Theme: Epidemiology & Public Health Research Year: 2024
Background: Hepatitis C (HCV) treatments with direct-acting antiviral therapy (DAA) are an easy and effective option among people who inject drugs (PWID). However, difficulties in accessing and monitoring treatment in community services and abandonment upon release from prison are detected among PWID. The study’s aim is therefore to determine the access barriers in diagnosing and treating HCV in community health services.
Methods: An exploratory qualitative study was carried out through semi-structured interviews with PWID recruited in the largest preventive detention centre in Barcelona by 2022. With the information obtained, the data was analysed using grounded theory approach.
Results: Thirty-three participants were interviewed, six were women, one of them transgender. Average age was 38.6 years. Eighteen were Spanish and 15 foreigners, mainly from Eastern Europe. All reported active drug use, of whom 23 reported heroin and cocaine use (“speedball”) intravenously. Nineteen with opioid substitution treatment and 24 had attended harm reduction centres. Nineteen people were diagnosed with HCV upon entering prison. Of those interviewees who started DAA, six abandoned it before completion. Six finished treatments but did not attend their follow-up appointment to confirm SVR.
Participants described different barriers, which we classified into three levels: a) personal: heavy drug use, lack of interest and knowledge about HCV and social exclusion; b) health providers: receiving little information, not accessing screening and treatment and having poor interactions with health personnel; c) health system: complicated circuit, little comprehensive care and lack of community support.
Conclusion: Many barriers to HCV treatment remain, and further efforts to identify them and propose solutions will involve reducing or eliminating them. It’s recommended to intensify prevention and treatment AAD campaigns for professionals and patients, improve health education, make the diagnosis and treatment process more flexible and promote social policies and comprehensive care to better meet the needs of PWID.