Views and experiences of hepatitis C testing and diagnosis among people who inject drugs: Systematic review of qualitative research |
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| Affiliation: | 1. Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK;2. Public Health Wales, Haydn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK;1. Department of Criminology and Criminal Justice, University of South Carolina, 1305 Greene Street, Columbia, SC 29208, USA;2. RAND Drug Policy Research Center, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138, USA;1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul''s Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6;2. School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3;3. Department of Medicine, University of British Columbia, St. Paul''s Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6;4. School of Public Policy, Simon Fraser University, SFU Harbour Centre, 515 West Hastings Street, Suite 3271, Vancouver, BC, Canada V6B 5K3;1. Departamento de Ingeniería Industrial, Universidad de Antioquia, Colombia, Calle 67 # 53-108, Office 21-407, Medellin, Colombia;2. Universidad Jorge Tadeo Lozano and Universidad Nacional de Colombia, AA 1027 Medellin, Colombia;1. INSERM, UMR912 “Economics and Social Sciences Applied to Health & Analysis of Medical Information” (SESSTIM), 13006 Marseille, France;2. Aix Marseille University, UMR_S912, IRD, 13006 Marseille, France;3. ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France;4. Institut National des études Démographiques (Ined), Paris, France;5. INSERM, U669, Univ Paris-Sud and Univ Paris Descartes, UMR-S0669 Paris, France;6. Institut National de Prévention et d’Education pour la Santé (INPES), 93203 St Denis Cedex, France;7. Cermes3 - Equipe Cesames (Centre de recherche Médecine, Sciences, Santé, Santé mentale, Société, Université Paris Descartes, Sorbonne Paris Cité/CNRS UMR 8211/Inserm U988/EHESS), Paris Cedex 06, France |
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| Abstract: | BackgroundMany developed countries are facing a major challenge to improve identification of individuals acutely and chronically infected with hepatitis C virus (HCV) infection. We explored the views and experiences of people who inject drugs (PWID) in relation to HCV testing, and diagnosis through a review and synthesis of qualitative research.MethodsBased on the thematic synthesis of qualitative research. Searches were conducted in 14 databases and supplemented by reference checking, hand searching of selected journals, and searches of relevant websites. Studies of any qualitative design that examined the views and experiences of, and attitudes towards, HCV testing and diagnosis among PWID or practitioners involved in their care were included. Key themes and sub-themes were systematically coded according to the meaning and content of the findings of each study which proceeded to the preparation of a narrative account of the synthesis.Results28 qualitative studies were identified. We identified a number of overarching descriptive themes in the literature, finding overall that PWID hold complex and differing views and experiences of testing and diagnosis. Three major themes emerged: missed opportunities for the provision of information and knowledge; shifting priorities between HCV testing and other needs; and testing as unexpected and routine. Evidence of missed opportunities for the provision of knowledge and information about HCV were clear, contributing to delays in seeking testing and providing a context to poor experiences of diagnosis. Influenced by the nature of their personal circumstances, perceptions of the risk associated with HCV and the prioritisation of other needs acted both to encourage and discourage the uptake of HCV testing. Undergoing HCV testing as part of routine health assessment, and an unawareness of being testing was common. An unexpected positive diagnosis exacerbated anxiety and confusion.ConclusionThis review has identified that there are modifiable factors that affect the uptake of HCV testing and experiences of HCV diagnosis among PWID. Intervention development should focus on addressing these factors. There is a need for further research that engages PWID from a diverse range of populations to identify interventions, strategies and approaches that they consider valuable. |
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| Keywords: | Hepatitis C Screening Injecting drug use Qualitative synthesis |
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