Reducing Barriers to Hepatitis C Treatment among Drug Users: An Integrated Hepatitis C Peer Education and Support Program

Roose, Robert J.; Cockerham-Colas, Lauren; Soloway, Irene; Batchelder, Abigail; Litwin, Alain H.

doi:10.1353/hpu.2014.0096

Cited by 46 publications

(51 citation statements)

References 16 publications

(14 reference statements)

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“…Peer-support programs have been successful in providing the social support necessary to enhance linkage to HCV care (Crawford & Bath, 2013;Grebely et al, 2007;Keats et al, 2015;Roose, Cockerham-Colas, Soloway, Batchelder, & Litwin, 2014;Treloar et al, 2015). They have also been shown to reduce patients' mistrust in the health care system, address barriers to HCV treatment through discussions with workers and peers, and improve knowledge about HCV and treatment (Crawford & Bath, 2013;Keats et al, 2015;Roose et al, 2014;Treloar et al, 2015).…”

Section: Epidemiology and Prevention Of Hcv Infection Among Pwidmentioning

confidence: 99%

“…They have also been shown to reduce patients' mistrust in the health care system, address barriers to HCV treatment through discussions with workers and peers, and improve knowledge about HCV and treatment (Crawford & Bath, 2013;Keats et al, 2015;Roose et al, 2014;Treloar et al, 2015). In a qualitative evaluation of two community-controlled peer support services in OST clinics in Australia, Treloar et al found that the peer support services were acceptable to both clients and clinic staff, met its goals of engaging clients, building trusting relationships and providing instrumental support for clients to access HCV treatment (Treloar, this issue).…”

Section: Epidemiology and Prevention Of Hcv Infection Among Pwidmentioning

confidence: 99%

See 1 more Smart Citation

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

Grebely

Bruggmann

Treloar

et al. 2015

International Journal of Drug Policy

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Section: Epidemiology and Prevention Of Hcv Infection Among Pwidmentioning

confidence: 99%

Section: Epidemiology and Prevention Of Hcv Infection Among Pwidmentioning

confidence: 99%

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

Grebely

Bruggmann

Treloar

et al. 2015

International Journal of Drug Policy

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“…While similar programs have emerged in Australia in recent years (Treloar et al, 2013), the Einstein program provides substance users in a low-income, urban, U.S. setting with accessible HCV treatment information, and has cultivated a nonjudgmental culture by fostering peer educator support and offering on-site HCV treatment options (Litwin et al, 2005, 2009; Roose et al, 2014; Stein et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

“Hepatitis C treatment turned me around:” Psychological and behavioral transformation related to hepatitis C treatment

Batchelder

Peyser

Nahvi

et al. 2015

Drug and Alcohol Dependence

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Background Hepatitis C (HCV) is a significant public health problem that primarily affects current and former substance users. However, individuals with a history of substance use are less likely to have access to or engage in HCV care. Psychological and behavioral barriers prevent many HCV-infected individuals from initiating or engaging in HCV treatment. This study aimed to investigate the psychological and behavioral experiences of current and former substance users receiving HCV treatment within a combined methadone and primary care clinic in the United States. Methods We conducted 31 semi-structured qualitative interviews with opioid-dependent adults enrolled in an integrated HCV treatment program within a methadone maintenance clinic in the Bronx, NY. We used thematic analysis, informed by grounded theory, and inquired about perceptions of HCV before and after initiating HCV treatment, reasons for initiating HCV treatment, and the decision to participate in individual versus group HCV treatment. Results Participants described psychological and behavioral transformation over the course of HCV treatment. These included reductions in internalized stigma and shame related to HCV and addiction, increases in HCV disclosure and self-care, reductions in substance use, and new desire to help others who are living with HCV. Conclusions Integrating HCV treatment with methadone maintenance has the potential to create psychological and behavioral transformations among substance using adults, including reductions in HCV- and addiction-related shame and improvements in overall self-care.

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“…The involvement of peers in HCV testing and treatment provision can: help reduce PWID fears of testing and treatment; improve PWID HCV knowledge and engagement through the care cascade; improve healthcare provider appreciation of PWID needs; and challenge structural barriers (Crawford & Bath, 2013;Norman et al, 2008;Roose et al, 2014;Harris et al, 2014). At the same time as providing a generally positive valuation, researchers often reify and package peer support such that its implementation can seem somewhat fixed and straightforward, irrespective of social and service contexts or the concerns of PWID and those who take on peer roles.…”

Section: Introductionmentioning

confidence: 99%

“…At the same time as providing a generally positive valuation, researchers often reify and package peer support such that its implementation can seem somewhat fixed and straightforward, irrespective of social and service contexts or the concerns of PWID and those who take on peer roles. In this respect, HCV peer functions tend to reduce to a toolkit comprising the cofacilitation of treatment, chaperoning patients to hospital appointments and engaging in educative activities within and outside of drug service settings (Norman et al, 2008;Crawford & Bath, 2013;Roose et al, 2014;Treloar et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Tensions in relation: How peer support is experienced and received in a hepatitis C treatment intervention

Bonnington

Harris

2017

International Journal of Drug Policy

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Tensions in relation: how peer support is experienced and received in a hepatitis C treatment intervention Abstract Background:Peer support and involvement is recognised as a vital component of hepatitis C (HCV) treatment provision for marginalised populations, such as people who inject drugs (PWID). Developments in HCV treatments enable increased provision in community settings -expanding the possibilities for meaningful peer involvement in HCV treatment plans. To date, HCV peer support has generally been viewed as a positive intervention, with little critical reflection on the ways social structures, policies, health and drug services and social identity impact on how peer support is experienced and received. Methods:We report on the qualitative component of a UK-based intervention designed to increase HCV diagnosis and treatment in primary care and drug treatment settings.Data were collected between 2014 and 2016. Pre-Intervention, a total of 35 PWID clients took part in nine in-depth interviews and four focus groups. In addition, 22 drug services and intervention providers took part in two focus groups and nine interviews. Post-intervention, one focus group and eight interviews were conducted with 13 PWID clients, and four focus groups and ten interviews were conducted with 26 drug services and intervention providers. Our data generation and thematic analysis focused on the peer education and buddy support component of the intervention. 3 Results:Participants had common expectations of the peer role (to 'just be there') and its occupants' attributes (empathy, trustworthy, etc.). However, in practice, peers faced constraints on realising these expectations. A 'recovery' dominated drug treatment ethos in the UK appeared to influence the selection of 'recovery champions' as peers for the intervention. This created tensions in relations with clients, particularly when risk-adverse discourses were internalised by the peers. Peers were poorly integrated and supported within the service, affecting opportunities to relate and build trust with clients. Thus, the scope for peer support to impact on the nature and extent of clients' testing and treatment for HCV was limited. Conclusion:The efficacy of peer involvement can be constrained by organisational structures and boundaries -especially regarding who is deemed to be 'a peer'. Peer programmes take time and care to implement and weave into wider recovery and harm reduction frameworks.

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Reducing Barriers to Hepatitis C Treatment among Drug Users: An Integrated Hepatitis C Peer Education and Support Program

Cited by 46 publications

References 16 publications

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

“Hepatitis C treatment turned me around:” Psychological and behavioral transformation related to hepatitis C treatment

Tensions in relation: How peer support is experienced and received in a hepatitis C treatment intervention

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