Popular Knowledge of Hepatitis C Risk Factors Is Low but Correlates with Level of Formal Education

Abstract

Introduction: Affecting approximately three million people, Chronic Hepatitis C Virus (HCV) is a major health concern in the U.S. Novel, tolerable, highly effective therapy is available. Because HCV is frequently asymptomatic, patients are identified by screening tests. Testing is indicated in high risk cohorts (e.g., those born between 1945-1965) and those with risk factors. Unfortunately, patients may have inadequate or inaccurate understanding of HCV risk factors. This study evaluated the effect of educational attainment on knowledge of HCV transmission within an historically underserved community with a high prevalence of HCV. Methods: Individuals attending a health fair sponsored by the Rodham Institute completed an anonymous survey. The exposition was hosted in an urban setting with a population that is 92% African American. The survey included questions on demographic information, access to primary care, insurance status, as well as knowledge of various topics related to Hepatitis C. Responses were excluded if they did not answer questions regarding education level or HCV transmission. The university institutional review board approved the study. Statistical analysis was performed using Fisher's exact test, with significance set at p < 0.05 Results: Ninety-five responses were analyzed. All individuals reported access to Primary Care Provider (PCP). Twenty nine (30.5%) reported completion of college or graduate coursework and 17 (58.6%) understood that sharing intravenous needles was a risk factor for HCV transmission. Sixty six patients reports a lower level of formal education and 19 (28.8%) knew that shared needles could transmit HCV. Those with higher education were more likely to be aware of this risk factor (p=0.0107). Conclusion: Education is an important social determinant of health and may correlate with health literacy. This study found that, in a high-prevalence community, knowledge of HCV risk factors was low and that patients with less-than-college education levels failed to identify needle sharing as a mode of HCV transmission at twice the rate of the college educated respondents. These results indicate that outreach efforts should focus not only on the availability of treatment, but also on the risk factors HCV infection. Communities with lower levels of formal education may see even more benefits from such efforts. As many communities face a resurgence of injection opioid use, education about risks related to needle sharing becomes even more essential.