Drug use-related stigma, safer injection norms, and hepatitis C infection among a network-based sample of young people who inject drugs

Williams, Leslie D.; Mackesy‐Amiti, Mary Ellen; Latkin, Carl A.; Boodram, Basmattee

doi:10.1016/j.drugalcdep.2021.108626

Cited by 18 publications

(9 citation statements)

References 43 publications

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“…[58,59] Healthcare stigma surrounding IVDU may restrict healthcare access for these individuals. [58,59] Thus, a population of IV drug users may have medication adherence patterns that differ from those receiving regular healthcare.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported healthcare stigmatization as a significant risk factor for HCV infection in IV drug users. [58,59] Healthcare stigma surrounding IVDU may restrict healthcare access for these individuals. [58,59] Thus, a population of IV drug users may have medication adherence patterns that differ from those receiving regular healthcare.…”

Section: Discussionmentioning

confidence: 99%

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Factors impacting medication adherence in a birth cohort at higher risk for Hepatitis C infection

et al. 2022

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Due to the high prevalence of Hepatitis C virus (HCV) infection among individuals born between 1945 and 1965, in 2012 the Centers for Disease Control and Prevention began recommending HCV screening for this birth cohort. As adherence to HCV treatment is essential for sustained virologic response, identifying factors influencing medication adherence is important. The validated Adherence to Refills and Medications Scale (ARMS) is used to study recent medication adherence in those with chronic disease. This cross-sectional pilot study assesses factors associated with reduced adherence, indicated by higher ARMS scores, among individuals in this birth cohort. To elucidate factors associated with medication adherence, measured by the ARMS score, among a birth cohort at higher risk for HCV to guide future treatment and improve adherence. Patients born between 1945 and 1965, accessing care at an academic family medicine clinic, were recruited between April and June 2019. Demographics, prior HCV diagnosis, HCV risk factors (prior imprisonment, tattoos, and intravenous drug use), depression assessment (Patient Health Questionnaire-9), adverse childhood experiences (ACEs), and ARMS scores were collected. Mean ARMS scores were compared using t tests and analysis of variance (α = 0.05), while multiple variable models were performed using linear regression. Women comprised 58% of participants (n = 76), 52% reported depression and 37% 4 or more ACEs. The mean ARMS score was 16.3 (SD = 3.43) and 10% reported prior diagnosis of HCV. In the final multiple variable model, ARMS scores were 2.3 points higher in those with mild depression (95% CI: 0.63, 4.04), 2.0 in those with at least 4 ACEs (95% CI: 0.55, 3.49), and 1.8 in those with tattoos (95% CI: 0.30, 3.28). ACEs and food insecurity were identified as confounding variables in those with moderate to severe depression. This study found medication adherence was related to depression, ACEs, tattoos, and food insecurity among patients in this birth cohort at higher risk for HCV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors impacting medication adherence in a birth cohort at higher risk for Hepatitis C infection

et al. 2022

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“…Common network metrics to understand the structure include density, degree, and centrality [ 19 , 20 , 21 ]. There is also extensive literature on statistical modeling approaches in networks to quantify associational parameters that model the network structure itself or features of the study participants [ 22 , 23 , 24 , 25 ]. We can compare HIV risk networks with other types of networks including social, sexual, and drug use networks to better understand the role of these types of networks in relation to HIV transmission risk [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Methods for Assessing Spillover in Network-Based Studies of HIV/AIDS Prevention among People Who Use Drugs

et al. 2023

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Human Immunodeficiency Virus (HIV) interventions among people who use drugs (PWUD) often have spillover, also known as interference or dissemination, which occurs when one participant’s exposure affects another participant’s outcome. PWUD are often members of networks defined by social, sexual, and drug-use partnerships and their receipt of interventions can affect other members in their network. For example, HIV interventions with possible spillover include educational training about HIV risk reduction, pre-exposure prophylaxis, or treatment as prevention. In turn, intervention effects frequently depend on the network structure, and intervention coverage levels and spillover can occur even if not measured in a study, possibly resulting in an underestimation of intervention effects. Recent methodological approaches were developed to assess spillover in the context of network-based studies. This tutorial provides an overview of different study designs for network-based studies and related methodological approaches for assessing spillover in each design. We also provide an overview of other important methodological issues in network studies, including causal influence in networks and missing data. Finally, we highlight applications of different designs and methods from studies of PWUD and conclude with an illustrative example from the Transmission Reduction Intervention Project (TRIP) in Athens, Greece.

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“…This is in part because the initial phases of HCV infection are often asymptomatic ( 3 , 4 ). Other reasons are the significant barriers PWID can face when accessing HCV testing and care services ( 11 , 12 ). The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) recently published a checklist specifying the potential barriers to HCV testing at the system, provider, and client levels ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

“…The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) recently published a checklist specifying the potential barriers to HCV testing at the system, provider, and client levels ( 13 ). Some of the most common problems identified in the European context are the lack of knowledge and awareness of HCV infection among healthcare providers and clients, social marginalization and stigmatization of PWID, and inadequate regulations of HCV testing and care in community settings ( 11 , 12 , 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C antibody prevalence and behavioral correlates in people who inject drugs attending harm reduction services in Lisbon, Portugal

Curado

Nogueira

Virgolino

et al. 2022

Front. Public Health

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The hepatitis C virus (HCV) infection is an important public health problem, affecting millions of people worldwide. People who inject drugs (PWID) are at increased risk of HCV infection due to, among other factors, widespread unsafe injecting practices, such as sharing of infected equipment or unprotected sexual practices. In Portugal, there is a lack of data regarding the proportion of infected persons through injecting drug use. This study aimed to evaluate the anti-HCV prevalence and behavioral correlates of infection in PWID attending harm reduction services in the Metropolitan Area of Lisbon, Portugal. A cross-sectional study with a purposive sample of PWID was undertaken between March 2018 and March 2020. Participants were recruited through the harm-reduction services of a nongovernmental organization. A rapid diagnostic test for anti-HCV screening was performed. Data on drug consumption history and current practices, past HCV testing, care and treatment history, and knowledge regarding hepatitis C were also collected through a questionnaire applied by trained inquirers. A total of 176 PWID participated in this study. An overall prevalence of 70.5% of anti-HCV positive in this population was found. Those with an anti-HCV positive testing result tended to start consuming at a younger age and have a higher consumption of benzodiazepines in the last 30 days. Sharing needles and other injecting material is a frequent risk behavior among this group. Also, they are more likely to have attended an opioid agonist treatment and to have undertaken previous hepatitis C and HIV tests in the past. This study represents an important effort to better understand the HCV prevalence and behavioral correlates of infection among PWID in Portugal, as well as to better estimate those in need of HCV treatment.

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Drug use-related stigma, safer injection norms, and hepatitis C infection among a network-based sample of young people who inject drugs

Cited by 18 publications

References 43 publications

Factors impacting medication adherence in a birth cohort at higher risk for Hepatitis C infection

Factors impacting medication adherence in a birth cohort at higher risk for Hepatitis C infection

Methods for Assessing Spillover in Network-Based Studies of HIV/AIDS Prevention among People Who Use Drugs

Hepatitis C antibody prevalence and behavioral correlates in people who inject drugs attending harm reduction services in Lisbon, Portugal

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