注射吸毒者丙型肝炎治疗的获得情况：HOPE IV 研究的横断面结果。

Access to treatment for Hepatitis C among injection drug users: results from the cross-sectional HOPE IV study.

机构信息

Department of Social and Education Policy, University of Peloponnese, Faculty of Social and Political Sciences, Damaskinou & Kolokotroni Str, 20100, Corinth, Greece.

Health Policy Institute, 36-38, Amaryssias Artemidos Str, 15124, Athens, Greece.

出版信息

Int J Equity Health. 2017 Jun 14;16(1):101. doi: 10.1186/s12939-017-0601-3.

DOI:10.1186/s12939-017-0601-3

PMID:28615023

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5471999/

Abstract

BACKGROUND

Evidence suggests that Greece is among the European countries with increased trend in HCV prevalence among injecting drug users (IDUs) from 2008 to 2014. Nonetheless, the access of IDUs to treatment for Hepatitis C Virus (HCV) is very limited while the risk of co-infection and transmission remains high. In an effort to better understand the inhibitors to HCV treatment, the present study aimed to investigate the main barriers to access in a sample of IDUs.

METHODS

The cross-sectional study was carried out between July and September 2015 using a 23-items questionnaire. Participants were recruited from urban primary services, mobile health vans, community health services, day-care centers as well as during street work, located in Athens, Greece. Inclusion criteria were age above 18 years, understanding and speaking Greek sufficiently, HCV diagnosis, intravenous drug use. Data collection was carried out by health professionals of Praksis, a non-governmental organization. For the comparisons of proportions chi-square and Fisher's exact tests were used.

RESULTS

The study sample consisted of 101 HCV patients, 68% male. More than 80% of study participants experienced barriers in accessing their doctor and medication during the past 12 months. The most common obstacles in accessing a doctor were "delay in making the appointment and "difficulties in going to the doctor due to health condition or lack of means of transport". Access to physician or medication was not differed according to gender, but significant differences were found according to economic status and health insurance coverage. 56.1% of participants reported loss or treatment delay due to barriers to treatment. The majority of participants had deteriorated financial status, health status, access to health services and medication, higher financial burden for health services, worse mental health and lower adherence to medical instructions in 2015 compared to 2009.

CONCLUSIONS

The findings from the present study revealed that the vast majority of IDUs experience significant barriers in seeking HCV care in Greece, thus highlighting the need for immediate action in this particular area due to the high risk of co-infection and transmission.

摘要

背景

有证据表明，希腊是 2008 年至 2014 年期间欧洲注射吸毒者（IDU）中丙型肝炎病毒（HCV）流行率呈上升趋势的国家之一。尽管如此，IDU 获得 HCV 治疗的机会非常有限，而共同感染和传播的风险仍然很高。为了更好地了解 HCV 治疗的障碍，本研究旨在调查 IDU 样本中获得治疗的主要障碍。

方法

本横断面研究于 2015 年 7 月至 9 月间进行，使用了 23 项问卷。参与者是从雅典的城市初级服务机构、流动健康车、社区卫生服务机构、日托中心以及街头工作中招募的，符合年龄大于 18 岁、足够理解和说希腊语、HCV 诊断、静脉吸毒的标准。数据收集由 Praksis 非政府组织的卫生专业人员进行。对于比例的比较，使用了卡方检验和 Fisher 确切检验。

结果

研究样本由 101 名 HCV 患者组成，68%为男性。超过 80%的研究参与者在过去 12 个月中在获得医生和药物方面遇到了障碍。获得医生的最常见障碍是“预约延迟”和“由于健康状况或缺乏交通工具而难以去看医生”。获得医生或药物的机会不因性别而异，但根据经济状况和健康保险覆盖范围而有所不同。56.1%的参与者报告因治疗障碍而导致治疗中断或延误。与 2009 年相比，2015 年，大多数参与者的财务状况、健康状况、获得医疗服务和药物的机会恶化，医疗服务的经济负担增加，心理健康状况更差，对医嘱的遵从性更低。