Barriers to and Facilitators of Hepatitis C Testing, Management, and Treatment Among Current and Former Injecting Drug Users: A Qualitative Exploration

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Title: Barriers to and Facilitators of Hepatitis C Testing, Management, and Treatment Among Current and Former Injecting Drug Users: A Qualitative Exploration
Authors: Swan, Davina
Long, Jean
Carr, Olivia
Lambert, John
Cullen, Walter
et al.
Permanent link: http://hdl.handle.net/10197/9379
Date: 7-Dec-2010
Abstract: Hepatitis C (HCV) infection is common among injecting drug users (IDUs), yet accessing of HCV care, particularly HCV treatment, is suboptimal. There has been little in-depth study of IDUs experiences of what enables or prevents them engaging at every level of HCV care, including testing, follow-up, management and treatment processes. This qualitative study aimed to explore these issues with current and former IDUs in the greater Dublin area, Ireland. From September 2007 to September 2008 in-depth interviews were conducted with 36 service-users across a range of primary and secondary care services, including: two addiction clinics, a general practice, a community drop-in center, two hepatology clinics, and an infectious diseases clinic. Interviews were analyzed using a grounded theory approach. Barriers to HCV care included perceptions of HCV infection as relatively benign, fear of investigations and treatment, and feeling well. Perceptions were shaped by the discourse about HCV and "horror stories'' about the liver biopsy and treatment within their peer networks. Difficulties accessing HCV care included limited knowledge of testing sites, not being referred for specialist investigations and ineligibility for treatment. Employment, education, and addiction were priorities that competed with HCV care. Relationships with health care providers influenced engagement with care: Trust in providers, concern for the service-user, and continuity of care fostered engagement. Education on HCV infection, investigations, and treatment altered perceptions. Becoming symptomatic, responsibilities for children, and wanting to move on from drug use motivated HCV treatment. In conclusion, IDUs face multiple barriers to HCV care. A range of facilitators were identified that could inform future interventions.
Funding Details: Health Research Board
Type of material: Journal Article
Publisher: Mary Ann Liebert
Journal: AIDS Patient Care and STDs
Volume: 24
Issue: 12
Start page: 753
End page: 762
Copyright (published version): 2010 Mary Ann Liebert Publications
Keywords: HCV infectionWomenRiskHIVPrevalence
DOI: 10.1089/apc.2010.0142
Language: en
Status of Item: Peer reviewed
metadata.dc.date.available: 2018-05-14T09:47:54Z
Appears in Collections:Medicine Research Collection

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