Table 3.
Association of drug use stigma with hepatitis C virus (HCV) infection.
| Drug use stigma subscale | n | Outcome: HCV RNA positive |
|||
|---|---|---|---|---|---|
| %a | Univariable OR (95% CI) b | Multivariable Model 1: aOR (95% CI) b,c | Multivariable Model 2: aOR (95% CI) b,d | ||
|
| |||||
| Categorical variables | |||||
| Enacted stigma | |||||
| Never | 6,372 | 28.0 | Ref. | Ref. | Ref. |
| Ever | 5,130 | 43.0 | 1.35 (1.22–1.50) | 1.36 (1.22–1.52) | 1.27 (1.13–1.43) |
| Vicarious stigma | |||||
| Never | 3,602 | 32.2 | Ref. | Ref. | Ref. |
| Ever | 7,901 | 34.6 | 0.99 (0.86–1.15) | 1.02 (0.92–1.13) | 0.97 (0.86–1.10) |
| Felt/normative stigma | |||||
| < 25th percentile | 2,862 | 36.1 | Ref. | Ref. | Ref. |
| 25–75th percentile | 5,889 | 29.8 | 1.04 (0.89–1.21) | 1.02 (0.86–1.21) | 0.97 (0.83–1.13) |
| > 75th percentile | 2,600 | 41.5 | 1.01 (0.78–1.30) | 0.95 (0.71–1.27) | 0.92 (0.68–1.23) |
| Internalized stigma | |||||
| < 25th percentile | 2,850 | 21.3 | Ref. | Ref. | Ref. |
| 25–75th percentile | 6,338 | 35.6 | 1.52 (1.12–2.06) | 1.49 (1.13–1.98) | 1.42 (1.07–1.88) |
| > 75th percentile | 2,322 | 44.4 | 1.84 (1.26–2.68) | 1.73 (1.14–2.63) | 1.69 (1.11–2.56) |
|
| |||||
| Continuous variables | |||||
| Enacted stigma | 11,502 | - | 1.21 (1.10–1.34) | 1.26 (1.16–1.35) | 1.20 (1.11–1.30) |
| Vicarious stigma | 11,503 | - | 1.09 (0.94–1.27) | 1.09 (0.97–1.24) | 1.07 (0.93–1.23) |
| Felt/normative stigma | 11,351 | - | 1.02 (0.94–1.12) | 1.00 (0.91–1.10) | 0.98 (0.89–1.08) |
| Internalized stigma | 11,510 | - | 1.22 (1.09–1.37) | 1.20 (1.07–1.35) | 1.16 (1.04–1.30) |
Prevalence of HCV RNA (>30 IU/mL) was estimated using a composite weight of the relative city size and RDS-II weights.
Separately for each stigma subscale, odds ratios (OR) of hepatitis C virus infection were estimated from a multilevel logistic regression model with a random-intercept for each site and scaled RDS-II weights.
Multivariable model 1 included adjustment for age group, gender, northeast region, educational attainment, homelessness, history of incarceration in the past 6 months, alcohol use (AUDIT), and HIV status.
Multivariable model 2 included adjustment for age group, gender, northeast region, educational attainment, homelessness, history of incarceration in the past 6 months, alcohol use (AUDIT), HIV status, frequency of injection in the past 6 months and a history of ever sharing needles/syringes.