Skip Page Header

Home > Barriers to and facilitators of hepatitis C care.

Long, Jean (2011) Barriers to and facilitators of hepatitis C care. Drugnet Ireland , Issue 37, Spring 2011 , p. 22.

[img]
Preview
PDF (Drugnet Ireland, Issue 37) - Published Version
795kB

Hepatitis C infection is common among injecting drug users (IDUs), yet access to hepatitis C care, particularly treatment, is suboptimal. There has been little in-depth study of IDUs’ experiences of what enables or prevents them engaging at every level of hepatitis C care, including testing, follow-up, management and treatment processes. 

A qualitative study aimed to explore these issues with current and former IDUs in the greater Dublin area.1 Between September 2007 and September 2008 in-depth interviews were conducted with 36 service users across a range of primary and secondary care services, including two addiction clinics, a general practice, a community drop-in centre, two hepatology clinics, and an infectious diseases clinic. Interviews were analysed using a grounded theory approach.
 
Of the 36 participants interviewed, 28 were men and eight were women. They ranged in age from 24 to 54 years, with a median age of 32 years. The median reported age at first injecting drugs was 18.5 years (range 14–29 years). Of the 28 who reported their main problem drug, 79% reported heroin and 21% cocaine. Thirty-three (91%) participants reported testing positive for hepatitis C, of whom four (11%) reported HIV/HCV co-infection.
 
Among the factors influencing access to and uptake of HCV care were:
·         perceptions that every injector had this invisible infection (hepatitis C) and that its effects were not as serious as those of HIV;
·         perceptions that the investigations and treatments for hepatitis C were more severe than the infection itself;
·         use of coping strategies, such as blocking awareness, escape, support and positive thinking, to deal with fears about the future effects of hepatitis C, or anxieties about investigations or treatment;
·         the quality of relationships with health care providers;
·         contact with services, encouraging and caring doctors and nurses, family ties, recovery from addiction, and convenient access to testing and treatment; and
·         continued substance use, employment (lack of free time), contraindications to treatment, lack of reminders and lack of opportunity.
 
In conclusion, IDUs face multiple barriers to HCV care but a range of facilitators were identified that could increase access to and uptake of treatment.
 
1. Swan D, Long J, Carr O, Flanagan J, Irish H, Keating S et al. (2010) Barriers to and facilitators of hepatitis C testing, management, and treatment among current and former injecting drug users: a qualitative exploration. AIDS Patient Care and STDS, 24(12): 753–762.  www.drugsandalcohol.ie/14416
Item Type
Article
Issue Title
Issue 37, Spring 2011
Date
2011
Page Range
p. 22
Publisher
Health Research Board
Volume
Issue 37, Spring 2011
EndNote
Accession Number
HRB (Available)

Repository Staff Only: item control page