title: "Hepatitis C treatment turned me around:" Psychological and behavioral transformation related to hepatitis C treatment.
abstract: BACKGROUND
  Hepatitis C (HCV) is a significant public health problem that primarily affects current and former substance users. However, individuals with a history of substance use are less likely to have access to or engage in HCV care. Psychological and behavioral barriers prevent many HCV-infected individuals from initiating or engaging in HCV treatment. This study aimed to investigate the psychological and behavioral experiences of current and former substance users receiving HCV treatment within a combined methadone and primary care clinic in the United States.
  
  
  METHODS
  We conducted 31 semi-structured qualitative interviews with opioid-dependent adults enrolled in an integrated HCV treatment program within a methadone maintenance clinic in the Bronx, NY. We used thematic analysis, informed by grounded theory, and inquired about perceptions of HCV before and after initiating HCV treatment, reasons for initiating HCV treatment, and the decision to participate in individual versus group HCV treatment.
  
  
  RESULTS
  Participants described psychological and behavioral transformation over the course of HCV treatment. These included reductions in internalized stigma and shame related to HCV and addiction, increases in HCV disclosure and self-care, reductions in substance use, and new desire to help others who are living with HCV.
  
  
  CONCLUSIONS
  Integrating HCV treatment with methadone maintenance has the potential to create psychological and behavioral transformations among substance using adults, including reductions in HCV- and addiction-related shame and improvements in overall self-care.
authors.affiliation: Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA; Osher Center for Integrative Medicine, University of San Francisco, San Francisco, 1545 Divisadero Street, 3rd Floor, San Francisco, CA 94115, USA. Electronic address: abigail.batchelder@ucsf.edu.
authors.forename: A W
authors.initials: AW
authors.lastname: Batchelder
authors.affiliation: Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA; Center for Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, USA. Electronic address: dpeyser@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Peyser
authors.affiliation: Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA. Electronic address: snahvi@montefiore.org.
authors.forename: S
authors.initials: S
authors.lastname: Nahvi
authors.affiliation: Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA. Electronic address: jarnsten@montefiore.org.
authors.forename: J H
authors.initials: JH
authors.lastname: Arnsten
authors.affiliation: Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA. Electronic address: alitwin@montefiore.org.
authors.forename: A H
authors.initials: AH
authors.lastname: Litwin
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000523:psychology*; D012648:Self Care; D012752:Shame; D013240:Stereotyping; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000523:psychology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: Hepatitis C; Injection drug use; Internalized stigma; Methadone maintenance; Shame