"Apparently, you can only be treated once": A qualitative study exploring perceptions of hepatitis C and access to treatment among people who inject drugs visiting a needle and syringe program.
Int J Drug Policy
; 121: 104124, 2023 Nov.
Article
en En
| MEDLINE
| ID: mdl-37451942
ABSTRACT
BACKGROUND:
Access to hepatitis C care within harm reduction community organizations for people who inject drugs is crucial for achieving hepatitis C elimination. However, there is a lack of data on how perceptions of hepatitis C and treatment have changed among individuals visiting these organizations during the era of direct-acting antivirals (DAAs). This study aimed to explore the perceptions of hepatitis C and treatment access for (re)infection among individuals visiting a needle and syringe program in Canada.METHODS:
Eighteen semi-structured interviews were conducted with individuals who recently injected drugs and visited a needle and syringe program. The interviews were guided by the Common-Sense Self-Regulation Model (CS-SRM) and aimed to explore cognitive and emotional representations of hepatitis C, perceptions of treatment, coping strategies and sources of information. Interviews were audio recorded, transcribed, and coded using thematic analysis.RESULTS:
Most of the participants identified as male, were of white ethnicity and had a median age of 45. While most underscored the therapeutic advancements and the effectiveness of DAAs, they expressed confusion regarding the mechanisms of access to treatment, especially in cases of reinfection. Perceptions of the controllability of hepatitis C were significantly influenced by the stigmatizing discourse surrounding treatment access, cost, and public coverage. This influence extended to their intentions for seeking treatment. Participants emphasized the social consequences of hepatitis C, including stigma. Emotional representations of hepatitis C evolved along the care cascade, encompassing initial shock at diagnosis and later fear of reinfection following successful treatment.CONCLUSION:
Nearly a decade after the advent of DAAs, misinformation about treatment access persists. Findings underscore a nexus of internalized and institutionalized stigma associated with hepatitis C, drug use, and the challenges of cost and access to treatment, pointing to a clear need for education and service delivery optimisation in harm reduction community organizations.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
10_ODS3_salud_sexual_reprodutiva
/
1_ASSA2030
/
2_ODS3
Problema de salud:
10_sexually_transmitted_infections
/
1_medicamentos_vacinas_tecnologias
/
2_cobertura_universal
/
2_enfermedades_transmissibles
/
2_sustancias_psicoativas
Asunto principal:
Abuso de Sustancias por Vía Intravenosa
/
Hepatitis C
/
Hepatitis C Crónica
/
Consumidores de Drogas
Tipo de estudio:
Prognostic_studies
/
Qualitative_research
Aspecto:
Implementation_research
Límite:
Humans
/
Male
Idioma:
En
Revista:
Int J Drug Policy
Asunto de la revista:
SAUDE PUBLICA
/
TRANSTORNOS RELACIONADOS COM SUBSTANCIAS
Año:
2023
Tipo del documento:
Article