School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada.
Health Sciences Library, Memorial University of Newfoundland, St. John's, Canada.
BMC Public Health. 2023 Jun 1;23(1):1038. doi: 10.1186/s12889-023-16017-8.
BACKGROUND: Injection drug use is the primary mode of transmission of hepatitis C virus (HCV) infection in the developed world and guidelines recommend screening individuals with current or history of injection drug use for HCV; however, the majority of those living with HCV in Canada are not aware of their positive status. This low level of HCV status awareness suggests that screening is not effective with current testing strategies. The aim of this review is to determine what barriers and enablers people who inject drugs (PWID) experience surrounding testing for HCV to help inform the development of an engaging testing strategy. METHODS: Comprehensive literature searches were conducted using Medline, Embase and CINAHL in February 2021. Included studies investigated the barriers and enablers to testing for HCV in PWID and the experiences of PWID in testing for HCV. Studies were included if they were qualitative or mixed-methods design, involved people with current injection drug use or those with a history of injecting drugs, and were written in the English language. Studies were compared and common themes were coded and analyzed. RESULTS: The literature search resulted in 1554 citations and ultimately nine studies were included. Common barriers included self-perception of low risk for HCV, fear of diagnosis, stigma associated with IV drug use and HCV, antipathy in relation to mainstream health care services, limited knowledge about HCV, lack of rapport with provider, lack of motivation or competing priority of drug use, and limited awareness of new treatment options. Common enablers to testing included increasing awareness of HCV testing and treatment and providing positive narratives around HCV care, positive rapport with provider, accessible testing options and individualized care. CONCLUSION: While there has been some qualitative research on barriers and enablers to testing for HCV in PWID more research is needed to focus on this research question as a primary objective in order to provide more understanding from the participant's perspective.
背景：在发达国家，注射毒品是丙型肝炎病毒 (HCV) 感染的主要传播途径，指南建议对当前或有注射毒品史的个体进行 HCV 筛查；然而，加拿大大多数 HCV 感染者并不知道自己的阳性状态。这种 HCV 知晓率低表明，目前的检测策略并不有效。本研究旨在确定注射毒品者 (PWID) 在 HCV 检测方面面临的障碍和促进因素，以帮助制定有吸引力的检测策略。
方法：2021 年 2 月，使用 Medline、Embase 和 CINAHL 进行了全面的文献检索。纳入的研究调查了 PWID 进行 HCV 检测的障碍和促进因素，以及 PWID 进行 HCV 检测的经验。如果研究是定性或混合方法设计，涉及当前使用注射毒品者或有注射毒品史者，且用英文书写，则纳入研究。对研究进行比较，并对共同主题进行编码和分析。
结果：文献检索产生了 1554 条引文，最终纳入了 9 项研究。常见障碍包括自我感知 HCV 风险低、害怕诊断、与 IV 药物使用和 HCV 相关的耻辱感、对主流医疗服务的反感、对 HCV 的了解有限、与提供者关系不佳、缺乏动力或吸毒的竞争优先事项，以及对新的治疗选择的认识有限。常见的检测促进因素包括提高对 HCV 检测和治疗的认识，提供 HCV 护理的积极叙述，与提供者建立良好的关系，提供便捷的检测选择和个性化的护理。
结论：虽然已经有一些关于 PWID 进行 HCV 检测的障碍和促进因素的定性研究，但需要更多的研究将这一研究问题作为主要目标进行重点关注，以便从参与者的角度提供更多的理解。
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