title: Limited uptake of hepatitis C treatment among injection drug users.
abstract: We characterized hepatitis C virus (HCV) treatment knowledge, experience and barriers in a cohort of community-based injection drug users (IDUs) in Baltimore, MD. In 2005, a questionnaire on HCV treatment knowledge, experience and barriers was administered to HCV-infected IDUs. Self-reported treatment was confirmed from medical records. Of 597 participants, 71% were male, 95% African-American, 31% HIV co-infected and 94% were infected with HCV genotype 1; 70% were aware that treatment was available, but only 22% understood that HCV could be cured. Of 418 who had heard of treatment, 86 (21%) reported an evaluation by a provider that included a discussion of treatment of whom 30 refused treatment, 20 deferred and 36 reported initiating treatment (6% overall). The most common reasons for refusal were related to treatment-related perceptions and a low perceived need of treatment. Compared to those who had discussed treatment with their provider, those who had not were more likely to be injecting drugs, less likely to have health insurance, and less knowledgeable about treatment. Low HCV treatment effectiveness was observed in this IDU population. Comprehensive integrated care strategies that incorporate education, case-management and peer support are needed to improve care and treatment of HCV-infected IDUs.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. shmehta@jhsph.edu
authors.forename: Shruti H
authors.initials: SH
authors.lastname: Mehta
authors.forename: Becky L
authors.initials: BL
authors.lastname: Genberg
authors.forename: Jacquie
authors.initials: J
authors.lastname: Astemborski
authors.forename: Ravi
authors.initials: R
authors.lastname: Kavasery
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kirk
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: David L
authors.initials: DL
authors.lastname: Thomas
mesh_terms: D001741:Black or African American; D015142:Baltimore / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012737:Sex Factors; D012944:Social Support; D015819:Substance Abuse, Intravenous / Q000821:virology*; D011795:Surveys and Questionnaires; D014504:Urban Health