Understanding facilitators and barriers of direct-acting antiviral therapy for hepatitis C virus infection in prison
Understanding facilitators and barriers of direct-acting antiviral therapy for hepatitis C virus infection in prison
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DOI：
10.1111/jvh.12987
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发表时间：
2018-12-01
影响因子：
2.5
通讯作者：
Treloar, Carla
中科院分区：
文献类型：
--
作者：
Lafferty, Lise;Rance, Jake;Treloar, Carla
丙型肝炎病毒（HCV）感染是一个主要的公共卫生问题。在全球范围内，15%的被监禁者是HCV抗体阳性（抗HCV）。即使在监狱内提供丙型肝炎病毒治疗的情况下，接受治疗的人数仍然很少。这项定性研究的目的是从囚犯的角度了解在监狱中提供HCV治疗的障碍和促进因素。这对于在惩教机构内为HCV治疗提供健康信息非常重要。32名有注射吸毒史的囚犯（包括8名妇女）参加了这项定性研究。参与者在四个惩教中心平等招募（n = 8每个网站）。总体而言，16名参与者（50%）在最近的测试中患有慢性HCV，两名参与者在面试时正在等待测试结果。结构（如接近卫生诊所）和患者水平（常规和动机）的因素被视为促进丙型肝炎病毒治疗的监狱设置。结构（如再感染的风险）和社会（如缺乏保密性和缺乏社会支持）因素被认为是基于监狱的HCV护理和治疗的障碍。总之，为了提高丙型肝炎病毒治疗的接受率，监狱方案应实施（或倡导）以患者为中心的治疗方法，保护隐私，提供社会支持，并促进获得清洁针头和替代疗法，以保护囚犯免受再感染。
Hepatitis C virus (HCV) infection is a major public health concern. Globally, 15% of those incarcerated are HCV-antibody positive (anti-HCV). Even where HCV treatment is available within prisons, treatment uptake has remained low. This qualitative study was conducted to understand the barriers and facilitators for the delivery of HCV treatment in prisons from the perspectives of prisoners. This is important to inform health messaging for HCV treatment within correctional institutions. Thirty-two prisoners (including eight women) with a history of injecting drug use participated in this qualitative study. Participants were equally recruited across four correctional centres (n = 8 per site). Overall, 16 participants (50%) had chronic HCV at their most recent test, and two participants were awaiting test results at time of interview. Structural (eg proximity of health clinic) and patient-level (routine and motivation) factors were viewed as facilitators of HCV treatment within the prison setting. Structural (eg risk of reinfection) and social (eg lack of confidentiality and lack of social support) factors were perceived as barriers to prison-based HCV care and treatment. In conclusion, to increase HCV treatment uptake, prison-based programmes should implement (or advocate for) patient-centred treatment approaches that protect privacy, provide social support, and promote access to clean needles and substitution therapy to protect prisoners from reinfection.