Will peer-based interventions improve hepatitis C virus treatment uptake among young people who inject drugs?

Abstract

People who inject drugs (PWID) are disproportionately affected by hepatitis C virus (HCV) and have low rates of direct-acting antiviral (DAA) treatment uptake, despite universal coverage of the medication in most Canadian settings. Investigation into peer-based interventions as a means of improving treatment uptake has yielded promising results in adult PWID populations. In this commentary, we discuss the benefits and considerations of integrating peer-based interventions into HCV care for adolescent and young adult PWID living with HCV. Given that young PWID experience high transmission rates and account for most new infections, improving strategies for youth engagement with DAA treatment is critical. We describe how peer-based interventions can feature the unique importance of peer relationships in this period of life and provide a low-barrier way of delivering health promotion messages. In particular, we discuss the ability of peer-based interventions to reshape the narrative of HCV care in young PWID peer networks by empowering youth to share experiences and knowledge with others. We conclude by addressing knowledge gaps in the literature which must be filled in order to strengthen the impact of peer-based interventions on treatment uptake rates among young PWID. RésuméLes personnes qui font usage de drogues par injection (PUDI) sont démesurément touchées par le virus de l'hépatite C (VHC) et présentent de faibles taux de recours aux traitements antiviraux à action directe (AAD), pourtant couverts par la plupart des régimes d'assurance-médicaments au Canada. Une enquête sur l'intervention par les pairs comme moyen d'améliorer le recours aux traitements a donné des résultats prometteurs dans des populations de PUDI adultes. Dans notre commentaire, nous expliquons les avantages d'intégrer l'intervention par les pairs dans les soins des adolescents et des jeunes adultes vivant avec le VHC qui font usage de drogues par injection, ainsi que les éléments à considérer. Comme les jeunes PUDI affichent des taux de transmission élevés et sont responsables de la plupart des nouveaux cas d'infection, il est essentiel d'améliorer les stratégies de recours aux traitements par AAD chez les jeunes. Nous expliquons que l'intervention par les pairs mise sur l'importance unique des égaux durant cette période de la vie et constitue un moyen « à bas seuil » de faire passer les messages de promotion de la santé. En particulier, nous expliquons que l'intervention par les pairs peut transformer le discours sur les soins du VHC dans les réseaux d'entraide de jeunes PUDI en donnant à ces jeunes le pouvoir de partager leur expérience et leurs connaissances avec d'autres. En conclusion, nous abordons les lacunes à combler dans la littérature scientifique pour renforcer l'impact de l'intervention par les pairs sur les taux de recours aux traitements chez les jeunes PUDI. KeywordsHepatitis C . Peer-based intervention . Young people who inject drugs . Treatment Mots-clés Hépatite C . intervention par les pairs . jeunes qui font usage de dr...

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