Barriers associated with the treatment of hepatitis C virus infection among illicit drug users Grebely, Jason; Genoway, Krista; Duncan, Fiona; Raffa, Jesse; Conway, Brian; Dhadwal, Gurbir; Rajan, Tasleem; Showler, Grey; Kalousek, Kate; Tyndall, Mark; Fraser, Chris; Fischer, Benedikt
Background: Illicit drug users account for the majority of cases of HCV in the developed world, but few have received treatment. Methods: We evaluated barriers to initiating HCV treatment – including general treatment willingness – and factors associated with these among HCV infected illicit drug users. Participants were recruited via convenience sampling from two community clinics in Canada. Individuals age >18 years with a history of illicit drug use completed interviewer-administered surveys. Those reporting positive HCV testing underwent additional questioning on willingness, uptake and barriers to treatment for HCV. Results: Of 188 HCV positive illicit drug users, 16% (n = 30) received treatment for HCV. Factors associated with a decreased treatment uptake included current heroin use and HIV/HCV co-infection. Among those not having received therapy, 77% (117/153) indicated a willingness to receive treatment. Factors associated with treatment willingness included not being infected with HIV, having not recently used drugs by injection and having reported physical health problems. Among those not having sought treatment (n = 107), the major reasons for not doing so were: lack of information about HCV or knowledge that treatment was available (23%), the absence of symptoms (20%) and the perceived side effects of treatment (14%). Conclusions: Among illicit drug users attending inner city clinics, we have observed a low uptake of HCV treatment, but a high willingness to receive therapy. An increased focus on improving education about the long-term consequences of HCV and the availability of effective treatment are important components for expanding HCV treatment among illicit drug users.
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