Harm Reduction Journal 2013;10:10. [doi: 10.1186/1477-7517-10-10]
Ashly E. Jordan (Beth Israel Medical Center), Carmen L. Masson, PhD (University of California, San Francisco, WS Node), Pedro Mateu-Gelabert, PhD (Center for Drug Use and HIV Research), Courtney McKnight, MPH (Beth Israel Medical Center), Nicole Pepper, MSSW (University of California, San Francisco, WS Node), Katie Bouche (San Francisco AIDS Foundation), Laura Guzman (Mission Neighborhood Resource Center), Evan Kletter (BAART Programs, WS Node), Randy M. Seewald, MD (Beth Israel Medical Center), Don C. Des-Jarlais, PhD (Beth Israel Medical Center), James L. Sorensen, PhD (University of California, San Francisco, WS Node), David C. Perlman, MD (Beth Israel Medical Center).
This is the Results Article for CTN-0035-Ot. Illicit drug users have a high prevalence of HCV and represent the majority of newly infected persons in the U.S. Despite the availability of effective HCV treatment, few drug users have been evaluated or treated for HCV. Racial and ethnic minorities have a higher incidence and prevalence of HCV and higher HCV-related mortality. Factors contributing to poor engagement in care are incompletely understood. In this study, National Drug Abuse Treatment Clinical Trials Network protocol CTN-0035-Ot ("Access to HIV and Hepatitis Screening and Care Among Ethnic Minority Drug Users In and Out of Drug Treatment"), fourteen mixed-gender focus groups of either African American or Latino/a drug users (N=95) discussed barriers to HCV testing and treatment. Themes were identified through content analysis of focus group discussions. Many drug users were tested for HCV in settings where they were receiving care. Outside of these settings, most were unaware of voluntary test sites. After testing HCV positive, drug users reported not receiving clear messages regarding the meaning of a positive HCV test, the impact of HCV infection, or appropriate next steps including HCV clinical evaluations. Many drug users perceived treatment as unimportant because they lacked symptoms, health care providers minimized the severity of the diagnosis, or providers did not recommend treatment. Mistrust of the motivations of health care providers was cited as a barrier to pursuing treatment. Social networks or social interactions were a source of HCV-related information and were influential in shaping drug users perceptions of treatment and its utility.
Conclusions: Drug users perceived a paucity of settings for self-initiated HCV testing and poor provider-patient communication at test sites and during medical encounters. Notably, drug users reported having an unclear understanding about the meaning of a positive HCV test, the health implications of HCV infection, the importance of clinical evaluations and monitoring, and of treatment options for HCV. Efforts to improve the delivery of clinical messages about HCV infection for drug users at test settings and clinical encounters are needed. (Article (Peer-Reviewed), PDF, English, 2013)
Keywords: African Americans | Community health services | CTN platform/ancillary study | CTN platform/ancillary study results | Hepatitis C | Hispanics and Latinos | Minority groups | Sexually transmitted diseases | Harm Reduction Journal (journal)
Document No: 1005, PMID: 23786800, PMCID: PMC3695813.
Submitted by CTN Dissemination Librarians, 6/25/2013.