Barriers associated with the treatment of hepatitis C virus infection among illicit drug users.
BACKGROUND
Illicit drug users account for the majority of cases of HCV infection in the developed world, but few have received treatment.


METHODS
We evaluated barriers to initiating HCV treatment -- including general treatment willingness -- and factors associated with these among HCV infected illicit drug users. Participants were recruited via convenience sampling from two community clinics in Canada. Individuals age >18 years with a history of illicit drug use completed interviewer-administered surveys. Those reporting positive HCV testing underwent additional questioning on willingness, uptake and barriers to treatment for HCV.


RESULTS
Of 188 HCV positive illicit drug users, 16% (n=30) had received treatment for HCV. Factors associated with a decreased treatment uptake included current heroin use and HIV/HCV co-infection. Among those not having received therapy, 77% (117/153) indicated a willingness to receive HCV treatment. Factors associated with treatment willingness included not being infected with HIV, having not recently used drugs by injection and having reported physical health problems. Among those not having sought HCV treatment (n=107), the major reasons for not doing so were: lack of information about HCV or knowledge that treatment was available (23%), the absence of symptoms (20%) and the perceived side effects of treatment (14%).


CONCLUSIONS
Among illicit drug users attending inner city clinics, we have observed a low uptake of HCV treatment, but a high willingness to receive therapy. An increased focus on improving education about the long-term consequences of HCV and the availability of effective treatment are important components for expanding HCV treatment among illicit drug users.
Grebely
Jason
J
Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada. jgrebely@interchange.ubc.ca
Genoway
Krista A
KA
Raffa
Jesse D
JD
Dhadwal
Gurbir
G
Rajan
Tasleem
T
Showler
Grey
G
Kalousek
Kate
K
Duncan
Fiona
F
Tyndall
Mark W
MW
Fraser
Chris
C
Conway
Brian
B
Fischer
Benedikt
B
D000328:Adult; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology; D015438:Health Behavior; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006526:Hepatitis C / Q000453:epidemiology* / Q000628:therapy*; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D009042:Motivation; D014505:Urban Population / Q000706:statistics & numerical data
D013287:Illicit Drugs