Barriers and Enablers to Testing for Hepatitis C Infection in People Who Inject Drugs – A Scoping Review of the Qualitative Evidence

Abstract

Background Injection drug use is the primary mode of transmission of hepatitis C virus (HCV) infection in the developed world and guidelines recommend screening individuals with current or history of injection drug use for HCV; however, the majority of those living with HCV in Canada are not aware of their positive status. This low level of HCV status awareness suggests that screening is not effective with current testing strategies. The aim of this review is to determine what barriers and enablers people who inject drugs (PWID) experience surrounding testing for HCV to help inform the development of an appealing testing strategy. Methods Comprehensive literature searches were conducted using Medline, Embase and CINAHL. Included studies investigated the barriers and enablers to testing for HCV in PWID and the experiences of PWID in testing for HCV. Studies were included if they involved people with current injection drug use or those with a history of injecting drugs, were written in the English language and set in the community. Studies were compared and common themes were coded and analyzed Results Nine studies were included most studies focused on barriers instead of enablers. Common barriers included self-perception of low risk for HCV, fear of diagnosis, stigma associated with IV drug use and HCV, antipathy in relation to mainstream health care services, limited knowledge about HCV, lack of rapport with provider, lack of motivation or competing priority of drug use, and limited awareness of new treatment options. Common enablers to testing included increasing awareness of HCV testing and treatment and providing positive narratives around HCV care, positive rapport with provider, accessible testing options and personalized care. Conclusion This scoping review determined that there has been some research in this area over the past decade though it has not been focused to specifically address this research question. Nevertheless, some common barriers and enablers to testing for HCV were observed across the available research.

Advances in Otorhinolaryngological Community Services: The HearWHO App in Southern Nigeria

“…Similar findings were reported by Cathy et al (2023) on people who injects drugs on themselves but refused screening Hepatitis C infection. 20 The predominance of the young adults in the study is not surprising as use of technologically driven screening is embraced by the younger generations compared to the elderly. However, agreeing with Pratten et al, (2005), no one should be left behind, whether young or old, in the knowledge and use of digital aids.…”