Theme: Social Science & Policy Research Year: 2019
Background : The listing of direct-acting antiviral (DAA) medicines for people with hepatitis C on
the Australian universal health system has set the trajectory to eliminate hepatitis C. A key
component is treatment for people who inject drugs (PWID) living with hepatitis C. Initial
uptake of treatment among PWID was promising but uptake is now slowing. This study
investigated the evolving barriers and motivators for PWID to access DAA and the implications for
scaling-up testing and treatment.
Methods: PWID peer workers have unique insight into the experiences of PWID who may not
participate in research/consultations. This study drew on the perspectives of peer workers and
volunteers and their networks to investigate experiences of PWID regarding DAA treatment
scale-up.
Ten focus groups and four semi-structured interviews were conducted across Australia in
three phases with:
I. Peer workers and volunteers from three collaborating peer-organisations to obtain
insights on PWID uptake of DAA treatment
II. individual PWID on their engagement with DAA treatment
Results: Three short reports to facilitate real-time translation of results into ongoing treatment
scale-up strategies and practice were produced. Common themes included attitudes on DAAs,
hepatitis C testing, access to health providers, and structural barriers to accessing treatment. We
found generalized hepatitis C treatment awareness campaigns were having reduced impact, and
conflicting advice and messaging, and stigmatising experiences encountered by PWID were
undermining scale-up programs. Targeted strategies emphasising benefits and relevance of
treatment at the individual level are needed. We also identified practices of health services
demonstrating progress in engaging PWID in DAA treatment.
Conclusions: PWID peer workers and volunteers insights are vital to the development of approaches
to increase access to DAA treatment. Harm reduction and hepatitis C agencies have integrated study
findings to strengthen policy advocacy strategies and health promotion interventions to tailor to
communities of people who inject.