Meyerson Beth E, Russell Danielle M, Downer Missy, Alfar Amirah, Garnett Irene, Lowther John, Lutz Rebecca, Mahoney Arlene, Moore Julie, Nuñez Greg, Samorano Savannah, Brady Benjamin R, Bentele Keith G, Granillo Brenda
Family & Community Medicine, College of Medicine Tucson, The University of Arizona, Tucson, Arizona.
Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, Arizona.
AJPM Focus. 2022 Nov 5;2(1):100047. doi: 10.1016/j.focus.2022.100047. eCollection 2023 Mar.
The purpose of this study was to characterize hepatitis C virus screening and treatment access experiences among people in treatment for opioid use disorder in Arizona during COVID-19.
Arizonans receiving treatment for opioid use disorder from methadone clinics and buprenorphine providers during COVID-19 were interviewed about hepatitis C virus testing, curative treatment, and knowledge about screening recommendations. Interviews were conducted with 121 people from August 4, 2021 to October 10, 2021. Qualitative data were coded using the categories of hepatitis C virus testing, knowledge of screening recommendations, diagnosis, and experiences seeking curative treatment. Data were also quantitated for bivariate testing with outcome variables of last hepatitis C virus test, diagnosis, and curative treatment process. Findings were arrayed along an adapted hepatitis C virus cascade framework to inform program and policy improvements.
Just over half of the sample reported ever having tested for hepatitis C virus (51.2%, =62) and of this group, 58.1% were tested in the past 12 months. Among those who were ever tested, 54.8% reported a hepatitis C virus diagnosis and 16.1% reported either being in treatment or having been declared cured of the hepatitis C virus. Among those who were diagnosed with hepatitis C, 14.7% indicated that they unsuccessfully tried to access curative treatment and would not attempt to again. Reasons cited for not accessing or receiving curative treatment included beliefs about treatment safety, barriers created by access requirements, natural resolution of the infection, and issues with healthcare coverage and authorization.
Structural barriers continue to prevent curative hepatitis C virus treatment access. Given that methadone and buprenorphine treatment providers serve patients who are largely undiagnosed or treated for hepatitis C virus, opportunities exist for them to screen their patients regularly and provide support for and/or navigation to hepatitis C virus curative treatment.
本研究旨在描述2019年冠状病毒病疫情期间亚利桑那州接受阿片类药物使用障碍治疗的人群中丙型肝炎病毒筛查及治疗可及性情况。
对2019年冠状病毒病疫情期间在美沙酮诊所和丁丙诺啡治疗机构接受阿片类药物使用障碍治疗的亚利桑那州居民进行访谈，内容涉及丙型肝炎病毒检测、治愈性治疗以及对筛查建议的了解情况。于2021年8月4日至2021年10月10日对121人进行了访谈。定性数据按照丙型肝炎病毒检测、筛查建议知晓情况、诊断以及寻求治愈性治疗经历等类别进行编码。还对数据进行了定量分析，用于对最后一次丙型肝炎病毒检测、诊断及治愈性治疗过程等结果变量进行双变量检验。研究结果按照一个经过调整的丙型肝炎病毒级联框架进行整理，以为项目和政策改进提供参考。
略超过一半的样本报告曾接受过丙型肝炎病毒检测（51.2%，n = 62），在这组人群中，58.1%在过去12个月内接受过检测。在曾接受检测的人群中，54.8%报告丙型肝炎病毒检测呈阳性，16.1%报告正在接受丙型肝炎病毒治疗或已被宣布治愈。在被诊断为丙型肝炎的人群中，14.7%表示他们曾尝试获取治愈性治疗但未成功，且不会再次尝试。未获取或接受治愈性治疗的原因包括对治疗安全性的看法、获取要求造成的障碍、感染的自然缓解以及医保覆盖和授权方面的问题。
结构性障碍继续阻碍丙型肝炎病毒治愈性治疗的可及性。鉴于美沙酮和丁丙诺啡治疗机构服务的患者大多未接受丙型肝炎病毒诊断或治疗，这些机构有机会定期为患者进行筛查，并为丙型肝炎病毒治愈性治疗提供支持和/或引导。
