“Hepatitis C treatment turned me around:” Psychological and behavioral transformation related to hepatitis C treatment

Abstract

Background Hepatitis C (HCV) is a significant public health problem that primarily affects current and former substance users. However, individuals with a history of substance use are less likely to have access to or engage in HCV care. Psychological and behavioral barriers prevent many HCV-infected individuals from initiating or engaging in HCV treatment. This study aimed to investigate the psychological and behavioral experiences of current and former substance users receiving HCV treatment within a combined methadone and primary care clinic in the United States. Methods We conducted 31 semi-structured qualitative interviews with opioid-dependent adults enrolled in an integrated HCV treatment program within a methadone maintenance clinic in the Bronx, NY. We used thematic analysis, informed by grounded theory, and inquired about perceptions of HCV before and after initiating HCV treatment, reasons for initiating HCV treatment, and the decision to participate in individual versus group HCV treatment. Results Participants described psychological and behavioral transformation over the course of HCV treatment. These included reductions in internalized stigma and shame related to HCV and addiction, increases in HCV disclosure and self-care, reductions in substance use, and new desire to help others who are living with HCV. Conclusions Integrating HCV treatment with methadone maintenance has the potential to create psychological and behavioral transformations among substance using adults, including reductions in HCV- and addiction-related shame and improvements in overall self-care.

Tensions in relation: How peer support is experienced and received in a hepatitis C treatment intervention

“…This contrasts with previous research (Crawford & Bath, 2013;Treloar et al, 2015). Indeed, there is a wealth of literature reporting the positive influence of peers on continued engagement in HCV treatment amongst PWID (Galindo et al, 2007;Norman et al, 2008;Rance and Treloar, 2012;Alavi et al, 2013;Ti et al, 2013;Rance and Treloar, 2014;Batchelder et al, 2015;Charlebois et al, 2012;Grebely et al, 2010;Harris et al, 2014). Two functions of peers are cited as important in this regard; first, their role in promoting patient empowerment and second their role in sharing their experiences of HCV testing and treatment (Norman et al, 2008;Treloar et al, 2013).…”

Elements of community‐based models for treating hepatitis C virus in supporting HCV elimination in Australia: A Delphi study

“…Although this provides the basis for creation of a safe and enabling environment, there are still many things to be done in relation to health care providers' attitudes, patients' internalised stigma, and clinic design . Special training for staff to provide HCV services within a nonjudgmental culture and changes to the clinic's physical design, can be helpful to establish a safe and enabling environment …”

‘Hep C’s like the common cold’: understanding barriers along the HCV care continuum among young people who inject drugs

“…Many of the determinants remain highly relevant; however, little is known about HCV treatment knowledge and treatment readiness among young PWID in the current era of DAAs, or factors that may contribute to treatment uptake and adherence, as few studies have examined the willingness to pursue new DAA treatments for HCV among young PWID, and how their experiences with the health care system contribute to – or impede – their preferences for care. The shorter treatment time, higher success rates, and reduced side effects associated with DAA treatment may impact many of the previously documented attitudes and behaviors among young PWID, as prior research on this issue may have a strong tie to side effects of interferon (Batchelder et al, 2015), thus limiting applications to the new treatments.…”