Grant: Operating Grant

The transmission of HIV and hepatitis C (HCV) contributes substantially to the morbidity and mortality caused by substance use disorders. Injection drug use is one of the main drivers of these two epidemics worldwide. The reasons why persons who inject drugs (PWID) engage in behaviours that put themselves and others at risk of HIV and HCV extend beyond rational decisions based on knowledge or the provision of resources such as clean syringes and injection materials. Epidemiological studies suggest that mental health disorders are highly prevalent in PWIDs and indirect evidence supports their role as major determinants of risk behaviour. There is scarce data, however, on the specific effect of mental health on transmission risk factors as well as on HIV and HCV incidences. Building on our current work and ongoing collaborations, The main goal of this proposal is to examine relationships between mental health problems, including psychiatric diagnoses and mental health states (impulsivity, anxiodepressive symptoms, psychological distress and craving), and HCV/HIV transmission among PWIDs. To achieve our goals, we will continue to follow at 3-month intervals active PWIDs in a prospective cohort study in Montreal. Interview-administered questionnaires, validated mental health measures and blood samples to test for HCV virus particles and antibodies, and HIV antibodies will be collected at each visit. Data will be analysed by statistical techniques allowing examining the relations between variables of interest and HIV/HCV infections overtime. Consistent with the importance of exploiting the richness of this long-lived longitudinal study, we will continue and expand our participation in national and international research initiatives on the aetiology and pathogenesis of HCV/HIV infections, and on vaccine development.