Abstract
Nationwide, the prevalence of the hepatitis C virus (HCV) has risen in recent years. At least 90% of infected persons must be treated to achieve global elimination targets. The current study aimed to explore barriers to, and facilitators of, direct-acting antiviral (DAA) HCV treatment uptake amongst pregnant and early-parenting women undergoing comprehensive substance use treatment. Twenty participants with documented HCV antibody positivity were recruited from two substance use treatment centers in central Kentucky. Semi-structured interviews were conducted to explore knowledge about HCV, previous experiences, and intentions to seek care. Themes were extracted using an inductive analytical approach. Most participants were aware of the dangers posed by HCV infection. However, there was a high degree of misinformation about transmission mechanisms and treatment eligibility requirements. Low priority for HCV treatment also surfaced as a barrier to treatment uptake. Participants reported being unable to seek care due to time and resource limitations in the presence of a highly demanding treatment process. Findings from the current study suggest that more work is needed to eliminate residual barriers that limit access to HCV treatment among pregnant and early-parenting women in treatment for substance use disorder.
Highlights
The increase in hepatitis C (HCV) incidence in the United States in recent years is largely attributed to the opioid epidemic and has predominantly affected younger Americans between 18–39 years of age [1]
We evaluated barriers to and facilitators of direct-acting antiviral (DAA) uptake among hepatitis C virus (HCV)-infected pregnant and early-parenting women receiving comprehensive treatment for substance use disorder (SUD)
In cases where initial information had been given to the women in our study, they didn’t receive updated information when, for example, policy changes were implemented that expanded insurance coverage and eligibility
Summary
The increase in hepatitis C (HCV) incidence in the United States in recent years is largely attributed to the opioid epidemic and has predominantly affected younger Americans between 18–39 years of age [1]. Vertical transmission represents the most common cause of pediatric HCV in the United States [3]. An estimated 60–85% of HCV-infected persons will progress to chronic infection [4], which accounts for over 350,000 annual deaths and, globally, is the leading cause of endstage liver disease requiring liver transplant [5,6]. Experts estimate that at least 90% of the HCV-infected population needs to be diagnosed and treated to achieve the World Health Organization’s 2030 elimination targets [8,9]
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