Stevens Annabelle, Lafferty Lise, Treloar Carla, Cunningham Evan B, Dore Gregory J, Grebely Jason, Marshall Alison D
The Kirby Institute, UNSW, Australia.
Centre for Social Research in Health, UNSW, Australia.
Int J Drug Policy. 2025 Mar;137:104720. doi: 10.1016/j.drugpo.2025.104720. Epub 2025 Jan 31.
Hepatitis C (HCV) testing innovations such as dried blood spot (DBS) and point-of-care testing should have fewer client-related barriers than traditional diagnostic pathways, yet there is limited evidence on their acceptability among people who inject drugs. To address this gap, this study sought to evaluate the acceptability of DBS and point-of-care testing among people at risk of HCV infection and understand the circumstances in which such testing is most preferred.
Participants were recruited from community sites involved in the Australian HCV Point-of-Care Testing Program. Inclusion criteria were aged ≥18 years, sufficient proficiency in the English language, history of HCV testing at least once, and informed consent. Between June and August 2023, in-depth, semi-structured interviews were conducted via telephone with clients on their perceptions and experiences of HCV DBS and point-of-care testing. Data were coded and analysed thematically with Sekhon's theoretical framework of acceptability.
Forty participants were interviewed: 18 had previously received HCV DBS testing, 8 had received HCV point-of-care testing, 8 had experience with both, and 6 had no prior experience with either test. Most participants preferred point-of-care compared to DBS and venepuncture due to the shorter time to result and some identified that this reduced anxiety while waiting for results (burden). Among participants in this study, many felt that the provision of non-judgemental care was more important than whether testing was performed by peers (ethicality). Many participants indicated a preference for assisted collection when compared to self-collected or mail testing service (self-efficacy).
Applying Sekhon's acceptability framework highlighted remaining service gaps to bridge client HCV testing experiences, including enhanced education on testing modalities and their results, an increased need for non-judgemental care, and the use of peer support in community settings.
丙型肝炎（HCV）检测创新方法，如干血斑（DBS）检测和即时检测，与传统诊断途径相比，应具有更少的与客户相关的障碍，但关于它们在注射吸毒者中的可接受性的证据有限。为了填补这一空白，本研究旨在评估DBS检测和即时检测在HCV感染风险人群中的可接受性，并了解在哪些情况下这种检测最受青睐。
参与者从参与澳大利亚HCV即时检测项目的社区场所招募。纳入标准为年龄≥18岁、英语水平足够、至少有过一次HCV检测历史且知情同意。在2023年6月至8月期间，通过电话对客户进行了深入的半结构化访谈，了解他们对HCV DBS检测和即时检测的看法和体验。数据使用塞洪的可接受性理论框架进行编码和主题分析。
采访了40名参与者：18人曾接受过HCV DBS检测，8人接受过HCV即时检测，8人两种检测都有经验，6人两种检测都没有经验。与DBS检测和静脉穿刺相比，大多数参与者更喜欢即时检测，因为出结果的时间更短，一些人认为这减少了等待结果时的焦虑（负担）。在本研究的参与者中，许多人认为提供无歧视护理比检测是否由同龄人进行更重要（道德性）。与自我采集或邮寄检测服务相比，许多参与者表示更喜欢辅助采集（自我效能感）。
应用塞洪的可接受性框架突出了在弥合客户HCV检测体验方面仍存在的服务差距，包括加强对检测方式及其结果的教育、增加对无歧视护理的需求，以及在社区环境中利用同伴支持。
