Human rights and access to hepatitis C treatment for people who inject drugs

Wolfe, Daniel; Luhmann, Niklas; Harris, Magdalena; Momenghalibaf, Azzi; Albers, Eliot Ross; Byrne, Jude; Swan, Tracy

doi:10.1016/j.drugpo.2015.05.007

Cited by 55 publications

(37 citation statements)

References 39 publications

(42 reference statements)

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“…This instinctive tolerance of health injustice speaks to theoretical arguments that suggest an individuals' capability to be healthy can be constrained by their physical and social environments, as well as the political, economic, cultural and legal determinants of those environments (Venkatapuram, 2011). It resonates with the lack of entitlement and therapeutic citizenship reported within HCV communities over the years (Rhodes, Harris, & Martin, 2013;Wolfe et al, 2015) and reinforces perceptions that control over the illness lies in political and economic domains, rather than in the hands of healthcare providers or the individuals themselves.…”

Section: Discussionsupporting

confidence: 59%

Hepatitis C in a new therapeutic era: Recontextualising the lived experience

Whiteley

Whittaker

Elliott

et al. 2017

Journal of Clinical Nursing

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Section: Discussionsupporting

confidence: 59%

Hepatitis C in a new therapeutic era: Recontextualising the lived experience

Whiteley

Whittaker

Elliott

et al. 2017

Journal of Clinical Nursing

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“…7-9 This increase in HCV may impact health care costs: due to the extremely high cost of new HCV treatments, several states have limited the coverage of these treatments in their Medicaid programs. 10 …”

Section: Introductionmentioning

confidence: 99%

Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015

Stopka¹,

Donahue²,

Hutcheson³

et al. 2017

Journal of the American Pharmacists Association

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Objectives To determine the prevalence of non-prescription naloxone and sterile syringe sales, factors associated with non-prescription sales, geospatial access to non-prescription naloxone and syringe selling pharmacies, and targets for potential interventions. Design Cross-sectional study. Setting and Participants Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus (HCV) cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to non-prescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease HCV transmission, respectively. We completed brief telephone surveys with 809 of 1,042 retail pharmacies across Massachusetts (response rate=77.6%) during 2015 to assess experience with non-prescription sales of naloxone and sterile syringes. Outcome Measures Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes/no) for non-prescription sales, and non-prescription syringe sales (yes/no). We conducted multivariable regression analyses and created maps using a geographic information system (GIS) to identify factors associated with non-prescription sales of naloxone and sterile syringes, and to improve our understanding geospatial access to pharmacy-based naloxone and syringe sales. Results Over 97% of pharmacies reported selling sterile syringes without requiring a prescription and 45% of pharmacies reported stocking and selling naloxone. Factors associated with non-prescription sales included: hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to non-prescription sale of sterile syringes is wide-spread, while geospatial access to naloxone is more limited. Training to better understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Conclusion Access to sterile syringes through non-prescription sales is strong across Massachusetts and, while over 350 pharmacies (45%) reported stocking and selling naloxone to prevent opioid overdose deaths, there is much room for improvement in access, and training among pharmacy staff.

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“…Numerous system-level barriers continue to prevent PWID from receiving HCV treatment, including treatment cost, criminalization of drug use, restrictive treatment protocols, and stigma and discrimination in healthcare settings (Wolfe et al, 2015). To address such obstacles, several strategies have been recommended, including clinical training, outreach support, integrated and flexible treatment services, reduced medication costs, elimination of laws and regulations limiting PWID’s treatment access and retention (Bruggmann & Grebely, 2015; Wolfe et al, 2015). …”

Section: Introductionmentioning

confidence: 99%

Implementing and scaling up HCV treatment services for people who inject drugs and other high risk groups in Ukraine: An evaluation of programmatic and treatment outcomes

Mazhnaya

Meteliuk

Barnard

et al. 2017

International Journal of Drug Policy

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Background HCV prevalence estimates among people who inject drugs (PWID) in Ukraine is high (60%-90%), yet barriers to HCV treatment and care remain substantial including limited access to direct acting antiviral (DAA) medications. A feasibility scale-up project implemented HCV treatment in community-based settings to improve access to DAA treatment for key populations in this context. Methods Using program-level data and verified medical records, we describe the development, implementation processes and outcomes for HCV treatment for PWID and other risks groups. Most participants (76%) received a combination of sofosbuvir, pegylated interferon, and ribavirin for 12 weeks. Treatment enrollment started in June 2015; the first two waves are reported. Data on demographics, HIV characteristics, HCV genotype and RNA levels, including sustained virologic response (SVR) were obtained from verified medical records. We used logistic regression to examine the independent correlates of achieving a SVR. Results The project was implemented in 19 healthcare institutions from 16 regions of Ukraine, mainly within AIDS specialty centers. Our analytical sample included 1,126 participants who were mostly men (73%) and the majority were HIV co-infected (79%). Treatment retention was 97.7% and the proportion of participants who achieved SVR for the 1,029 (91%) with complete data was 94.3% (95% CI 92.8%–95.7%). PWID who were currently injecting had comparable SVR rates (89.2%, 95% CI 81.5–94.5%) to PWID not injecting (94.4%, 95% CI 92.4–96.1), PWID on methadone (94.4%, 95%CI 92.4–96.1), and ‘other’ risk group (95.2%, 95% CI 91.3–97.7). Independent factors associated with achieving a SVR were females sex (AOR: 3.44, 95% CI 1.45–8.14), HCV genotype 3 (AOR: 4.57, 95% CI 1.97 - 10.59) compared to genotype 1. SVR rates in PWID actively injecting did not differ significantly from any other group. Conclusion Both patient-level and structural factors influence HCV treatment scale-up in Ukraine, but patient-level outcomes confirm high levels of achieving SVR in PWID, irrespective of injection and treatment status.

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Human rights and access to hepatitis C treatment for people who inject drugs

Cited by 55 publications

References 39 publications

Hepatitis C in a new therapeutic era: Recontextualising the lived experience

Hepatitis C in a new therapeutic era: Recontextualising the lived experience

Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015

Implementing and scaling up HCV treatment services for people who inject drugs and other high risk groups in Ukraine: An evaluation of programmatic and treatment outcomes

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