Falade-Nwulia Oluwaseun, Sacamano Paul, McCormick Sean D, Yang Cui, Kirk Greg, Thomas David, Sulkowski Mark, Latkin Carl, Mehta Shruti H
Johns Hopkins University School of Medicine, 725 N. Wolfe Street, Suite 215, Baltimore, MD 21205, USA.
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Int J Drug Policy. 2020 Apr;78:102714. doi: 10.1016/j.drugpo.2020.102714. Epub 2020 Mar 2.
Hepatitis C virus (HCV) treatment uptake among people who inject drugs (PWID), a population with disproportionately high rates of HCV, remains low. Peers have been shown to positively impact a broad range of health outcomes for PWID. There is, however, limited data on the impact of PWID social network members on HCV treatment.
HCV-infected PWID enrolled in an ongoing community-based cohort were recruited as "indexes" to complete an egocentric social network survey. The survey elicited from the index PWID a list of their network members and the index's perception of network member characteristics. Logistic regression analyses were conducted to compare individual and network factors associated with HCV treatment in the index PWID.
Among 540 HCV-infected PWID, the mean age was 55.7 years and the majority were black (87.2%) and male (69.8%). PWID reported a mean of 4.4 (standard deviation [SD] 3.2) network members, most of whom were relatives (mean 2.2 [SD 1.5]). In multivariable analysis, increasing index age and HIV infection were positively associated with HCV treatment, while drug use and homelessness in the preceding 6 months were negatively associated with HCV treatment. From a network perspective, having at least one network member who regularly talked with the index about seeing their doctor for HIV care was associated with HCV treatment (Adjusted Odds Ratio [AOR] 2.7; 95% Confidence Interval (CI) [1.3, 5.6]). Conversely, PWID who had at least one network member who helped them understand their HCV care were less likely to have been HCV treated (AOR 0.2; CI [0.1, 0.6).
HCV treatment uptake in this group of PWID appeared to be positively influenced by discussions with network members living with HIV who were in care and negatively influenced by HCV information sharing within PWID networks. These findings underscore the influence of peers on health seeking behaviors of their network members and emphasizes the importance of well-informed peers.
在注射吸毒者（PWID）中，丙型肝炎病毒（HCV）治疗的接受率仍然很低，而这一人群的HCV感染率高得不成比例。已有研究表明，同伴对PWID的广泛健康结果有积极影响。然而，关于PWID社交网络成员对HCV治疗影响的数据有限。
招募参与一项正在进行的基于社区队列研究的HCV感染PWID作为“索引”，以完成一项自我中心社交网络调查。该调查从索引PWID那里获取其网络成员列表以及索引对网络成员特征的看法。进行逻辑回归分析，以比较与索引PWID中HCV治疗相关的个体因素和网络因素。
在540名HCV感染的PWID中，平均年龄为55.7岁，大多数为黑人（87.2%）和男性（69.8%）。PWID报告的网络成员平均数量为4.4名（标准差[SD]为3.2），其中大多数是亲属（平均2.2名[SD 1.5]）。在多变量分析中，索引年龄的增加和HIV感染与HCV治疗呈正相关，而前6个月的吸毒和无家可归与HCV治疗呈负相关。从网络角度来看，至少有一名网络成员经常与索引谈论看医生接受HIV治疗与HCV治疗相关（调整后的优势比[AOR]为2.7；95%置信区间[CI][1.3, 5.6]）。相反，至少有一名网络成员帮助他们了解HCV护理的PWID接受HCV治疗的可能性较小（AOR为0.2；CI[0.1, 0.6]）。
这组PWID中的HCV治疗接受情况似乎受到与接受护理的HIV感染者网络成员讨论的积极影响，而受到PWID网络内HCV信息共享的消极影响。这些发现强调了同伴对其网络成员健康寻求行为的影响，并强调了信息充分的同伴的重要性。
