格鲁吉亚注射吸毒者中与 HCV 病毒血症检测相关的障碍。
Barriers of linkage to HCV viremia testing among people who inject drugs in Georgia.
机构信息
Health Research Union/Clinic NEOLAB, 8 Nutsubidze str., 0177, Tbilisi, Georgia.
University of Georgia, 77a M.Kostava str, 0171, Tbilisi, Georgia.
出版信息
Subst Abuse Treat Prev Policy. 2022 Mar 28;17(1):23. doi: 10.1186/s13011-022-00438-6.
BACKGROUND
People who inject drugs (PWID) in Georgia have a high prevalence of hepatitis C virus antibody (anti-HCV). Access to care among PWID could be prioritized to meet the country's hepatitis C elimination goals. This study assesses barriers of linkage to HCV viremia testing among PWID in Georgia.
METHODS
Study participants were enrolled from 13 harm reduction (HR) centers throughout Georgia. Anti-HCV positive PWID who were tested for viremia (complete diagnosis [CD]), were compared to those not tested for viremia within 90 days of screening anti-HCV positive (not complete diagnosis [NCD]). Convenience samples of CD and NCD individuals recorded at HR centers using beneficiaries' national ID were drawn from the National HCV Elimination Program database. Participants were interviewed about potential barriers to seeking care.
RESULTS
A total of 500 PWID were enrolled, 245 CD and 255 NCD. CD and NCD were similar with respect to gender, age, employment status, education, knowledge of anti-HCV status, and confidence/trust in the elimination program (p > 0.05). More NCD (13.0%) than CD (7.4%) stated they were not sufficiently informed what to do after screening anti-HCV positive (p < 0.05). In multivariate analysis, HCV viremia testing was associated with perceived affordability of the elimination program (adjusted prevalence ratio = 8.53; 95% confidence interval: 4.14-17.62).
CONCLUSIONS
Post testing counselling and making hepatitis C services affordable could help increase HCV viremia testing among PWID in Georgia.
背景
格鲁吉亚的注射毒品者（PWID）中丙型肝炎病毒抗体（抗-HCV）的流行率很高。为了实现该国消除丙型肝炎的目标，可以优先为 PWID 提供获得医疗保健的机会。本研究评估了格鲁吉亚 PWID 与丙型肝炎病毒血症检测联系的障碍。
方法
研究参与者是从格鲁吉亚的 13 个减少伤害（HR）中心招募的。对丙型肝炎病毒抗体（抗-HCV）阳性且进行了病毒血症检测（完全诊断[CD]）的 PWID 与在筛查抗-HCV 阳性后 90 天内未进行病毒血症检测的人（未完全诊断[NCD]）进行比较。从国家 HCV 消除计划数据库中，从 HR 中心记录的方便样本中抽取 CD 和 NCD 个体的个人资料，使用受益人的国家身份证。对参与者进行了关于寻求护理的潜在障碍的访谈。
结果
共纳入了 500 名 PWID，其中 245 名 CD 和 255 名 NCD。在性别、年龄、就业状况、教育程度、对抗-HCV 状态的了解程度以及对消除计划的信心/信任方面，CD 和 NCD 相似（p>0.05）。与 CD（7.4%）相比，更多的 NCD（13.0%）表示他们在筛查抗-HCV 阳性后没有得到足够的信息，不知道该怎么做（p<0.05）。在多变量分析中，HCV 病毒血症检测与认为消除计划负担得起的程度有关（调整后的患病率比=8.53；95%置信区间：4.14-17.62）。
结论
对检测后咨询和使丙型肝炎服务负担得起，可以帮助增加格鲁吉亚 PWID 中的 HCV 病毒血症检测。
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