Identifying the Hidden Population: Former Intravenous Drug Users Who Are No Longer in Contact with Services. "Ask a Friend".

Sarah R Donaldson,John F Dillon,Andrew Radley

doi:10.3390/diagnostics11020170

Sarah R Donaldson, John F Dillon + Show 1 more

Open Access

https://doi.org/10.3390/diagnostics11020170

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Journal: Diagnostics	Publication Date: Jan 25, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: University of Dundee, NHS Tayside, Ninewells Hospital

Abstract

People who, after a period of drug use, have changed their lifestyle and left substance use behind them are a hidden population within our communities. Lack of contact with drug services may mean that they are not tested for hepatitis C (HCV) infection through service-led initiatives and, therefore, may be exposed to the chronic morbidity and risk of death inherent with a legacy of HCV infection. This study utilized respondent-driven sampling (RDS) in a novel fashion to find those at historical risk of HCV. The social networks of people with a history of drug use were mapped, and individuals not currently in contact with services were invited to come forward for testing by members of their social network. The study used a reference group to inform study methodology and communication methods to reach out to this hidden population. One hundred and nine individuals received dry blood spot tests for HCV, 17.4% were antibody positive. Fifty one individuals met the inclusion criteria for this study. One hundred and twenty three invite-to-test coupons were issued; however, only one wave of recruitment consisting of one participant resulted from this method. Using RDS in historical social networks was not effective in this study and did not reach this hidden population and increase testing for HCV. This study is registered with clinicaltrials.gov (Ref NCT03697135).

Highlights

National Health Service (NHS) Tayside, a health board area in Scotland, has targeted significant resources over the past 7 years to test, treat and care for people with hepatitis C (HCV)
In order to investigate the likely feasibility of this approach, a reference group was established with participants who had lived experience of substance use or had worked in drug services
Fifty of the individuals that accepted dry blood spot testing (DBST) did not return for their results despite numerous attempts by the researchers to find them and so were not eligible to be recruited to deliver the study protocol

Summary

Introduction

National Health Service (NHS) Tayside, a health board area in Scotland, has targeted significant resources over the past 7 years to test, treat and care for people with hepatitis C (HCV). The population that has moved beyond substance use has far been hidden and out of reach of the novel treatment pathways developed and is recognised as an important but complex group that is difficult to reach [3]. A number of novel studies have successfully targeted people who have a history of substance use to improve the health of each individual and to utilise treatment as prevention to improve the health of the community [3,4,5,6,7,8]. Social networks can provide support and guide positive lifestyle choices, improving the health of the individual and providing a downstream effect that influences the health behaviours of other group members [10,11]. Successful recovery from substance use is associated with changing your social network [12,14,15]

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