugs in Georgia: integrated bio-behavioral survey (IBBS).

INTRODUCTION

Injection drug use (IDU) poses significant public health risks, including the transmission of blood-borne infections such as hepatitis B (HBV) and hepatitis C (HCV). This study aims to evaluate the prevalence of risk behaviors associated with IDU and the prevalence of HBV and HCV among people who inject drugs (PWID) in Georgia.

METHODS

A cross-sectional study was conducted in seven cities of Georgia in 2022, involving 2005 PWID aged ≥18 years. Participants were recruited using respondent-driven sampling. Data were collected through face-to-face interviews and blood samples were collected for HCV/HBV testing.

RESULTS

The majority of study participants (98.6%) were males, 63.2% were older than 40 years, and 51.3% had a history of imprisonment. 24.4% reported using a needle/syringe previously used by someone else. HCV seropositivity was found in 58.1% of respondents, with 32.1% of anti-HCV positive individuals testing positive for HCV RNA. HBV surface antigen was detected in 2.5%. Only 7.5% reported being vaccinated for hepatitis B and 27.8% expressed willingness to be vaccinated. 33.9% had HCV treatment history. HCV prevalence was significantly higher among males, older PWID, those with a history of incarceration and history of sharing needles used by others.

CONCLUSION

Our findings highlight the high prevalence of HCV and low HBV vaccination rates among PWID in Georgia, emphasizing the need for strengthened harm reduction strategies. Expanding sterile injection access, integrating HBV vaccination, and removing structural barriers are key to improving prevention and testing efforts and linkage to care.