School of Public Health, The University of Queensland, 288 Herston Road, Herston 4006, QLD, Australia.
J Subst Abuse Treat. 2021 Aug;127:108460. doi: 10.1016/j.jsat.2021.108460. Epub 2021 May 8.
Direct acting antiviral (DAA) treatment has made the elimination of hepatitis C virus (HCV) a realisable global public health goal and people who inject drugs are a key target population. This study investigates barriers and enablers to DAA treatment of HCV in general practice settings in Australia, from the patient perspective. Semi-structured interviews were conducted with 28 patients; of these patients, seventeen participants were currently on opioid agonist therapy, and four were currently injecting drugs. Thematic data analysis was undertaken and a personal, provider and systems framework was used to describe the barriers and enablers to DAA treatment. Results suggest a range of initiatives are required to support the uptake of DAA in general practice settings. These include the provision of formalised peer information and support, and increasing the accessibility of blood tests and liver assessment on-site. Further, there remains a need to address stigma and discrimination affecting people who inject drugs in community healthcare settings.
直接作用抗病毒(DAA)治疗使消除丙型肝炎病毒(HCV)成为一个可行的全球公共卫生目标,而注射毒品者是一个关键的目标人群。本研究从患者角度出发,调查了澳大利亚普通实践环境中 DAA 治疗 HCV 的障碍和促进因素。对 28 名患者进行了半结构化访谈;其中 17 名参与者正在接受阿片类激动剂治疗,4 名正在注射毒品。进行了主题数据分析,并使用个人、提供者和系统框架来描述 DAA 治疗的障碍和促进因素。结果表明,需要采取一系列举措来支持 DAA 在普通实践环境中的应用。这些举措包括提供正式的同伴信息和支持,并增加现场血液检测和肝脏评估的可及性。此外,仍需要解决影响社区医疗保健环境中注射毒品者的污名化和歧视问题。