Community-Based Research Laboratory, Coalition PLUS, Pantin, France.
Advocacy Department, Coalition PLUS, Pantin, France.
Harm Reduct J. 2023 Feb 9;20(1):15. doi: 10.1186/s12954-023-00743-8.
To inform the development of updated World Health Organization (WHO) guidelines on simplified service delivery for HCV infection, a global survey was undertaken among people affected or infected by HCV. The objective of this analysis is to identify specific needs and preferences among people who inject drugs.
A multi-country, anonymous, self-administered online survey conducted in 2021 was developed by Coalition PLUS and the World Hepatitis Alliance in partnership with the WHO. Preferences for test and treat locations and simplifying HCV care were collected among people affected or infected by HCV. Chi-square tests were used to compare respondents who identified with current or former injection drug users through identification with key population to other respondents who did not identify with this key population.
Among 202 respondents, 62 (30.7%) identified with current/former injection drug users. Compared to other respondents, they were: older [median (IQR): 48 (36-57) vs. 39 (31-51) years, p = 0.003]; more likely to have been tested for HCV (90.2% vs. 64.3%, p = 0.001); more likely to prefer testing in a community-based centre (CBC) (55.4% vs. 33.3%, p = 0.005); or in a support centres for people who use drugs (SCPUD)(50.0% vs. 9.8%, p < 0.001). The most important considerations regarding testing locations among people identified with current/former injection drug users (compared to the other respondents) were: non-judgemental atmosphere (p < 0.001), anonymity (p = 0.018) and community worker (CW) presence (p < 0.001). People identified with current/former injection drug users were more likely to prefer to receive HCV treatment in a CBC (63.0% vs. 44.8%, p = 0.028) or in a SCPUD (46.3% vs. 9.5%, p < 0.001), compared to the other respondents. The most important considerations regarding treatment locations among people identified with current/former injection drug users were the non-stigmatising/non-judgemental approach at the site (p < 0.001) and the presence of community-friendly medical personnel or CW (p = 0.016 and 0.002), compared to the other respondents.
The preferences of people identified with current/former injection drug users indicated specific needs concerning HCV services. Integration of HCV services in community-based risk reduction centres may be an important element in the development of adapted services to increase uptake and retention in HCV care among this population.
为了为世界卫生组织（WHO）关于丙型肝炎感染简化服务提供的更新指南提供信息，对受丙型肝炎感染或影响的人群进行了全球调查。本分析的目的是确定注射毒品者的具体需求和偏好。
Coalition PLUS 和世界肝炎联盟与世界卫生组织合作，于 2021 年开展了一项多国家、匿名、自我管理的在线调查。在受丙型肝炎感染或影响的人群中收集了对检测和治疗地点的偏好以及简化丙型肝炎护理。通过与关键人群的认同，对识别为当前或过去注射吸毒者的受访者与未识别为关键人群的受访者进行了比较。
在 202 名受访者中，有 62 名（30.7%）识别为当前/过去的注射吸毒者。与其他受访者相比，他们：年龄更大[中位数（IQR）：48（36-57）比 39（31-51）岁，p=0.003]；更有可能接受过 HCV 检测（90.2%比 64.3%，p=0.001）；更愿意在社区为基础的中心（CBC）进行检测（55.4%比 33.3%，p=0.005）；或在药物使用支持中心（SCPUD）进行检测（50.0%比 9.8%，p<0.001）。在当前/过去注射吸毒者中，关于检测地点的最重要考虑因素（与其他受访者相比）是：非评判性氛围（p<0.001）、匿名性（p=0.018）和社区工作者（CW）的存在（p<0.001）。与其他受访者相比，识别为当前/过去注射吸毒者的人更愿意在 CBC（63.0%比 44.8%，p=0.028）或 SCPUD（46.3%比 9.5%，p<0.001）接受 HCV 治疗。在当前/过去注射吸毒者中，关于治疗地点的最重要考虑因素是现场无污名化/无评判性的方法（p<0.001）以及对社区友好的医务人员或 CW 的存在（p=0.016 和 0.002），与其他受访者相比。
识别为当前/过去注射吸毒者的人的偏好表明，HCV 服务存在具体需求。将 HCV 服务纳入基于社区的减少风险中心，可能是为该人群制定适应服务的重要内容，以提高 HCV 护理的参与度和保留率。
