Experience of hepatitis C testing among injecting drug users in Sydney, Australia

Abstract

Testing injecting drug users (IDUs) for HIV and hepatitis C virus (HCV) provides a useful opportunity for health promotion, risk-reduction assessment and counselling, and increases opportunities for treatment assessment, yet little is known about IDUs' experience of testing. This study aimed to examine the experiences of testing among IDUs recruited through primary healthcare and drug treatment services. Almost all the 229 participants recruited had been previously tested for HIV (96%) and HCV (97%), a median of five and four times respectively. Reasons for seeking testing were similar for both HIV and HCV, the most common being to protect others (72 and 74%, respectively), blood/needle exposure (66 and 70%, respectively) and to receive early treatment (66%, both). The most common locations for testing were general medical practices (GPs) (53%), specialised clinics (45%) and methadone clinics (43%). Preferred locations were similar for HIV and HCV testing: methadone clinics (47 and 48%, respectively), GPs (42%, both), specialised clinics (32%, both). The most common reasons for delaying testing were being anxious about waiting for results (66%), scared or afraid of finding out results (65%) and having trouble keeping appointments (64%). The majority of participants (HIV 62%; HCV 59%) reported that they would prefer pre-test counselling to be delivered in person rather than receiving written information and would prefer test results to be delivered face-to-face (HIV 83%; HCV 80%). High prevalence of testing suggests good uptake and high acceptability among this population in Australia. Specialised services for drug users such as methadone clinics and primary healthcare are suitable locations to provide access to testing.

HIV and hepatitis C virus test uptake at methadone clinics in Southern China: opportunities for expanding detection of bloodborne infections

“…Free HCV testing at methadone clinics eliminates a potential barrier to screening associated with clinic-based testing. One study showed IDUs preferred methadone clinics more than general medicine clinics or specialized clinics as locations for HIV and HCV testing [23]. Our research suggests that routine HIV/HCV screening at methadone clinics can provide a successful model for scaling up HIV/HCV prevention and control programs.…”

Associations between prescription opioid injection and Hepatitis C virus among young injection drug users

“…First, since the study did not conduct HCV serologic testing, all data on HCV are self-report, including history of testing and HCV status. Self-report data for HCV status may be subject to social desirability and recall biases, but studies on HCV self-report data among IDUs indicate that large proportions know their true HCV serologic status – particularly IDUs who self-report being HCV positive (Day et al, 2008; Hagan et al, 2006; O’Keefe, Aitken, Higgs, & Dietz, 2013). In the present study, IDUs who did not know their status or had never been tested were excluded from the analysis.…”

Recommendations on hepatitis C screening for adults

“…Concerns related to stigma and to access to care were reported as important factors for decision-making. [67][68][69][70][71][72][73][74] A survey of 15 patients commissioned by the task force generally reinforced these findings and found that participants placed equal value on the benefits and harms of screening. 20 Reduced mortality was perceived as a very important benefit, and concerns were noted about stigma and psychological adverse events from positive results of screening tests.…”

“…The screening review 16 found moderate-to low-quality evidence from 12 observational studies, [67][68][69][70][71][72][73][74] which reported on patient preferences and values related to the decision to be screened for HCV. Findings were highly variable in terms of patient preferences related to screening and there was a high level of uncertainty about the value that patients place on the clinical outcomes considered in the review.…”