Acceptability and Effectiveness of Hepatitis C Care at Syringe Service Programs for People Who Inject Drugs in New York City

Abstract

Introduction/Objectives: The incidence of hepatitis C (HCV) infection is rising among people who inject drugs (PWID). Even in the context of known HCV prevention and treatment strategies, some PWID remain unengaged in HCV care. This study aimed to identify and characterize experiences and perceptions of PWID regarding the acceptability and effectiveness of HCV testing and treatment at a local syringe service program (SSP). Methods: A total of 36 PWID participated in semi-structured interviews at an SSP in New York City. Interviews were audio-recorded, transcribed, and coded by three coders, following a constructivist grounded theory approach. Relevant themes were identified as they emerged from the data. Results: Interviews with PWID revealed three themes related to the impact of SSPs on HCV care: (1) non-stigmatizing SSP environments, (2) the role of SSPs in improving HCV knowledge, and (3) acceptability of SSPs as sites for HCV care among PWID. Discussion: This paper contributes to the ongoing understanding that SSPs provide a well-accepted source of HCV services for PWID. Participants believed that SSPs are accessible and effective sites for HCV care, and suggested that stigma among PWID continues to affect receipt of HCV care in traditional settings. Conclusions: Understanding attitudes and beliefs of PWID regarding the effectiveness of SSPs as sites for HCV care is crucial for the development of focused strategies to reduce HCV transmission, and to ultimately achieve HCV elimination. Given this, further research is warranted investigating how best to improve HCV care at harm reduction sites such as SSPs.

Keywords:

• Cluster
• Syringe service programs
• Hepatitis C
• people who inject drugs
• stigma

Acknowledgements

The authors would like to thank Johnny Bresset, Rebecca Bolinski, Wiley Jenkins, David Frank, Sam Friedman, Mai Pho, and Brent Van Ham for their support and contributions to study enrollment and data collection. We thank Alexis Roth and John Schnieder for their feedback on the development of the qualitative guide. We also thank all the participants of this study and our community partner [unnamed to protect their identity]. Without them, this research could not have been conducted.

Contributors

BM- Data coding and analysis, writing of original manuscript, editing and revision of manuscript

AEJ- Editing and revision of manuscript

DCP- Editing and revision of manuscript

DF – Data acquisition, editing and revision of manuscript

DCO- Study conceptualization and design, editing and revision of manuscript

SMW- Study conceptualization and design, data acquisition, data coding and analysis, writing of original manuscript, editing and revision of manuscript

All authors reviewed and approved the final manuscript

Data availability

Data are not publicly available to protect participant confidentiality. Data may be made available upon reasonable request from the corresponding author (BM).

Disclosures statement

The authors report no conflict of interest.

Additional information

Funding

This study was funded through a pilot grant from New York University’s Center for Drug Use and HIV/HCV Research (CDUHR), funded by the National Institute on Drug Abuse (P30DA011041), and NYU’s Clinical and Translational Science Institute (CTSI), funded by NIH Clinical and Translational Science Awards Program (UL1TR001445). SMW is funded by the NIDA-funded Behavioral Sciences Training in Drug Abuse Research (BST) program (T32 DA007233), Ending Transmission of HIV, HCV, and STDs and Overdose in Rural Communities of People Who Inject Drugs (4UH3DA044829-03) and the Interdisciplinary Research Institute in Hispanic Drug Abuse (R25DA026401). DCP and DCO are funded, in part, by CDUHR (P30DA011041 23).