Hepatitis C treatment in pharmacotherapy services: increasing treatment uptake needs a critical view.
OBJECTIVE
In an effort to increase the number of people undergoing hepatitis C treatment, a range of initiatives are planned or underway to provide treatment in non-specialist services, such as opioid pharmacotherapy treatment (OPT) clinics.


METHODS
This commentary considers the implications of this new approach to treatment delivery, taking account of individual-level issues generally discussed in the literature, such as knowledge of treatment and concerns about side effects. In addition, because less visible organisational and structural factors would equally influence the successful implementation of hepatitis C treatment in OPT services, these are also explored.


RESULTS
Provision of hepatitis C treatment in OPT services raises a broad range of pressing questions, from individual knowledge and concern about treatment, to workforce issues, such as discrimination, and tensions between the need for supportive care during hepatitis C treatment and the surveillant, regulatory nature of OPT clinic operations.


CONCLUSIONS
A thorough critical examination of the structure and delivery of all services involved is necessary. Social research can play a unique role in this assessment because of its ability to generate detailed insights into lived experience and make use of social theories that allow previously invisible operations of power to become visible.


CONCLUSIONS
The success of hepatitis C treatment in new sectors, such as OPT clinics, is not a given. Close attention needs to be paid to the context and culture in which OPT is delivered. In turn, this needs to be considered alongside the context and culture necessary for successful hepatitis C treatment delivery.
Treloar
Carla J
CJ
National Centre in HIV Social Research, The University of New South Wales, Sydney, Australia. c.treloar@unsw.edu.au
Fraser
Suzanne M
SM
D001315:Australia / Q000453:epidemiology; D003695:Delivery of Health Care; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000150:complications / Q000628:therapy*; D006801:Humans; D009293:Opioid-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D011287:Prejudice; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration