Background:
The Finnish government has launched a national Hepatitis C (HCV) elimination programme for 2025–2027. This study supports the programme by evaluating the effectiveness of local implementation and identifying barriers and facilitators related to testing, diagnosis, and treatment. There is limited research in Finland on the experiences of people who inject drugs (PWID) in testing and treatment services and on the obstacles they face in accessing these services.
Approach:
The most effective model for HCV care integrates testing and treatment within the same low-threshold settings already serving PWID. This qualitative study focuses on both clients and professionals in these services, exploring structural and policy-level factors as well as clinical and practical aspects – underpinned by a theoretical emphasis on community-based participatory research (CBPR). CBPR stresses that effective work with marginalized, stigmatized groups requires shared decision-making, local knowledge, and adaptive practices tailored to community needs. The study draws on the Health Equity Implementation Framework, which highlights the importance of addressing determinants across multiple levels – from outer policy contexts to inner clinic interactions—to promote equitable care delivery.
Analysis:
Preliminary findings suggest several structural barriers, including fragmented service pathways, limited availability of point-of-care testing devices, and regional disparities. Staff resourcing is a major challenge, as professionals face competing demands within their roles. On the practice level, stigma and inflexible procedures hinder access, whereas trust-based relationships, integration of testing into routine contacts, and peer-supported outreach facilitate engagement. Locally adapted models are essential to addressing diverse needs and contexts; effective responses appear to be built on an understanding of local realities and engagement with affected communities.
Conclusion:
The study provides new evidence on the multi-level determinants of HCV care access among PWID. Insights gained can support improvements in service integration, staff capacity, and testing infrastructure. Conference attendees will gain actionable knowledge relevant for advancing HCV elimination in Finland and beyond, particularly through strategies that support context-sensitive, inclusive, and equitable implementation. |