Author: Aponte-Melendez Y, Mateu-Gelabert P, Fong C, Quinn K, Rodriguez A, Smith M, Eckhardt B, Davis, Kapadia S, Marks K

Theme: Clinical Research Year: 2019

Background: Hepatitis C virus (HCV) is very prevalent among people who inject drugs (PWID) yet HCV
treatment is low. Stigma experienced by PWID may pose a significant barrier to HCV care. This analysis
examines correlates of stigma experienced by PWID in health care settings.
Methods: Data are from 121 New York City (NYC) PWID participating in an on-going study to assess the
efficacy of providing HCV care at Syringe Exchange Programs. Eligibility criteria includes positive HCV
RNA test and injection drug use in the past 3 months. Structured interviews covered topics such as drug
use history, health care related-experiences, and prior history with HCV care. Stigma experiences were
measured at study entry by a 10-item scale developed by principal components analysis. The scale is
divided into two subscales: internal (3 items reflecting participants’ attitudes/behaviors) and external (7
items reflecting perceptions of medical providers’ attitudes/behaviors) stigma. Stigma was numerically
scored from 1 (least stigma) to 5 (most stigma)
Results: Sample descriptives include: mean age 42.9 (sd=10.9); 78% males; 59% Latino; 31% Non-Latino
White; 6% Non-Latino Black; 5% other. Prior to enrollment, 94% were aware of their HCV+ status and
77% of them had not sought HCV treatment. Latinos had higher mean baseline stigma scores (3.61) than
non-Latino Whites and Blacks (3.07) (p<0.001). Participants with higher baseline stigma scores reported being less willing to disclose HCV status (p=0.004) and less likely to discuss health problems and concerns with doctors (p=0.009). Higher internal stigma scores were associated with riskier injection behaviors (i.e. cooker sharing p=0.015). Conclusion: Drug-related stigma may discourage engagement in HCV care among PWID. Destigmatized access to health care may be crucial to the effective prevention, treatment and elimination of HCV among PWID. This may be particularly true for Latino PWID in NYC. Disclosure of Interest Statement: Drs. Eckhardt, Kapadia, and Marks have received research grants from Gilead Sciences Inc. No pharmaceuticals grants were received in the development of this study.

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