Prevalence of blood-borne viral and sexually transmitted infections among homeless people in Berlin
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Authors
Steffen, G
Weber, C
Cawley, C
Leicht, A
Sarma, N
Jansen, K
Kröger, S
Kajikhina, K
Zimmermann, R
Bremer, V
Issue Date
2022-10-25
Type
Article
Language
en_US
Keywords
Sexually Transmitted Infections , Blood-Borne
Alternative Title
Abstract
Background:
Risk factors associated with precarious living conditions make people experiencing homelessness (PEH) also highly vulnerable for blood-borne viral and sexually transmitted infections (BBVSTI) and tuberculosis (TB). The number of PEH in Germany is rising, yet little data is available on the infectious burden among this population. A pilot study assessed the prevalence of BBVSTI, TB, behaviours and access to medical services among PEH.
Methods:
We recruited PEH from April-June 2021 in five low-threshold medical services in Berlin. Behavioural data was collected via questionnaire-based interviews. Serological/molecular testing from venous blood samples was performed for Hepatitis B (HBV), Hepatitis C (HCV), HIV, syphilis and TB and from urine for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT).
Results:
Of 216 participants, 88% (191/216) were male and 73% (158/215) were born abroad. Mean age was 41 years (range 19-68). No health insurance was reported by 57% (123/216) and previous incarceration by 71% (153/214). Of all, 53% (114/216) injected drugs in the last 30 days, and 41% (89/216) reported unprotected sex in the last 12 months. Prevalence of active HBV was 1.9% (4/212), of active HCV 15.9% (34/213), and of HIV 2.8% (6/213). No active TB was diagnosed, while 14.4% (31/216) tested positive for latent TB infection. Active syphilis was found in 1.4% (3/212), NG in 2.0% (4/197), CT in 3.0% (6/197), and serological evidence of HBV vaccination in 26% (56/212). While 44% (96/216) of participants were ever tested for HCV, 71% (36/51) of those with HCV antibodies knew about their infection, 36% (13/36) of them reported previous/current treatment.
Conclusions:
Burden of HCV and HIV was high among PEH in Berlin, and risk behaviours were frequently reported. There is a need to improve access to regular health care, accompanied by low-threshold prevention offers in cooperation with drug and homeless services. A nationwide expansion of the study is planned.
Description
Citation
Steffen, G., Weber, C., Cawley, C., Leicht, A., Sarma, N., Jansen, K., Kröger, S., Kajikhina, K., Zimmermann, R., & Bremer, V. (2022). Prevalence of blood-borne viral and sexually transmitted infections among homeless people in Berlin: Navina Sarma. The European Journal of Public Health, 32(Suppl 3), ckac131.201. https://doi.org/10.1093/eurpub/ckac131.201
Publisher
The European Journal of Public Health