Health Care for the Homeless (HCH) serves 5,300 clients a year in Baltimore;
3,200 at the HCH clinic and 2,100 more in outreach. Basic demographics: 96% are
homeless, 69% are men, 82% are African-American, 18% have a history of mental
illness, 4% are HIV positive, and 18% report illicit drug use. Because hepatitis
C is particularly severe among clients with HIV and/or alcohol abuse, we began
screening for hepatitis C in 1997.
We were interested in risk factors for clients testing positive for hepatitis
C, and especially what percentage of them would be eligible for vaccination
against hepatitis B and A. We conducted a study from January 1, 1997-June 30,
2000, testing HCH clinic clients for hepatitis C infection. We collected basic
demographic data and information on behavioral risk factors, such as unprotected
heterosexual sex, men having sex with men, injection drug use, non-injection
drug use, and alcohol use.
During this time period, we had 397 clients test positive for hepatitis C.
Out of these, 274 were eligible for hepatitis B immunization and approximately
313 were eligible for hepatitis A immunization.
We then compared these 397 hepatitis C positive clients (cases) with 2,535
hepatitis C negative clients (controls). These cases and controls were very
similar in terms of their basic demographics. We looked at the hepatitis C
clients’ risk factors and co-morbidities compared to the controls, and got the