title: Depression, Anxiety, and Stress Among People With Chronic Hepatitis C Virus Infection and a History of Injecting Drug Use in New South Wales, Australia.
abstract: The aims of this study were to assess symptoms of depression, anxiety, and stress and associated sociodemographic factors among people living with chronic hepatitis C virus (HCV) infection with a history of injecting drug use and to assess the association between symptoms of depression, anxiety, or stress and HCV treatment intent, specialist assessment, or treatment uptake.
  
  
  
  The Enhancing Treatment for Hepatitis C in Opioid Substitution Settings was an observational cohort study evaluating the provision of HCV assessment and treatment among people with chronic HCV and a history of injecting drug use, recruited from 9 community health centers and opioid substitution therapy (OST) clinics (New South Wales, Australia). Symptoms were assessed using the Depression Anxiety Stress Scales (DASS-21). Analyses were performed using logistic regression.
  
  
  
  Among 415 participants (mean age 41 years, 71% male), 47%, 52%, and 36% demonstrated moderate to extremely severe symptoms of depression, anxiety, and stress, respectively. In adjusted analyses, depression symptoms were associated with recent injecting drug use [adjusted odds ratio (aOR) 1.63, 95% confidence interval (CI) 1.07-2.49), whereas stress symptoms were associated with unemployment (aOR 2.99, 95% CI 1.09-8.15) and not living with a spouse or other relatives/friends (aOR 1.55, 95% CI 1.01-2.39). Symptoms of depression, anxiety, or stress or having a history of treated mental illness were not independently associated with HCV treatment intent, specialist assessment, or treatment uptake.
  
  
  
  Findings suggest a need for improved interventions and care regarding mental health among people living with chronic HCV with a history of injecting drug use, but suggest that symptoms of depression, anxiety, and stress should not be immediate contraindications to HCV assessment and treatment.
authors: Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal (EF, JB); CHUM Research Center, Centre Hospitalier de l'Université de Montréal, Montréal (EF, JB), QC, Canada; The Kirby Institute, UNSW Australia, Sydney, NSW, Australia (EF, MA, MM, GJD, JG); St. Vincent's Hospital, Sydney, NSW, Australia (JP); Centre for Mental Health, University Health Network, University of Toronto, Toronto, ON, Canada (SS); University of Newcastle (AJD); Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle (AJD); Clinic 96, Kite St Community Health Centre, Orange (ACB); Drug Health Service, Royal Prince Alfred Hospital (CAD, PSH); Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney (CAD); Centre for Social Research in Health, UNSW Australia (CT); NSW Health (NB); Sydney Medical School, University of Sydney (PSH), Sydney, NSW, Australia.
authors: Emmanuel
authors: E
authors: Fortier
authors: Maryam
authors: M
authors: Alavi
authors: Julie
authors: J
authors: Bruneau
authors: Michelle
authors: M
authors: Micallef
authors: Jacinta
authors: J
authors: Perram
authors: Sanjeev
authors: S
authors: Sockalingam
authors: Adrian J
authors: AJ
authors: Dunlop
authors: Annie C
authors: AC
authors: Balcomb
authors: Carolyn A
authors: CA
authors: Day
authors: Carla
authors: C
authors: Treloar
authors: Nicky
authors: N
authors: Bath
authors: Paul S
authors: PS
authors: Haber
authors: Gregory J
authors: GJ
authors: Dore
authors: Jason
authors: J
authors: Grebely
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014478:Unemployment / Q000706:statistics & numerical data*