Hepatitis C Virus–Related Knowledge and Willingness to Receive Treatment Among Patients on Methadone Maintenance

Abstract

Objectives Although persons who inject drugs have high prevalence of hepatitis C virus (HCV) infection, few receive treatment mostly because of lack of knowledge about the infection and its treatment. We assessed the level of HCV-related knowledge and willingness to participate in HCV treatment among methadone-maintained patients. Methods A 30-item survey covering HCV-related knowledge and willingness to engage in HCV-related education and treatment was developed and completed by 320 methadone-maintained patients. Results Respondents’ mean age was 53 ± 8.7 years, 59.5% were male, 55.1% were African American, and 38.3% were Hispanic. The mean duration of methadone maintenance was 7 ± 6.7 years. In the preceding 6 months, 6.9% of patients reported injection drug use, whereas 37.3% used noninjection drugs. Hepatitis C virus seropositivity was self-reported by 46.3% of patients. The majority of patients (78%) expressed willingness to participate in HCV-related education and to receive HCV treatment. Most patients (54.7%) correctly answered 5 or more of 7 questions assessing HCV knowledge. Hepatitis C virus–seropositive individuals and prior attendees at HCV-related educational activities demonstrated a higher level of HCV-related knowledge (P < 0.001 and P = 0.002, respectively). Younger patients (P = 0.014), those willing to attend an HCV-related educational activity (P < 0.001), and those with higher–HCV-related knowledge (P = 0.029) were more accepting of HCV treatment. Fear of medication-related side effects was the most common reason for treatment avoidance. Conclusions The majority of patients reported willingness to receive HCV-related education and treatment. Treatment willingness was significantly associated with previous attendance at an HCV educational activity and a higher level of HCV-related knowledge.

Knowledge of hepatitis C and treatment willingness amongst people who inject drugs in an era of direct acting antivirals

“…Consistent with previous studies (Norton et al, 2014; Surjadi et al, 2011; Zeremski et al, 2014), we found that a greater knowledge of HCV was associated with an increased willingness to undergo HCV therapy. These same studies have also demonstrated that educational interventions can increase participant knowledge levels as well as increase treatment willingness and subsequent follow up attendance at specialist clinics suggesting that knowledge does in fact play a role in willingness to undergo therapy.…”

“…These studies have used different questionnaires to attempt to assess HCV knowledge and have evaluated diverse populations with or without a history of HCV infection or injection drug use, respectively (Cohen-Moreno et al, 2010; Dunn et al, 2013; Stein, Maksad, & Clarke, 2001; Strauss et al, 2007; Surjadi et al, 2011; Treloar, Hull, Dore, & Grebely, 2012; Zeremski et al, 2014). Among these studies, baseline average HCV knowledge scores were reported to range from 42–71% with lower scores generally reported in studies using more rigorous assessment tools.…”

“…Conversely, factors associated with increased healthcare exposure such as opioid agonist treatment (OAT) and more frequent visits to general practitioners have been associated with increased HCV knowledge (Dunn et al, 2013; Treloar et al, 2011). An important finding for treatment programs is that willingness to undergo HCV therapy has been associated with higher baseline HCV knowledge (Surjadi et al, 2011; Zeremski et al, 2014). Understanding which factors are associated with HCV knowledge levels enables development of targeted interventions to enhance HCV knowledge with the ultimate goal of increasing treatment uptake and completion.…”

Medical and Behavioral Approaches to Engage People Who Inject Drugs Into Care for Hepatitis C Virus Infection

“…Specifically with regard to hepatitis C virus, engagement of active persons with substance use disorders into hepatitis C virus care could serve as a gateway into the health care system. Among patients on opioid replacement therapy, those who self-report hepatitis C virus seropositivity and those with higher levels of knowledge about the virus and its management have demonstrated increased willingness to undergo hepatitis C virus treatment 110. In addition, hepatitis C virus education of persons with substance use disorders results in increases in hepatitis C virus–related knowledge 111.…”

Hepatitis C Virus Testing and Treatment Among Persons Receiving Buprenorphine in an Office-Based Program for Opioid Use Disorders

“…PWID are among those least likely to receive HCV treatment with initiation rates as low as 6% (S. Mehta & Genberg, 2008), despite studies demonstrating a willingness to be treated (Zeremski et al, 2014), successful treatment outcomes (Hellard, Sacks-Davis, & Gold, 2009), and refined national guidelines recommending that HCV treatment be considered for PWID on a case-by-case basis (Ghany, Strader, Thomas, Seeff, & American Association for the Study of Liver Diseases, 2009; “Hepatitis C Guidance: AASLD-IDSA Recommendations for Testing, Managing, and Treating Adults Infected with Hepatitis C Virus.,” 2015). …”