Associations Between Self‐Reported Previous Hepatitis C Diagnosis, Hepatitis C Treatment, and Current Binge Drinking Among Persons Who Inject Drugs—National HIV Behavioural Surveillance, 2015–2024

Persons who inject drugs (PWID) are disproportionately affected by hepatitis C virus (HCV). Excessive alcohol use among PWID can lead to more rapid progression of liver disease among persons with HCV. We assessed associations between ever reporting HCV infection, ever reporting HCV treatment, and current binge drinking among PWID who participated in National HIV Behavioural Surveillance (NHBS) during 2015-2024. NHBS conducted biobehavioural surveys among PWID using respondent-driven sampling in 2015, 2018, 2022, and 2024. We estimated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) to assess the association between self-report of ever having HCV infection, HCV treatment, and binge drinking in the past 30 days. The percentage of PWID reporting binge drinking was 25.8% in 2015, 24.0% in 2018, 13.3% in 2022, and 17.2% in 2024. In adjusted analysis, we found a significant negative relationship between self-reported ever having HCV infection and binge drinking in the past 30 days in three of the four surveys: 2018 (aPR: 0.90, 95% CI: 0.83-0.99), 2022 (aPR: 0.79, 95% CI:0.70-0.90), and 2024 (aPR:0.78, 95% CI: 0.65-0.93). We did not find significant associations between previously ever receiving treatment for HCV infection and binge drinking in the past 30 days across the four survey years. Among PWID, HCV infection was associated with reduced prevalence of binge drinking in 2018, 2022, and 2024. Our results support the importance of testing PWID for HCV infection and continued education on the harms associated with excessive alcohol use, including among persons who have received treatment for HCV infection.