Practical solutions to resolve social barriers to hepatitis C treatment initiation among people who inject drugs: a qualitative study.

IF 4 2区社会学 Q1 SUBSTANCE ABUSE Harm Reduction Journal Pub Date : 2024-12-20 DOI:10.1186/s12954-024-01136-1

Phyo Aung, Margaret Hellard, Paul Dietze, Bek Petrovic, Peter Higgs, Mark Stoové

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Abstract

Background: We aimed to identify motivators for people who inject drugs to pursue treatment for hepatitis C virus (HCV) infection and uncover opportunities that could make treatment more appealing.

Methods: Between November 2023 and January 2024, we conducted semi-structured interviews with 15 HCV RNA-positive individuals with a history of injecting drug use and self-reported as either untreated or treated but delayed treatment for more than 6 months. Thematic and framework data analysis was employed and interpreted using the Capability, Opportunity and Motivation (COM-B) framework of behaviour change.

Results: The findings suggest that a combination of stability through secure housing, mental readiness and overcoming drug dependence supported by OAT (Capability), accessible and convenient healthcare like mobile outreach services coupled with financial incentives (Opportunity), and supportive relationships (Motivation) could serve to help people who inject drugs take up HCV treatment.

Conclusion: Alcohol and other drug and primary care services for people who use drugs should adopt person-centred approaches and recognise the gradual nature of behavioural change to foster empathy and supportive relationships to promote engagement in HCV care. Additionally, integrating HCV treatment with mobile outreach services and providing practical assistance, such as housing and financial incentives, are critical to ensuring that individuals remain engaged in HCV care.

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解决注射吸毒者开始丙型肝炎治疗的社会障碍的实际解决办法：一项定性研究。

背景：我们旨在确定注射吸毒者寻求丙型肝炎病毒（HCV）感染治疗的动机，并发现可能使治疗更具吸引力的机会。方法：在2023年11月至2024年1月期间，我们对15名HCV rna阳性个体进行了半结构化访谈，这些个体有注射吸毒史，自我报告未治疗或治疗但延迟治疗超过6个月。使用行为改变的能力、机会和动机（COM-B）框架对主题和框架数据进行分析和解释。结果：研究结果表明，通过安全住房的稳定性、由OAT（能力）支持的精神准备和克服药物依赖、可获得和方便的医疗保健（如移动外诊服务）加上经济激励（机会）和支持关系（动机）可以帮助注射吸毒者接受HCV治疗。结论：针对吸毒者的酒精和其他药物和初级保健服务应采用以人为本的方法，并认识到行为改变的渐进性质，以促进移情和支持关系，以促进参与丙型肝炎病毒治疗。此外，将丙型肝炎病毒治疗与流动外展服务结合起来，并提供住房和财政奖励等实际援助，对于确保个人继续参与丙型肝炎病毒治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.90

自引率

9.10%

发文量

126

审稿时长

26 weeks

期刊介绍： Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.