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APHA Scientific Session and Event Listing

Corrine E. Munoz-Plaza, MPH¹, Shiela M. Strauss, PhD¹, Janetta Astone-Twerell, PhD¹, Don Des Jarlais, PhD², Marya Gwadz, PhD, Holly Hagan, PhD⁴, Andrew Osborne, MS⁵, and Andrew Rosenblum, PhD¹. (1) Institute for Treatment Services Research, National Development & Research Institutes, 71 West 23rd Street, 8th Floor, New York, NY 10010, 212.845.4537, munoz-plaza@ndri.org, (2) Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003, (3) Center for Drug Use & HIV Research, National Development & Research Institutes, 71 West 23rd Street, 8th Floor, New York, NY 10010, (4) Training Institute, National Development & Research Institutes, 71 West 23rd Street, 8th Floor, New York, NY 10010

Research indicates that the majority of newly acquired infections with hepatitis C virus (HCV) occur among intravenous drug users (IDUs). While the current standard for HCV pharmacological therapy is effective in drug users, infected individuals with substance abuse issues are likely to face a unique set of challenges in addressing their disease. These challenges include fear, HCV-related stigma and lack of access to medical services and resources. Recommendations for this population suggest that they should be considered for treatment on a case-by-case basis and that their treatment decisions should be respected. Therefore, we examine drug users' experiences concerning their decision-making processes related to beginning HCV therapy in order to contextualize their perceptions of the barriers they face in pursuing a course of treatment. From 2003-2005, we conducted 11 focus groups with clients at drug treatment programs (methadone maintenance and drug free programs) as part of the STOP HEP C project. Our findings indicate that HCV-positive drug users want information that can help them make treatment decisions, but often feel that providers present confusing, conflicting and insufficient guidance around these issues. Furthermore, many participants reported past encounters with insensitive and discriminatory medical practitioners. Often, these encounters served as roadblocks to accessing HCV therapy; at other times, individuals described feeling left out of the decision-making process altogether. Finally, participants described a negative “rumor mill” among drug users about the difficult side effects of the treatment, which they said raises anxiety levels and introduces intense feelings of fear into their treatment decision-making processes.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Discuss 3 barriers related to providers’ words and actions that HCV-positive drug users may face when trying to make decisions about initiating treatment for their infection.
• Discuss 3 barriers identified by peers that HCV-positive drug users may face when trying to make decisions about initiating treatment for their infection. 3.Identify at least one strategy HCV-positive drug users can use to overcome these barriers.

Keywords: Hepatitis C, Medical Care

Presenting author's disclosure statement:

Not Answered