#VP119: Scaling Up Hepatitis C Treatment Within The Prison Setting: The Role Of Social Capital

Author: Lise Lafferty Jake Rance Gregory Dore Andrew Lloyd

Theme: Social Science and Policy Research Year: 2021

Background: Hepatitis C (HCV) prevalence is substantially higher in the prison setting than the general population. Direct acting antivirals (DAAs) have dramatically changed the HCV treatment landscape, allowing for treatment scale-up efforts sufficient to potentially achieve prevention of onward transmission (known as treatment as prevention; TasP). The Surveillance and Treatment of Prisoners with hepatitis C (SToPC) study enrolled over 3600 prisoners across four Australian correctional centres and was the first trial to examine and demonstrate the efficacy of HCV TasP using DAAs in the prison setting. Social capital, referring to the networks of relationships among people, is a social resource which has been found to influence health outcomes. This qualitative study sought to understand the role of social capital within a HCV TasP trial in the prison setting. Methods: A total of n=23 men in prison participated in semi-structured interviews, including (n=20 from maximum security prisons and n=3 from a minimum security prison). Interview participants were recruited from the SToP-C study following HCV treatment completion. Results: Social capital was found to enhance HCV care engagement and treatment uptake within a HCV TasP trial in the prison setting. Bonding social capital encouraged treatment uptake and adherence, while also alleviating concerns of treatment side-effects; bridging social capital supported prison-wide treatment uptake; and linking social capital improved health care engagement via dedicated HCV nurses and correctional officers. Conclusion: Social capital was found to be integral to the success of HCV treatment scale up amid TasP efforts. Social capital fostered treatment uptake and adherence among peers, while providing linkages to care through dedicated nurses and officers in an environment not typically amenable to trusting relationships. It is likely that peer support roles, such as HCV champions within prison wings, would further enhance HCV scale up efforts. Disclosure of Interest Statement: LL and JR have nothing to declare. GJD is an advisory board member and receives honorarium from Gilead, Merck, and Abbvie, has received research grant funding from Gilead, Merck, and Abbvie, and travel sponsorship from Gilead, Merck, and Abbvie. ARL has received investigator initiated research support from Gilead and Abbvie. CT has received speaker fees from AbbVie and Gilead Sciences.

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