Despite access to hepatitis C treatment, many people who inject drugs still perceive numerous barriers to starting treatment, including the attitudes of healthcare workers, the difficulty of juggling treatment with competing demands, a lack of support to navigate the healthcare system and problems with blood tests due to damaged veins, an Australian study published in PLOS One reports.
Australia has one of the most extensive hepatitis C treatment programmes in the world. It also has a hepatitis C virus (HCV) epidemic that is highly concentrated in current and former injecting drug users. Recent reports on treatment uptake suggest that after an early rush to access treatment, the number of people starting treatment has plateaued, suggesting that barriers to treatment may exist for people who inject drugs.
A qualitative study designed by the University of New South Wales’s Centre for Social Research in Health set out to identify barriers other than non-availability of treatment to the uptake of direct-acting antivirals (DAAs) by people who inject drugs in the Australian state of Victoria. To achieve elimination of HCV in Australia and other countries where the majority of people living with HCV are current or former injecting drug users, what psychosocial and structural issues need to be addressed?
The study is based on interviews conducted by a peer researcher with experience of injecting drug use and hepatitis C with 24 people who had injected drugs in the past six months. Participants were recruited through community networks by Harm Reduction Victoria at four sites in Melbourne. The study recruited a cross-section of people who declined treatment or deferred treatment, people contemplating starting, people currently on DAA treatment and those who had completed a course of DAA treatment. Interviews took place in 2016 and 2017 and were analysed for themes relating to barriers to treatment.