Barriers of Linkage to Hepatitis C Care and Treatment Among People Who Inject Drugs in Georgia

Abstract

Background: People who inject drugs (PWID) in Georgia have a high prevalence of hepatitis C virus antibody (anti-HCV). Access to care among PWID could be prioritized to meet the country’s hepatitis C elimination goals. This study assesses barriers of linkage to hepatitis C care among PWID in Georgia.Methods: Study participants were enrolled from 13 harm reduction centers throughout Georgia. Anti-HCV positive PWID who were tested for viremia (linked to care [LC]), were compared to those not tested for viremia within 90 days of screening anti-HCV positive (not linked to care [NLC]). Participants were interviewed about potential barriers to seeking care.Results: A total of 500 PWID were enrolled, 245 LC and 255 NLC. LC and NLC were similar with respect to gender, age, employment status, education, knowledge of anti-HCV status, and confidence/trust in the elimination program (p>0.05). More NLC (13.0%) than LC (7.4%) stated they were not sufficiently informed what to do after screening anti-HCV positive (p<0.05). In multivariate analysis, linkage to care was associated with perceived affordability of the elimination program (adjusted prevalence ratio=8.53; 95% confidence interval: 4.14-17.62). Conclusions: Post testing counselling and making hepatitis C services affordable could help increase linkage to care among PWID in Georgia.