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“I want to feel young again” : Experiences and perspectives of young people who inject drugs living with hepatitis C in Vancouver, Canada Jacob, Jessica; Goodyear, Trevor; Couland, Pierre-julien; Hoong, Peter; Ti, Lianping; Knight, Rod E.

Abstract

Objectives: People who inject drugs (PWID) are disproportionately impacted by hepatitis C virus (HCV). Despite the availability and efficacy of direct-acting antiviral (DAA) HCV therapies, treatment rates remain low among PWID. Among PWID, those who are young (under age 30) experience high rates of HCV and also face distinct barriers to care. The objective of this study is to identify facilitators and barriers to navigating various facets of the HCV cascade of care, including DAA treatment access, among young PWID. Methods: We draw on data from in-depth, semi-structured interviews, conducted between May and November 2019, with a sample of 11 young, street-involved PWID who have lived experience of HCV and who live in Metro Vancouver, Canada. Informed by a social constructivist epistemology, data were thematically analyzed using an equity-oriented theoretical framework. Results: Our analysis yielded two key themes. First, participants described facilitators to HCV care access, including individual (e.g. desire to be cured, knowledge of side effects) and healthcare and socio-contextual factors (e.g. peer supports, supportive youth-specific services). Second, participants described a contrasting set of barriers to HCV care access, including concerns over treatment side effects and (in)eligibility, complex healthcare system navigation, substance use- and housing-related stigma, and clinician gatekeeping of DAAs. Conclusion: Findings from this study underscore the need for HCV-related knowledge-building efforts among young PWID and clinicians. Also needed are structural policy interventions to facilitate access to DAAs, including anti-stigma efforts, access to safe housing, and the scale-up of low-barrier youth-specific services and decentralized HCV care.

Item Metadata

Title
“I want to feel young again” : Experiences and perspectives of young people who inject drugs living with hepatitis C in Vancouver, Canada
Creator
Jacob, Jessica; Goodyear, Trevor; Couland, Pierre-julien; Hoong, Peter; Ti, Lianping; Knight, Rod E.
Contributor
British Columbia Centre on Substance Use
Publisher
Canadian Journal of Public Health
Date Issued
2021-10
Description
Objectives: People who inject drugs (PWID) are disproportionately impacted by hepatitis C virus (HCV). Despite the availability and efficacy of direct-acting antiviral (DAA) HCV therapies, treatment rates remain low among PWID. Among PWID, those who are young (under age 30) experience high rates of HCV and also face distinct barriers to care. The objective of this study is to identify facilitators and barriers to navigating various facets of the HCV cascade of care, including DAA treatment access, among young PWID. Methods: We draw on data from in-depth, semi-structured interviews, conducted between May and November 2019, with a sample of 11 young, street-involved PWID who have lived experience of HCV and who live in Metro Vancouver, Canada. Informed by a social constructivist epistemology, data were thematically analyzed using an equity-oriented theoretical framework. Results: Our analysis yielded two key themes. First, participants described facilitators to HCV care access, including individual (e.g. desire to be cured, knowledge of side effects) and healthcare and socio-contextual factors (e.g. peer supports, supportive youth-specific services). Second, participants described a contrasting set of barriers to HCV care access, including concerns over treatment side effects and (in)eligibility, complex healthcare system navigation, substance use- and housing-related stigma, and clinician gatekeeping of DAAs. Conclusion: Findings from this study underscore the need for HCV-related knowledge-building efforts among young PWID and clinicians. Also needed are structural policy interventions to facilitate access to DAAs, including anti-stigma efforts, access to safe housing, and the scale-up of low-barrier youth-specific services and decentralized HCV care.
Subject
Hepatitis C; direct-acting antivirals; treatment; youth; people who inject drugs; qualitative research
Geographic Location
Downtown-Eastside (Vancouver, B.C.)
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2022-06-11
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0407073
URI
http://hdl.handle.net/2429/80934
Affiliation
Applied Science, Faculty of; Medicine, Faculty of; Medicine, Department of; Nursing, School of
Citation
Jacob J, Goodyear T, Coulaud P, Hoong P, Ti L, & Knight R. (2021). "I want to feel young again": Experiences and perspectives of young people who inject drugs living with hepatitis C in Vancouver, Canada. Canadian Journal of Public Health. 112(5): 947-956.
Publisher DOI
10.17269/s41997-021-00535-2
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher; Postdoctoral; Graduate
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International