Background:
In Malaysia, interventions to engage people who use drugs (PWUD) to comprehensive HIV services including harm reduction and Hepatitis C (HCV) care are supported by outreach model of care within the community. However, less is known about the role of this model of care. This study aimed to assess the number of people initiating treatment following the implementation of a patient navigation model and to estimate social and behavioural factors associated with access to health services.
Methods:
Between November 2022 and January 2024, we implemented a longitudinal, single-arm cohort study that linked PWUD to testing and treatment services through community-based, patient navigators. Each participant was followed up four times over a period of six months. In this analysis, data was restricted to a sample of individuals who tested positive for HCV antibodies. We performed multivariable generalized mixed-effects analyses to estimate factors associated with HCV treatment uptake.
Results:
The study enrolled 136 participants, of which, 66 (49%) tested positive for HCV antibodies. Among these individuals, treatment uptake increased from 21 (32%) at baseline to 34 (52%) individuals by the end of the study. In a multivariable model, the uptake of HCV treatment was associated with having at least a high school education (adjusted odds ratio [AOR] = 2.45, 95% confidence interval [CI]: 1.31–4.65), testing positive for HIV (AOR = 3.81, 95% CI: 1.78–8.46), current use of amphetamine-type stimulants (AOR = 0.43, 95% CI: 0.22–0.81), monthly household income per RM100 increment (AOR = 1.02, 95% CI: 1.00–1.03), and current enrollment in methadone treatment (AOR = 3.13, 95% CI: 1.70–5.90).
Conclusion:
HCV treatment uptake increased but remains low, particularly among participants who were not engaged in HIV or methadone care. Although community‐based navigation was delivered, innovative strategies are further needed to minimize delays in HCV treatment. |