Hepatitis C meanings and preventive strategies among street-involved young injection drug users in Montréal

Views and experiences of hepatitis C testing and diagnosis among people who inject drugs: Systematic review of qualitative research

“…PWID perceived themselves as never being completely safe from, or in control of HCV transmission despite their intentions and actions to reduce risk (Carrier et al, 2005;Davis, Rhodes, & Martin, 2004;Harris, 2009b;Rhodes, Davis, & Judd, 2004;Roy, Nonn, Haley, & Cox, 2007;Sutton & Treloar, 2007;Swan et al, 2010;Wozniak, Prakash, Taylor, & Wild, 2007). However, there were exceptions, with studies noting that the extent to which PWID participated in the 'normalised discourse' was influenced by their situation, social context and personal relationships (Wozniak et al, 2007;Roy et al, 2007;Harris, 2009b).…”

“…However, there were exceptions, with studies noting that the extent to which PWID participated in the 'normalised discourse' was influenced by their situation, social context and personal relationships (Wozniak et al, 2007;Roy et al, 2007;Harris, 2009b). While PWID were motivated by concerns that they may have acquired HCV through injecting and the belief that HCV was an expected consequence of injecting drug use (Khaw et al, 2007;Roy et al, 2007;Swan et al, 9 2010; Temple-Smith et al, 2004;Wozniak et al, 2007) there was also evidence that PWID perceived themselves to be at low risk of infection related to a belief in the minimisation of infection risk within their injecting network (Gyarmarthy et al, 2006). In a UK study (Perry & Chew-Graham, 2003) of GP's experiences of HCV testing, denial of possible infection among PWID was viewed as a barrier to the informed consent process and therefore testing.…”

“…392) Reactions to a positive diagnosis, primarily among people who were injecting drugs at the time of diagnosis, included being unaware of or indifferent to the meaning of a positive diagnosis, and commonly denial Copeland, 2004;Faye & Irurita, 2003;Swan et al, 2010;Temple-Smith et al, 2004). A diagnosis of HCV (Harris, 2009b;Roy et al, 2007) was not viewed as overly concerning as there was a perception of HCV as a health condition that developed over many years; as such HCV was viewed as inconsequential relative to other disruptions, for example, a drugs overdose. However, injecting behaviour was also a motivation for testing with PWID citing social or personal responsibility to others, such as those within their injecting networks (Craine et al, 2004;Khaw et al, 2007;Roy et al, 2007).…”

“…A diagnosis of HCV (Harris, 2009b;Roy et al, 2007) was not viewed as overly concerning as there was a perception of HCV as a health condition that developed over many years; as such HCV was viewed as inconsequential relative to other disruptions, for example, a drugs overdose. However, injecting behaviour was also a motivation for testing with PWID citing social or personal responsibility to others, such as those within their injecting networks (Craine et al, 2004;Khaw et al, 2007;Roy et al, 2007). For those with concerns about a positive diagnosis, anxiety over the impact of HCV on the chances of finding a long term partner, sexual relations, starting a family and the possibility of transmission predominated (Carrier et al, 2005;Harris, 2009b;Temple-Smith et al, 2004;Tompkins et al, 2005;.…”

“…PWID perceived themselves as never being completely safe from, or in control of HCV transmission despite their intentions and actions to reduce risk (Carrier et al, 2005;Davis, Rhodes, & Martin, 2004;Harris, 2009b;Rhodes, Davis, & Judd, 2004;Roy, Nonn, Haley, & Cox, 2007;Sutton & Treloar, 2007;Swan et al, 2010;Wozniak, Prakash, Taylor, & Wild, 2007). However, there were exceptions, with studies noting that the extent to which PWID participated in the 'normalised discourse' was influenced by their situation, social context and personal relationships (Wozniak et al, 2007;Roy et al, 2007;Harris, 2009b). While PWID were motivated by concerns that they may have acquired HCV through injecting and the belief that HCV was an expected consequence of injecting drug use (Khaw et al, 2007;Roy et al, 2007;Swan et al, 9 2010; Temple-Smith et al, 2004;Wozniak et al, 2007) there was also evidence that PWID perceived themselves to be at low risk of infection related to a belief in the minimisation of infection risk within their injecting network (Gyarmarthy et al, 2006).…”