Linkage to Care for Suburban Heroin Users with Hepatitis C Virus Infection, New Jersey, USA

Akyar, Eda; Seneca, Kathleen; Akyar, Serra; Schofield, Neal; Schwartz, Mark P.; Nahass, Ronald

doi:10.3201/eid2205.151980

Cited by 20 publications

(16 citation statements)

References 9 publications

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“…In the USA, alarming increases in injection drug use (IDU) [1,2] and hepatitis C virus (HCV) infection incidence [3][4][5][6][7] are occurring among young persons who inject drugs (PWID) from non-urban communities [4,[8][9][10][11][12][13][14]. IDU is a well-established risk factor for HIV and the primary mode of HCV transmission in developed countries [15].…”

Section: Introductionmentioning

confidence: 99%

High-Risk Geographic Mobility Patterns among Young Urban and Suburban Persons who Inject Drugs and their Injection Network Members

et al. 2017

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Young people in the USA who inject drugs, particularly those at a risk of residence instability, experience the highest incidence of hepatitis C (HCV) infections. This study examined associations between geographic mobility patterns and sociodemographic, behavioral, and social network characteristics of 164 young (ages 18-30) persons who inject drugs (PWID). We identified a potential bridge sub-population who reported residence in both urban and suburban areas in the past year (crossover transients) and higher-risk behaviors (receptive syringe sharing, multiple sex partners) compared to their residentially localized counterparts. Because they link suburban and urban networks, crossover transients may facilitate transmission of HIV and HCV between higher and lower prevalence areas. Interventions should address risk associated with residential instability, particularly among PWID who travel between urban and suburban areas.

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Section: Introductionmentioning

confidence: 99%

High-Risk Geographic Mobility Patterns among Young Urban and Suburban Persons who Inject Drugs and their Injection Network Members

et al. 2017

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“…Our study focuses on New Jersey (NJ), where HCV has also been shown to be highly prevalent in young suburban heroin users, including those attending an acute detoxification program. Our study findings suggest that NJ may be experiencing a second wave of HCV infection [21]. The Centers For Disease Control and Prevention (CDC) reports indicate that NJ is included in the eleven states that account for 67.6% of the chronic HCV case reported in the US [1].…”

Section: Introductionmentioning

confidence: 92%

Gaps in HCV Knowledge and Risk Behaviors among Young Suburban People Who Inject Drugs

Jost

Tempalski

Vera

et al. 2019

IJERPH

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Background: Hepatitis C virus (HCV) among young suburban people who inject drugs (PWID) is a growing epidemic in the United States, yet little is known about the factors contributing to increased exposure. The goal of this study was to explore and assess HCV knowledge and attitudes about treatment and identify risk behaviors among a cohort of young suburban PWID. Methods: We conducted interviews with New Jersey (NJ) service providers and staff from the state’s five syringe service programs to inform a semistructured survey addressing HCV knowledge, treatment, and risk factors among young suburban PWID. We then used this survey to conduct qualitative interviews with 14 young suburban PWID (median age 26 years) in NJ between April and May 2015. Data were analyzed using a modified grounded theory approach and coded to identify thematic relationships among respondents. Results: Most participants had substantial gaps in several aspects of HCV knowledge. These included: HCV transmission, HCV symptoms, and the availability of new direct-acting antiviral therapy. Participants also downplayed the risk of past and current risk behaviors, such as sharing drug paraphernalia and reusing needles, which also reflected incomplete knowledge regarding these practices. Conclusion: Young suburban PWID are not receiving or retaining accurate and current HCV information. Innovative outreach and prevention messages specifically tailored to young suburban PWID may help to disseminate HCV prevention and treatment information to this population.

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“…In one study of 861 suburban heroin users aged 17–35 years in New Jersey, 237 had a positive HCV antibody on screening, but only 16 (6.8%) patients attended an in-office visit, and only 3 (1.3%) initiated DAA therapy. [ 12 ]…”

Section: Linkage and Access To Carementioning

confidence: 99%

Building a Hepatitis C Clinical Program: Strategies to Optimize Outcomes

Zuckerman

Carver

Chastain

2018

Curr Treat Options Infect Dis

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Purpose of reviewAn increasing number of specialists and non-specialists are developing clinical programs to treat and cure hepatitis C virus (HCV). The goal of this paper is to evaluate and describe optimal strategies to improve outcomes related to HCV care delivery.Recent findingsScreening and diagnosis of HCV should be guided by established recommendations. Given the recognized disparity in HCV diagnosis and linkage to care, a multi-modal approach involving care coordination and technology resources should be used to improve patient engagement. Access to HCV treatment may be optimized through systematic documentation, prior authorization, and appeal processes. Treatment monitoring should emphasize medication adherence, side effect and drug interaction management, as well as elimination of practical barriers. Finally, post-treatment engagement to promote liver health and reduce the risk of complications or reinfection maximizes the benefit of HCV treatment.SummaryThe landscape of HCV treatment has evolved from a specialist-driven model with few patients qualifying for treatment to an opportunity for non-specialists and other providers to provide curative therapies in most patients. Innovative practice models that employ a multidisciplinary approach will likely improve screening, diagnosis, engagement, and treatment outcomes.

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Linkage to Care for Suburban Heroin Users with Hepatitis C Virus Infection, New Jersey, USA

Cited by 20 publications

References 9 publications

High-Risk Geographic Mobility Patterns among Young Urban and Suburban Persons who Inject Drugs and their Injection Network Members

High-Risk Geographic Mobility Patterns among Young Urban and Suburban Persons who Inject Drugs and their Injection Network Members

Gaps in HCV Knowledge and Risk Behaviors among Young Suburban People Who Inject Drugs

Building a Hepatitis C Clinical Program: Strategies to Optimize Outcomes

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