Abstract
BackgroundAlthough opioid-dependent patients are disproportionately impacted by hepatitis C (HCV), many do not receive treatment. In addition to HCV treatment-access barriers, substance-using patients may be reluctant to pursue treatment because of wariness of the medical system, lack of knowledge, or stigma related to HCV treatment. Implementation of a formal peer education program is one model of reducing provider- and patient-level barriers to HCV treatment, by enhancing mutual trust and reducing stigma.MethodsWe used thematic qualitative analysis to explore how 30 HCV patients and peer educators perceived a HCV peer program within an established methadone maintenance program in the USA.ResultsParticipants unanimously described the program as beneficial. Participants described the peer educators’ normalization and dispelling of myths and fears around HCV treatment, and their exemplification of HCV treatment success, and reductions in perceived stigma. Peer educators described personal benefits.ConclusionsThese findings indicate that HCV peer educators can enhance HCV treatment initiation and engagement within opioid substitution programs.
Highlights
Opioid-dependent patients are disproportionately impacted by hepatitis C (HCV), many do not receive treatment
The non-peer educator participants described benefiting from experiencing the emotional support provided by the peer educators, having myths and fears related to Hepatitis C (HCV) treatment dispelled, having their experiences normalized, and seeing examples of HCV treatment success
Patient benefits The peer educators and non-peer educator participants described four main benefits from the HCV peer educator that contributed to sustained engagement and completion of treatment among those who had initiated treatment
Summary
Opioid-dependent patients are disproportionately impacted by hepatitis C (HCV), many do not receive treatment. Medical providers’ may be hesitant to treat substance-using populations due to concerns about poor medication adherence, adverse side effects, co-morbid psychiatric illness, medical illness, and alcohol abuse, as well as the potential risk for re-infection [16, 17]. In addition to these barriers, substance-using patients may be reluctant to pursue HCV treatment because of wariness of the medical system, belief they do not need treatment, low levels of social support, or experienced or perceived stigma or shame related to approaching their provider about HCV treatment [15, 18, 19]
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