Understanding Attitudes and Concerns Regarding The Use of Molecular Cluster Detection as a Hepatitis C Elimination Strategy: A Qualitative Study of Persons who Inject Drugs

Author: Matthew Lambert Wajiha Akhtar Carol Galletly David Seal Sarah Dietz Rebecca Miller Emma Grellinger Ravina Sachdev Ryan Westergaard Ryan

Theme: Social Science & Policy Research Year: 2022

Global Hepatitis Outbreak and Surveillance Technology (GHOST) is a cloud-based informatics system
developed by the Centers for Disease Control and Prevention (CDC) to enable detection and
visualization of hepatitis C transmission clusters based on next generation sequencing data. Its
application could lead to targeted control efforts in low resourced communities. In preparation for
future implementation in public health settings, we investigated attitudes and barriers regarding its use
among persons who inject drugs (PWID).
We recruited participants from among PWID who recently tested positive for hepatitis C at two syringe
service program sites and conducted two rounds of sequential semi-structured interviews. In
interviews, we shared a standardized description of molecular cluster detection and its application for
hepatitis C control. Participants were provided opportunity for clarifying questions. Their
understanding, general reactions, and concerns were explored through specific follow up questions.
Interviews were transcribed and inductive analytic approaches were completed by at least two
reviewers for each transcript to identify emergent themes. Themes identified during the first round of
interviews informed specific follow up questions in the second round.
Thirteen participants were recruited, and nineteen interviews completed. Nearly all participants noted
the potential for positive impact on the control of hepatitis C through use of molecular cluster detection
and contact tracing but required several reviews of the concepts. Participants reported high levels of
trust in public institutions but expressed concerns related to privacy. Attitudes were divergent
regarding consent for the use of molecular diagnostic techniques and willingness to participate in
contact tracing.
Our findings highlight a prevailingly positive attitude towards implementation of molecular cluster
detection of hepatitis C by public health agencies, while also identifying several key barriers related to
understanding, privacy, and participant engagement. These results are similar to documented attitudes
towards molecular cluster detection in HIV transmission.
Disclosure of Interest Statement:
The listed authors have no relevant disclosures related to the work conducted in this project.

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