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HCV is transmitted primarily through percutaneous (parenteral) exposure that can result from injection drug use, needle stick injuries, and inadequate infection control in health care settings. Much less often, HCV transmission occurs among HIV positive persons, especially MSM, as a result of sexual contact with an HCV infected partner (29, 30), among persons who receive tattoos in unregulated settings (30), and among infants born to HCV infected mothers (31). After adjustment for populations not sampled in the NHANES household surveys (32), such as incarcerees and the homeless, there are an estimated 3.2 million chronically HCV infected persons in the United States (11)..
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