Curatio International Foundation, Tbilisi, Georgia.
College of Global Public Health, New York University, New York, NY, United States of America.
PLoS One. 2019 Apr 29;14(4):e0216123. doi: 10.1371/journal.pone.0216123. eCollection 2019.
Hepatitis C virus (HCV) infection is a significant public health concern worldwide. Georgia is among the countries with a high burden of HCV infection. People who inject drugs (PWID) have the highest burden of infection in Georgia. In 2015, the Government of Georgia, with partners' support, initiated one of the world's first Hepatitis C Elimination Programs. Despite notable progress, challenges to achieving targets persist. This qualitative study is aimed to better understand some of the barriers and facilitators to HCV testing and treatment services for PWID to inform HCV treatment policies and practices. The study instrument examined social, structural, and individual factors influencing HCV testing and treatment practices. We started with key informant interviews to guide the study instrument development and compare the study findings against health care planners' and health care providers' views. Forty PWID with various HCV testing and treatment experiences were recruited through the snowball method. The study found that along with structural factors such as political commitment, co-financing of diagnostic and monitoring tests, and friendly clinic environments, knowledge about HCV infection and elimination program benefits, and support from family and peers also play facilitating roles in accessing testing and treatment services. On the other hand, inability to co-pay for diagnostic tests, fear of side effects associated with treatment, poor knowledge about HCV infection, and lack of social support hampered testing and treatment practices among PWID. Findings from this study are important for increasing the effectiveness of this unique program that targets a population at high risk of HCV infection.
丙型肝炎病毒（HCV）感染是全球范围内一个重大的公共卫生关注点。格鲁吉亚是 HCV 感染负担较高的国家之一。在格鲁吉亚，注射毒品者（PWID）的感染负担最高。2015 年，格鲁吉亚政府在合作伙伴的支持下，启动了世界上最早的 HCV 消除计划之一。尽管取得了显著进展，但仍存在实现目标的挑战。本定性研究旨在更好地了解影响 PWID HCV 检测和治疗服务的一些障碍和促进因素，为 HCV 治疗政策和实践提供信息。该研究工具考察了影响 HCV 检测和治疗实践的社会、结构和个人因素。我们首先进行了关键知情人访谈，以指导研究工具的开发，并将研究结果与医疗保健规划者和医疗保健提供者的观点进行比较。通过滚雪球的方法，我们招募了 40 名具有不同 HCV 检测和治疗经验的 PWID。研究发现，除了结构因素（如政治承诺、诊断和监测测试的共同融资以及友好的诊所环境）外，对 HCV 感染和消除计划益处的了解以及来自家庭和同伴的支持也在获得检测和治疗服务方面发挥了促进作用。另一方面，无法共同支付诊断测试费用、担心治疗相关的副作用、对 HCV 感染的知识匮乏以及缺乏社会支持，阻碍了 PWID 的检测和治疗实践。本研究的结果对于提高这一针对 HCV 感染高风险人群的独特计划的效果非常重要。
