A gender lens is needed in hepatitis C elimination research

Larney, Sarah; Madden, Annie; Marshall, Alison D.; Martin, Natasha K.; Treloar, Carla

doi:10.1016/j.drugpo.2022.103654

Cited by 15 publications

(7 citation statements)

References 42 publications

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“…As such, “precarious housing for women” was a group experiential theme. As noted by others, many women who inject drugs have a different lived reality to most men who inject drugs (Iversen et al , 2015) and our findings support calls for greater attention to be given to gender in hepatitis C research (Larney et al , 2022). For example, gendered differences were seen in our interviews when Nicolas suggested hepatitis C treatment was “easy” while he was sleeping rough.…”

Section: Case 3: Nicolas and Innissupporting

confidence: 87%

“No, my name’s not on the lease at all”: an interpretive phenomenological analysis of unstable housing and hepatitis C among people who inject drugs

McColl,

Higgs,

Harney

2024

DHS

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Purpose Globally, hepatitis C treatment uptake is lower among people who are homeless or unstably housed compared to those who are housed. Understanding and addressing this is essential to ensure no one is left behind in hepatitis C elimination efforts. This study aims to explore peoples’ experiences of unstable housing and health care, and how these experiences influenced engagement in hepatitis C treatment. Design/methodology/approach Purposive sampling was used to recruit people with lived experience of injection drug use, hepatitis C and unstable housing in Melbourne, Australia. In-depth semistructured interviews were conducted and a case study approach with interpretative phenomenological analysis was used to identify personal experiential themes and group experiential themes. Findings Four people were interviewed. The precarious nature of housing for women who inject drugs was a group experiential theme, however, this did not appear to be a direct barrier to hepatitis C treatment. Rather, competing priorities, including caregiving, were personal experiential themes and these created barriers to treatment. Another group experiential theme was “right place, right time, right people” with these three elements required to facilitate hepatitis C treatment. Originality/value There is limited research providing in-depth insight into how personal experiences with unstable housing and health care shape engagement with hepatitis C treatment. The analyses indicate there is a need to move beyond a “one size fits-all” approach to hepatitis C care. Instead, care should be tailored to the needs of individuals and their personal circumstances and regularly facilitated. This includes giving greater attention to gender in intervention design and evaluation, and research more broadly.

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Section: Case 3: Nicolas and Innissupporting

confidence: 87%

“No, my name’s not on the lease at all”: an interpretive phenomenological analysis of unstable housing and hepatitis C among people who inject drugs

McColl,

Higgs,

Harney

2024

DHS

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“… 27 , 28 , 29 High-volume testing and treatment in custodial settings has the potential to significantly reduce HCV prevalence and incidence among people who inject drugs, but may also, perversely, reinforce gender disparities in access to HCV care unless complementary efforts targeting women who inject drugs are enacted. 11 …”

Section: Discussionmentioning

confidence: 99%

“…Failure to identify and explicitly account for these differences in HCV prevention and treatment programming may impede progress towards the goal of eliminating viral hepatitis as a public health problem by 2030. 11 , 12 We therefore aimed to estimate sex and gender differences in HCV risk, prevention, and the cascade of care in people who inject drugs.…”

Section: Introductionmentioning

confidence: 99%

Sex and gender differences in hepatitis C virus risk, prevention, and cascade of care in people who inject drugs: systematic review and meta-analysis

Levinsson,

Zolopa,

Vakili

et al. 2024

eClinicalMedicine

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“…While it is possible that transgender people were included in our studies, often as part of MSM cohorts, this finding is most likely reflective of deficiencies in the collection and reporting of gender identity in health records and research. The adoption of a gender lens to HCV care and research to explore the impacts of gender disparities on HCV elimination is required 35 . Finally, as nearly all included studies were from high‐income country settings, any consideration of HCV testing frequency recommendations should be applied to high‐income settings only due to differences in HCV risk context including local drivers of HCV transmission and availability of resources.…”

Section: Discussionmentioning

confidence: 99%

“…The adoption of a gender lens to HCV care and research to explore the impacts of gender disparities on HCV elimination is required. 35…”

Section: Hcv Reinfection Incidence By Testing Regimementioning

confidence: 99%

Determining reinfection rates by hepatitis C testing interval among key populations: A systematic review and meta‐analysis

Munari,

Traeger,

Menon

et al. 2023

Liver International

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Background & AimsDetecting hepatitis C virus (HCV) reinfection among key populations helps prevent ongoing transmission. This systematic review aims to determine the association between different testing intervals during post‐SVR follow‐up on the detection of HCV reinfection among highest risk populations.MethodsWe searched electronic databases between January 2014 and February 2023 for studies that tested individuals at risk for HCV reinfection at discrete testing intervals and reported HCV reinfection incidence among key populations. Pooled estimates of reinfection incidence were calculated by population and testing frequency using random‐effects meta‐analysis.ResultsForty‐one single‐armed observational studies (9453 individuals) were included. Thirty‐eight studies (8931 individuals) reported HCV reinfection incidence rate and were included in meta‐analyses. The overall pooled estimate of HCV reinfection incidence rate was 4.13 per 100 per person‐years (py) (95% confidence interval [CI]: 3.45–4.81). The pooled incidence estimate among people who inject drugs (PWID) was 2.84 per 100 py (95% CI: 2.19–3.50), among men who have sex with men (MSM) 7.37 per 100 py (95% CI: 5.09–9.65) and among people in custodial settings 7.23 per 100 py (95% CI: 2.13–16.59). The pooled incidence estimate for studies reporting a testing interval of ≤6 months (4.26 per 100 py; 95% CI: 2.86–5.65) was higher than studies reporting testing intervals >6 months (5.19 per 100 py; 95% CI: 3.92–6.46).ConclusionsHCV reinfection incidence was highest in studies of MSM and did not appear to change with retesting interval. Shorter testing intervals are likely to identify more reinfections, help prevent onward transmission where treatment is available and enable progress towards global HCV elimination, but additional comparative studies are required.

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A gender lens is needed in hepatitis C elimination research

Cited by 15 publications

References 42 publications

“No, my name’s not on the lease at all”: an interpretive phenomenological analysis of unstable housing and hepatitis C among people who inject drugs

“No, my name’s not on the lease at all”: an interpretive phenomenological analysis of unstable housing and hepatitis C among people who inject drugs

Sex and gender differences in hepatitis C virus risk, prevention, and cascade of care in people who inject drugs: systematic review and meta-analysis

Determining reinfection rates by hepatitis C testing interval among key populations: A systematic review and meta‐analysis

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