Limited Uptake of Hepatitis C Treatment Among Injection Drug Users

  • Shruti H. Mehta
  • Becky L. Genberg
  • Jacquie Astemborski
  • Ravi Kavasery
  • Gregory D. Kirk
  • David Vlahov
  • Steffanie A. Strathdee
  • David L. Thomas
Original Paper

Abstract

We characterized hepatitis C virus (HCV) treatment knowledge, experience and barriers in a cohort of community-based injection drug users (IDUs) in Baltimore, MD. In 2005, a questionnaire on HCV treatment knowledge, experience and barriers was administered to HCV-infected IDUs. Self-reported treatment was confirmed from medical records. Of 597 participants, 71% were male, 95% African-American, 31% HIV co-infected and 94% were infected with HCV genotype 1; 70% were aware that treatment was available, but only 22% understood that HCV could be cured. Of 418 who had heard of treatment, 86 (21%) reported an evaluation by a provider that included a discussion of treatment of whom 30 refused treatment, 20 deferred and 36 reported initiating treatment (6% overall). The most common reasons for refusal were related to treatment-related perceptions and a low perceived need of treatment. Compared to those who had discussed treatment with their provider, those who had not were more likely to be injecting drugs, less likely to have health insurance, and less knowledgeable about treatment. Low HCV treatment effectiveness was observed in this IDU population. Comprehensive integrated care strategies that incorporate education, case-management and peer support are needed to improve care and treatment of HCV-infected IDUs.

Keywords

Hepatitis C virus Injection drug use Antiviral therapy Health care access 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Shruti H. Mehta
    • 1
  • Becky L. Genberg
    • 1
  • Jacquie Astemborski
    • 1
  • Ravi Kavasery
    • 1
  • Gregory D. Kirk
    • 1
    • 2
  • David Vlahov
    • 3
  • Steffanie A. Strathdee
    • 4
  • David L. Thomas
    • 1
    • 2
  1. 1.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Division of Infectious DiseasesJohns Hopkins School of MedicineBaltimoreUSA
  3. 3.Center for Urban Epidemiologic StudiesNew York Academy of MedicineNew YorkUSA
  4. 4.Division of International Health and Cross-Cultural MedicineUniversity of California San Diego, School of MedicineSan DiegoUSA

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