Hepatitis B virus infection among street youths in Montreal

Background: Street youths are at high risk for many health problems, includ ing sexually transmitted diseases and bloodborne infections. The authors co nducted a cross-sectional anonymous study from December 1995 to September 1 996 involving street youths in Montreal to estimate the prevalence of risk behaviours for hepatitis B virus (HBV) infection and of markers of past and present HBV infection. Methods: Participants were 437 youths aged 14 to 25 meeting specific criter ia for itinerancy who were recruited in collaboration with the 20 major str eet youth agencies in Montreal. Sociodemographic and lifetime risk factor d ata were obtained during a structured interview, and a blood sample was tak en to test for HBV markers (hepatitis 8 surface antigen and antibodies to t he hepatitis B core antigen). Univariate analyses and multivariate logistic regressions were conducted. Results: The mean age of the subjects was 19.5 years; 69.3% (303/437) were males. Many subjects had high-risk behaviours: 45.8% (200/437) had injected drugs, 24.5% (107/436) had engaged in prostitution, and 8.7% (38/437) repo rted having a sexual partner with a history of unspecified hepatitis. The p revalence rate for one or both HBV markers was 9.2% (40/434) (95% confidenc e interval [CI] 6.7%-12.3%). Multivariate logistic regression analysis show ed that being over 18 years of age (adjusted odds ratio [OR] 4.5, 95% CI 1. 8-11.7), having injected drugs (adjusted OR 3.5, 95% CI 1.5-8.3) and having had a sexual partner who had unspecified hepatitis (adjusted OR 3.2, 95% C I 1.3-7.5) were all associated with HBV infection. Interpretation: Street youths are at high risk for HBV infection. Early and complete HBV vaccination among this vulnerable population is urgently need ed.