A study of young people who inject drugs: an opportunity to decrease high risk injecting by improving knowledge about hepatitis C prevention

The population of young people who inject drugs (PWID) displays a unique constellation of features that are not found in other groups who are at risk of acquiring hepatitis C: they exhibit a smaller pool of existing infection and a higher incidence of unsafe injecting. This means there is vast opportunity to prevent the spread of hepatitis C for young PWID. This article uses survey data collected from clients of a community pharmacy needle exchange scheme in New South Wales, Australia, to describe the extent of unsafe injecting among young PWID, their knowledge about hepatitis C prevention and use of services. It examines whether poor knowledge and service use are related to unsafe injecting. A sample of 215 respondents aged 18–25 years was compared to 1464 respondents aged 26 years or older. Young respondents engaged in riskier injecting practices than their older counterparts, with higher proportions saying they had shared needles and other injecting equipment. Moreover, those who had shared equipment did so in a more risky manner than older respondents by sharing with a larger number of people and with people who were possibly less well-known to them, such as casual sex partners. While knowledge about hepatitis C transmission was good among young respondents, it was significantly worse than that of older respondents. More importantly, however, this poorer knowledge was related to both increased needle sharing and increased ancillary equipment sharing. Many studies do not observe a relationship between knowledge and risk behaviour but the findings of this study suggest a pressing opportunity to improve knowledge of young PWID. While it is unlikely that better knowledge will alone prevent infection among young people, it is a necessary starting point and, in the current case, has the potential to decrease young people’s risk of acquiring hepatitis C.