Engagement in the Hepatitis C care continuum among people who use drugs

ABSTRACT

Background: Despite high rates of Hepatitis C virus (HCV) infection among people who use drugs (PWUDs), access to the HCV care continuum combined with the receipt of medications for addiction treatment in primary care settings remains suboptimal.

Methods: A qualitative study was conducted among adults admitted for inpatient detoxification for opioid use disorder (OUD) in New York City (n = 23) to assess barriers and facilitators with HCV prevention, screening, treatment, interactions with primary care providers, and experiences with integrated care approaches.

Results: Study findings yielded six major themes related to HCV care. Major gaps persist in knowledge regarding HCV harm reduction strategies, voluntary HCV testing services, and eligibility for HCV treatment. Treatment coordination challenges reinforce the importance of enhancing linkages to HCV care in key access-points utilized by PWUDs (e.g., emergency rooms, specialty addiction treatment settings). Peer networks combined with frequent patient-physician communication were elicited as important factors in facilitating linkage to HCV care. Additional care coordination needs in primary care settings included access to integrated treatment of HCV and OUD, and administrative support for enrollment in Medicaid, subsidized housing, and access to transportation vouchers.

Discussion: Strategies are needed to enhance access to harm reduction and treatment services for PWUDs, including improved clinical and administrative support in primary care, and patient education.

KEYWORDS:

• Hepatitis C
• opioid use disorder
• primary health care
• drug users

Acknowledgments

The authors would like to thank Dr. Holly Hagan, from the Center for Drug Use and HIV Research, for her comments and revisions to this manuscript.

Authors’ contributions

All co-authors made substantial contributions to conception, design, interpretation of data, and drafting of the manuscript. BT, SS, CC, and JDL were involved with the acquisition and analysis of data.

Disclosure of potential conflicts of interest

None of the authors have any conflicts of interest to disclose.

Additional information

Funding

This study was supported by the National Institute on Drug Abuse [K23DA042140-01A1]; Center for Drug Use and HIV Research [P30DA011041]; and the NIH National Center for Advancing Translational Sciences [UL1 TR001445].