Department of Physiatrics and Nursing, University of Zaragoza, Calle Domingo Miral s/n, 50009, Zaragoza, Spain.
Global Research Institute Foundation (GLORI), 125 Suyumbaev Street apt 21, 720011, Bishkek, Kyrgyzstan.
BMC Infect Dis. 2021 Jun 26;21(1):609. doi: 10.1186/s12879-021-06332-z.
BACKGROUND: The prevalence of hepatitis C virus (HCV) among people who inject drugs (PWID) continues to be a major public-health burden in this highly stigmatised population. To halt transmission of HCV, rapid HCV self-testing kits represent an innovative approach that could enable PWID to know their HCV status and seek treatment. As no HCV test has yet been licenced for self-administration, it is crucial to obtain knowledge around the factors that may deter or foster delivery of HCV self-testing among PWID in resource-constrained countries. METHODS: A qualitative study to assess values and preferences relating to HCV self-testing was conducted in mid-2020 among PWID in the Bishkek and Chui regions of Kyrgyzstan. Forty-seven PWID participated in 15 individual interviews, two group interviews (n = 12) and one participatory action-research session (n = 20). Responses were analysed using a thematic analysis approach with 4 predefined themes: awareness of HCV and current HCV testing experiences, and acceptability and service delivery preferences for HCV self-testing. Informants' insights were analysed using a thematic analysis approach. This research received local ethics approval. RESULTS: Awareness of HCV is low and currently PWID prefer community-based HCV testing due to stigma encountered in other healthcare settings. HCV self-testing would be accepted and appreciated by PWID. Acceptability may increase if HCV self-testing: was delivered in pharmacies or by harm reduction associations; was free of charge; was oral rather than blood-based; included instructions with images and clear information on the test's accuracy; and was distributed alongside pre- and post-testing counselling with linkage to confirmatory testing support. CONCLUSIONS: HCV self-testing could increase awareness of and more frequent testing for HCV infection among PWID in Kyrgyzstan. It is recommended that peer-driven associations are involved in the delivery of any HCV self-testing. Furthermore, efforts should be maximised to end discrimination against PWID at the healthcare institutions responsible for confirmatory HCV testing and treatment provision.
背景：在这个高度污名化的人群中，静脉注射吸毒者（PWID）中丙型肝炎病毒（HCV）的流行仍然是一个主要的公共卫生负担。为了阻止 HCV 的传播，快速 HCV 自检试剂盒代表了一种创新的方法，可以使 PWID 了解自己的 HCV 状况并寻求治疗。由于尚无 HCV 检测可用于自我管理，因此了解可能阻碍或促进资源有限国家 PWID 提供 HCV 自检的因素至关重要。
方法：2020 年中期，在吉尔吉斯斯坦比什凯克和楚伊地区，对 47 名 PWID 进行了一项评估与 HCV 自检相关的价值观和偏好的定性研究。参与者参加了 15 次个人访谈、2 次小组访谈（n=12）和 1 次参与式行动研究会议（n=20）。使用主题分析方法分析了受访者的回复，该方法有 4 个预设主题：对 HCV 的认识和当前 HCV 检测经验，以及对 HCV 自检的可接受性和服务提供偏好。使用主题分析方法分析了知情人的见解。这项研究获得了当地的伦理批准。
结果：对 HCV 的认识很低，目前 PWID 由于在其他医疗机构中遇到的耻辱感，更喜欢社区为基础的 HCV 检测。HCV 自检将被 PWID 接受和赞赏。如果 HCV 自检：在药店或通过减少伤害协会提供；免费；是口服而不是基于血液；包括带有图像和测试准确性的清晰信息的说明；并与预测试和后测试咨询一起分发，并与确认测试支持相联系，那么接受度可能会增加。
结论：HCV 自检可以提高吉尔吉斯斯坦 PWID 对 HCV 感染的认识和更频繁的检测。建议涉及同伴驱动的协会提供任何 HCV 自检。此外，应尽最大努力消除负责确认 HCV 检测和治疗的医疗机构对 PWID 的歧视。
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