Exploring opportunities for hepatitis C treatment uptake among people who inject drugs in Australia: a qualitative study

Abstract

ABSTRACT Background and objective This study aims to understand the reasons people avoid or delay HCV treatment and identify potential pathways that can increase the uptake of HCV treatment from a health systems perspective. Methods Semi-structured interviews with 15 participants who were HCV positive and had a history of active or recent injecting drug use were conducted. Thematic and framework analyses based on an integrated framework by Høj and colleagues were used to identify barriers and opportunities to HCV treatment. Results The study identified barriers and enablers to HCV treatment at individual, socio-structural, and system levels. Competing priorities, unstable housing, and stigma were barriers, while engagement in opioid agonist therapy and peer support were enablers. Misinformation, limited OAT prescribers, and gaps in care coordination, especially within the prison system, were identified as missed opportunities at the system level, while organizational support and respectful relationships with service providers were key to engagement. Conclusions Person-centered care addressing the specific needs of PWID, such as housing, and drug and alcohol treatment, should be enhanced, and HCV care embedded within these services. Strengthening care pathways, especially within and between prisons and other primary care services, is urgently needed.