Factors That Influence an HIV Coinfected Patient's Decision to Start Hepatitis C Treatment

Osilla, Karen Chan; Ryan, Gery W.; Bhatti, Laveeza; Goetz, Matthew Bidwell; Witt, Mallory D.; Wagner, Glenn

doi:10.1089/apc.2009.0153

Cited by 21 publications

(19 citation statements)

References 33 publications

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“…Other studies have shown that many HCV co-infected patients have one or more psychiatric disorders, as did most patients in this study (61 %) [6,18,20]. Multiple regression analysis showed psychiatric co-morbidity to be an independent predictor of missing primary care appointments but not total appointments.…”

Section: Discussionsupporting

confidence: 61%

Health Beliefs and Co-morbidities Associated with Appointment-Keeping Behavior Among HCV and HIV/HCV Patients

et al. 2015

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Appointment-keeping behavior is an important requisite for HCV linkage and treatment initiation. In this study we examine what impact hepatitis C (HCV) knowledge and attitudes has on appointment-keeping behavior among a cohort of HCV and HCV/HIV patients. Knowledge scores and attitude scales, obtained from a cross-sectional survey, were correlated with proportion of appointments kept 1 year prior to taking the survey. Independent risk factors for missing appointments were examined by multiple regression analysis. 292 HCV patients completed the survey, and 149 (51%) were co-infected with HIV. HCV patients kept 67.5 ± 17.4% of their total appointments and a similar proportion (67 ± 38.2) of Liver Clinic appointments, but they attended a higher proportion (73 ± 24.4) of Primary Care Clinic appointments. However, certain health beliefs, psychiatric illness, and HIV co-infection were independently associated with lower levels of appointment-keeping behavior. HCV knowledge was not associated with appointment-keeping behavior. Health beliefs, psychiatric illness, and HIV co-infection are associated with missing appointments, but no link between knowledge and appointment keeping behavior is apparent. In order to increase engagement into HCV care, HCV care coordination programs need to focus on addressing health beliefs and providing resources to those at highest risk for missing appointments.

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Section: Discussionsupporting

confidence: 61%

Health Beliefs and Co-morbidities Associated with Appointment-Keeping Behavior Among HCV and HIV/HCV Patients

et al. 2015

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“…Bonding social capital has been shown to provide a protective effect for health through the social supports (associated with bonding social capital) available to a person. In the context of HCV treatment uptake, the availability of social support was pertinent among patients considering treatment in a study of (n=35) HIV and HCV co‐infected patients exploring factors influencing HCV treatment decisions . Those with greater social supports (an indicator for bonding social capital) were more likely to complete treatment .…”

Section: Discussionmentioning

confidence: 99%

“…In the context of HCV treatment uptake, the availability of social support was pertinent among patients considering treatment in a study of (n=35) HIV and HCV co‐infected patients exploring factors influencing HCV treatment decisions . Those with greater social supports (an indicator for bonding social capital) were more likely to complete treatment . Peer‐based support programmes in the prison setting have been shown to also foster greater opportunities for linking social capital between inmates and correctional personnel, as evidenced in a programme aimed at reducing HIV risk among drug‐using incarcerated women at a New York State Penitentiary …”

Section: Discussionmentioning

confidence: 99%

Social capital strategies to enhance hepatitis C treatment awareness and uptake among men in prison

Lafferty¹,

Treloar

Guthrie

et al. 2016

Journal of Viral Hepatitis

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Prisoner populations are characterized by high rates of hepatitis C (HCV), up to thirty times that of the general population in Australia. Within Australian prisons, less than 1% of eligible inmates access treatment. Public health strategies informed by social capital could be important in addressing this inequality in access to HCV treatment. Twenty-eight male inmates participated in qualitative interviews across three correctional centres in New South Wales, Australia. All participants had recently tested as HCV RNA positive or were receiving HCV treatment. Analysis was conducted with participants including men with experiences of HCV treatment (n=10) (including those currently accessing treatment and those with a history of treatment) and those who were treatment naïve (n=18). Social capital was a resourceful commodity for inmates considering and undergoing treatment while in custody. Inmates were a valuable resource for information regarding HCV treatment, including personal accounts and reassurance (bonding social capital), while nurses a resource for the provision of information and care (linking social capital). Although linking social capital between inmates and nurses appeared influential in HCV treatment access, there remained opportunities for increasing linking social capital within the prison setting (such as nurse-led engagement within the prisons). Bonding and linking social capital can be valuable resources in promoting HCV treatment awareness, uptake and adherence. Peer-based programmes are likely to be influential in promoting HCV outcomes in the prison setting. Engagement in prisons, outside of the clinics, would enhance opportunities for linking social capital to influence HCV treatment outcomes.

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“…This finding highlights the importance of the patient and provider relationship. 21,23 These providers may project attitudes about HCV treatment that lead patients to feel more confident and hopeful about their ability to tolerate and benefit from HCV treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Providers that recommend treatment with more urgency, and are perceived as trustworthy, nonjudgmental, and accepting are associated with patient decisions to start treatment. [18][19][20][21][22] Once the provider offers treatment, the patient ultimately makes the decision to initiate or defer treatment, and 15%-30% of coinfected patients decide to decline treatment. [12][13][14] Clearly, many patients perceive the risks of treatment to outweigh its benefits, 19 although few studies have examined specifically how coinfected patients make HCV treatment decisions.…”

Section: Introductionmentioning

confidence: 99%

Patient and Provider Characteristics Associated with the Decision of HIV Coinfected Patients to Start Hepatitis C Treatment

Osilla

Wagner²,

Garnett³

et al. 2011

AIDS Patient Care and STDs

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Hepatitis C (HCV) and HIV coinfection is common and liver disease is a leading cause of morbidity and mortality among coinfected patients. Despite advances in HCV treatment, few HIV coinfected patients actually initiate treatment. We examined patient and provider characteristics associated with a patient's decision to accept or refuse HCV treatment once offered. We conducted patient chart abstraction and surveys with 127 HIV coinfected patients who were offered HCV treatment by their provider and surveys of their HCV care providers at three HIV clinics. Participants were mostly male (87%), minority (66%), and had a history of injection drug use (60%). Most had been diagnosed with HIV for several years (X=13.7 years) and reported HIV transmission through unprotected sex (47%). Of the 127 patients, 79 accepted treatment. In multivariate analysis, patients who had a CD4 greater than 200 cells/mm(3) and a provider with more confidence about HCV treatment were more likely to accept the recommendation to start treatment; younger age was marginally associated with treatment acceptance. In bivariate analysis, added correlates of treatment acceptance included male gender, no recent drug use, and several provider attitudes regarding treatment and philosophy about determination of patient treatment readiness. Patient and provider characteristics are important when understanding a patient's decision to start or defer HCV treatment. Further research is needed to better understand barriers to treatment uptake as new and more effective HCV treatments will soon be available.

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Factors That Influence an HIV Coinfected Patient's Decision to Start Hepatitis C Treatment

Cited by 21 publications

References 33 publications

Health Beliefs and Co-morbidities Associated with Appointment-Keeping Behavior Among HCV and HIV/HCV Patients

Health Beliefs and Co-morbidities Associated with Appointment-Keeping Behavior Among HCV and HIV/HCV Patients

Social capital strategies to enhance hepatitis C treatment awareness and uptake among men in prison

Patient and Provider Characteristics Associated with the Decision of HIV Coinfected Patients to Start Hepatitis C Treatment

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