title: Knowledge and barriers associated with assessment and treatment for hepatitis C virus infection among people who inject drugs.
abstract: OBJECTIVE
  Uptake of treatment for hepatitis C virus (HCV) infection among people who inject drugs is low. Further understanding is required of the relationship between HCV knowledge and treatment willingness, assessment and treatment in this population.
  
  
  METHODS
  A cross-sectional self-administered survey was conducted with clients of four opioid substitution therapy (OST) clinics and the Medically Supervised Injecting Centre in Sydney, Australia.
  
  
  RESULTS
  Of 132 participants, 85 (64%) self-reported having HCV infection. HCV knowledge was mixed (mean 6.5, range 0-12) and was relatively lower on items measuring knowledge of factors impacting HCV-related disease progression. The likelihood of being in a higher knowledge category was associated with being female [adjusted odds ratio (AOR) = 3.78, 95% confidence interval (CI) (1.79, 7.98)], higher formal education [AOR = 3.28, 95% CI (1.57, 6.88)], being on a current OST program [AOR = 2.61, 95% CI (1.10, 6.19)] and being older [AOR = 1.04, 95% CI (1.01, 1.09)]. Participants receiving OST were more likely to report higher willingness to have HCV treatment [OR = 4.45, 95% CI (2.23, 8.17)]. Having been assessed for HCV treatment was associated with younger age [AOR = 0.93; CI 95% (0.88, 1.00)] and higher formal education [AOR = 7.81; 95% CI (1.62, 37.71)].
  
  
  CONCLUSIONS
  Overall, knowledge scores were mid-range. Knowledge of modifiable factors influencing HCV-related liver disease progression was particularly low indicating the need for ongoing education. Education should also be targeted at older people and those not on OST, and be inclusive of those with lower literacy levels.
authors.affiliation: National Centre in HIV Social Research, The University of New South Wales, Sydney, Australia. c.treloar@unsw.edu.au
authors.forename: Carla
authors.initials: C
authors.lastname: Treloar
authors.forename: Peter
authors.initials: P
authors.lastname: Hull
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Dore
authors.forename: Jason
authors.initials: J
authors.lastname: Grebely
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003625:Data Collection; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006526:Hepatitis C / Q000503:physiopathology / Q000628:therapy* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D018671:Needle-Exchange Programs; D009517:New South Wales; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000534:rehabilitation; D012737:Sex Factors; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*