TY - JOUR
T1 - The eliminate hepatitis C (EC) experience study
T2 - baseline characteristics of a cohort of people who inject drugs in Melbourne, Australia
AU - Gunn, Jack
AU - O'Keefe, Daniel
AU - Draper, Bridget Louise
AU - Djordjevic, Filip
AU - Ryan, Kathleen
AU - Kerr, Phoebe
AU - Elsum, Imogen
AU - Gold, Judy
AU - Layton, Chloe
AU - Chan, Kico
AU - Dietze, Paul
AU - Higgs, Peter
AU - Doyle, Joseph
AU - Stoové, Mark A.
AU - Hellard, Margaret
AU - Pedrana, Alisa
N1 - Funding Information:
This work was supported by funding through a National Health and Medical Research Council partnership grant (grant no. 1116161), with additional funding provided by Gilead Sciences (grant no. not applicable). The Burnet Institute gratefully acknowledges the funding it receives from the Victorian Operational Infrastructure Fund.
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/7/3
Y1 - 2023/7/3
N2 - Objectives Direct-acting antivirals provide an opportunity to eliminate hepatitis C virus (HCV) as a public health threat in Australia, yet barriers to care remain. In this study, we use baseline data from a longitudinal cohort of people who inject drugs to understand differences in participant characteristics and explore experiences of stigma, health service utilisation and health literacy between three care cascade groups. Design Cross-sectional. Setting Community and private primary healthcare services in Melbourne, Australia. Participants Participants completed baseline surveys between 19 September 2018 and 15 December 2020. We recruited 288 participants; the median age was 42 years (IQR: 37-49 years) and 198 (69%) were male. At baseline, 103 (36%) self-reported being € not engaged in testing', 127 (44%) had HCV RNA positivity but were € not engaged in treatment' and 58 (20%) were € engaged in HCV treatment'. Outcome measures Descriptive statistics were used to present the baseline demographics, health service utilisation and experiences of stigma data. We explored differences in these scales between participant demographics using χ 2 test or fisher's exact tests, and differences between health literacy scores using one-way analysis of variance tests. Results A majority were in regular contact with multiple health services, and most had previously been identified as at-risk of HCV. In the 12 months preceding baseline, 70% reported any experiences of stigma related to injecting drug use. Assessment of health literacy data identified gaps for those € not engaged in testing' and € not engaged in treatment' across two relevant domains: € ability to appraise health information' and € ability to actively engage with healthcare providers'. Conclusion In eliminate hepatitis C experience, lower HCV testing and treatment may be explained by experiences of stigmatisation or gaps in health literacy. Enhanced interventions targeting people who inject drugs to promote HCV care are needed.
AB - Objectives Direct-acting antivirals provide an opportunity to eliminate hepatitis C virus (HCV) as a public health threat in Australia, yet barriers to care remain. In this study, we use baseline data from a longitudinal cohort of people who inject drugs to understand differences in participant characteristics and explore experiences of stigma, health service utilisation and health literacy between three care cascade groups. Design Cross-sectional. Setting Community and private primary healthcare services in Melbourne, Australia. Participants Participants completed baseline surveys between 19 September 2018 and 15 December 2020. We recruited 288 participants; the median age was 42 years (IQR: 37-49 years) and 198 (69%) were male. At baseline, 103 (36%) self-reported being € not engaged in testing', 127 (44%) had HCV RNA positivity but were € not engaged in treatment' and 58 (20%) were € engaged in HCV treatment'. Outcome measures Descriptive statistics were used to present the baseline demographics, health service utilisation and experiences of stigma data. We explored differences in these scales between participant demographics using χ 2 test or fisher's exact tests, and differences between health literacy scores using one-way analysis of variance tests. Results A majority were in regular contact with multiple health services, and most had previously been identified as at-risk of HCV. In the 12 months preceding baseline, 70% reported any experiences of stigma related to injecting drug use. Assessment of health literacy data identified gaps for those € not engaged in testing' and € not engaged in treatment' across two relevant domains: € ability to appraise health information' and € ability to actively engage with healthcare providers'. Conclusion In eliminate hepatitis C experience, lower HCV testing and treatment may be explained by experiences of stigmatisation or gaps in health literacy. Enhanced interventions targeting people who inject drugs to promote HCV care are needed.
KW - Health policy
KW - Health Services Accessibility
KW - Public health
UR - http://www.scopus.com/inward/record.url?scp=85163980424&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2023-071665
DO - 10.1136/bmjopen-2023-071665
M3 - Article
C2 - 37400235
AN - SCOPUS:85163980424
SN - 2044-6055
VL - 13
JO - BMJ Open
JF - BMJ Open
IS - 7
M1 - e071665
ER -
