title: Tackling the Health Challenge posed by Hepatitis C in Puerto Rico: A Call for Immediate Public Health Actions.
abstract: Within the past decade, researchers and hepatitis C specialists in Puerto Rico have highlighted the burden of hepatitis C and associated disease outcomes in the island to raise public awareness about this problem and set out a call to action to tackle prevention and control efforts, yet so far no concrete actions have taken place. The population-based studies on hepatitis C have documented that the main risk factor is the sharing of syringes and drug paraphernalia to inject drugs, that most seropositive individuals are unaware of their infection status, and that there are large knowledge deficits about the disease, its risk factors, and measures of prevention and control. The subject is further complicated by the fact that despite hepatitis C reporting is mandatory, there is no effective epidemiological surveillance system to provide the information needed for planning, implementation, monitoring, and evaluation of intervention strategies for this infection and access to medical and other existing therapies is limited. This document addresses the disparities in HC V infection and its adverse outcomes experienced among Puerto Ricans and attempts to set out strategies to address a public health response for hepatitis C at the meso and macro levels of the social-ecological model. Diverse organizations and major stakeholders are urged to mount an adequate response to hepatitis C by transforming current scientific evidence into public health actions to increase awareness, identify those who are actively infected, and link infected individuals into comprehensive care and treatment.
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.affiliation: Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Carmen E
authors.initials: CE
authors.lastname: Albizu-García
authors.affiliation: Department of Medicine, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Esther A
authors.initials: EA
authors.lastname: Torres
mesh_terms: D006526:Hepatitis C / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D011634:Public Health; D011647:Puerto Rico / Q000453:epidemiology
keywords: Hepatitis C; Public health response; Substance use disorders