Hepatitis C Positive: Stigma And Drug Use Challenges

Author: Lombard A, Marks R

Theme: Epidemiology & Public Health Research Year: 2018

Background: Stigma is experienced among hepatitis C (HCV) patients, especially with co-existing drug use behaviors. Stigma is associated with shame, injection drug use, and mistrust. Stigma may be a contributing factor to the “SILENCE”, lack of treatment – even though HCV is curable – and unmet capacity needed to eliminate the HCV epidemic. Description of model of care/intervention: The HCV survey was developed using a multidisciplinary approach and distributed to persons currently infected with HCV. Psycho-social factors related to care and treatment were explored. The 28 item instrument included quantitative and qualitative responses. The survey was HIPPA compliant and confidentially administered March to December 2015 via Survey Monkey. The distribution was facilitated by over 500 national/global networks, partners and providers yielding the recruitment of 281 unique respondents. 86% completed the survey in 10 or less minutes. Data was analyzed using Excel, SPSS and Medcalc. Effectiveness: After HCV diagnosis, 226 (80%) indicated that they wanted to be treated. 166 (59%) received treatment “ever” and of those, 60% had to wait five or more months for treatment once it was ordered. Treatment barriers included “stigma”, “I didn’t feel safe with provider”, and “drug and alcohol use”. 64 (23%) reported that drug and alcohol use was a significant part of their lives; 59 (21%) indicated no; 207 (74%) did not respond to the question. 94 (34%) self-reported stigma, 18 (6%) indicated that they did not experience stigma; 169 (60%) of the respondents did NOT respond to the question. The majority was SILENT; did not respond to the stigma, drug and alcohol use items. Conclusion and next steps: Further study is needed to address HCV structural and social stigma, the syndemic intersection with the opioid epidemic, and educational support groups for patients and providers. Outcomes are informing HCV models of care and best practices. Disclosure of Interest Statement: HCMSG received Gilead Pharmaceuticals unrestricted funding to support this project.

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