title: Exploring drug users' attitudes and decisions regarding hepatitis C (HCV) treatment in the U.S.
abstract: Individuals with a history of injecting drugs are at the highest risk of becoming infected with the hepatitis C virus (HCV), with studies of patients in methadone maintenance treatment programmes (MMTPs) reporting that 60-90 percent of intravenous drug users (IDUs) have the virus. Fortunately, HCV therapy has been shown to be effective in 42-82 percent of all patients with chronic HCV infection, including IDUs. While the decision to start HCV therapy requires significant consideration, little research exists that explores the attitudes of drug users toward HCV therapy. Therefore, this paper examines how drug users perceive the treatment, as well as the processes by which HCV-positive individuals examined the advantages and disadvantages of starting the HCV medications. Interviews were conducted with 164 patients from 14 drug treatment programmes throughout the United States, and both uninfected and HCV-positive drug users described a pipeline of communication among their peers that conveys largely negative messages about the medications that are available to treat HCV. Although many of the HCV-positive individuals said that these messages heightened their anxiety about the side effects and difficulties of treatment, some patients said that their peers helped them to consider, initiate HCV treatment or both. Gaining a better understanding of drug users' perceptions of HCV treatment is important, because so many of them, particularly IDUs, are already infected with HCV and may benefit from support in addressing their HCV treatment needs. In addition, currently uninfected drug users will likely remain at high risk for contracting HCV and may need to make decisions about whether or not to start the HCV medical regimen in the future.
authors.affiliation: National Development and Research Institutes Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, United States. munoz-plaza@ndri.org
authors.forename: Corrine E
authors.initials: CE
authors.lastname: Munoz-Plaza
authors.forename: Shiela
authors.initials: S
authors.lastname: Strauss
authors.forename: Janetta
authors.initials: J
authors.lastname: Astone-Twerell
authors.forename: Don Des
authors.initials: DD
authors.lastname: Jarlais
authors.forename: Marya
authors.initials: M
authors.lastname: Gwadz
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
authors.forename: Andrew
authors.initials: A
authors.lastname: Osborne
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenblum
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001290:Attitude; D003625:Data Collection; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014481:United States
chemical_list: D000998:Antiviral Agents