Access to treatment for Hepatitis C among injection drug users: results from the cross-sectional HOPE IV study

Abstract

BackgroundEvidence suggests that Greece is among the European countries with increased trend in HCV prevalence among injecting drug users (IDUs) from 2008 to 2014. Nonetheless, the access of IDUs to treatment for Hepatitis C Virus (HCV) is very limited while the risk of co-infection and transmission remains high. In an effort to better understand the inhibitors to HCV treatment, the present study aimed to investigate the main barriers to access in a sample of IDUs.MethodsThe cross-sectional study was carried out between July and September 2015 using a 23-items questionnaire. Participants were recruited from urban primary services, mobile health vans, community health services, day-care centers as well as during street work, located in Athens, Greece. Inclusion criteria were age above 18 years, understanding and speaking Greek sufficiently, HCV diagnosis, intravenous drug use. Data collection was carried out by health professionals of Praksis, a non-governmental organization. For the comparisons of proportions chi-square and Fisher’s exact tests were used.ResultsThe study sample consisted of 101 HCV patients, 68% male. More than 80% of study participants experienced barriers in accessing their doctor and medication during the past 12 months. The most common obstacles in accessing a doctor were “delay in making the appointment and “difficulties in going to the doctor due to health condition or lack of means of transport”. Access to physician or medication was not differed according to gender, but significant differences were found according to economic status and health insurance coverage. 56.1% of participants reported loss or treatment delay due to barriers to treatment. The majority of participants had deteriorated financial status, health status, access to health services and medication, higher financial burden for health services, worse mental health and lower adherence to medical instructions in 2015 compared to 2009.ConclusionsThe findings from the present study revealed that the vast majority of IDUs experience significant barriers in seeking HCV care in Greece, thus highlighting the need for immediate action in this particular area due to the high risk of co-infection and transmission.

Clinical and epidemiological characteristics of hepatitis C virusinfected people who inject drugs: a Greek descriptive analysis

“…For example, in Patras, although there is a well-organized PWID substitution unit, there is no FibroScan available, so patients have to travel in order to have elastography measurements. Thus, consistently with the literature [ 23 ], our data revealed that in some settings there is significant lack of coverage of services or barriers when patients try to access services, mainly for geographical reasons.…”

WITHDRAWN: HIV patient access to healthcare services in post-austerity era in Greece

“…MethodsA cross-sectional study was carried out between February and April 2019 to assess barriers in access to HIV care faced by people living with HIV. An online, self-reporting questionnaire was developed on the basis of the HOPE I, II, III and IV(6,7,8,9) studies tool and adapted to the specific clinical and societal characteristics of HIV. The questionnaire consists of three main sections.…”

Increasing success and evolving barriers in the hepatitis C cascade of care during the direct acting antiviral era

“…[ 25 , 26 ] In the modern CoC, this concern is likely driven primarily by social factors including unstable housing, mental illness, or active alcohol and substance abuse rather than severe side effects from the medication. [ 14 , 25 , 27 ] Given the high prescription, initiation, and completion rates seen in the population in our study, concern regarding non-adherence may not be warranted in all settings. To facilitate initiation and completion of HCV treatment, providers should place an emphasis on engaging this population with social workers, case managers, and addiction counselors.…”