A new study reveals significant insights into the challenges that can occur for hepatitis C virus (HCV) micro-elimination efforts in people with HIV (PWH). Due to the opioid epidemic, the prevalence of co-infection with HIV and HCV has been increasing. If left untreated, HCV infection can lead to liver damage, cancer, and death. Although HIV requires lifelong therapy, HCV can be cured with a few months of oral medications.
To understand the barriers in providing hepatitis C care, the authors conducted a mixed-methods analysis that involved conducting focus groups with 14 healthcare providers across 11 clinics in the United States. Practitioners interviewed in the study identified several barriers to micro-elimination, with housing instability, medication nonadherence concerns, and inability to motivate patients being the most prioritized.
Importantly, the researchers found that implicit biases pervaded a majority of the responses offered by providers. As a result, the authors assert that overcoming barriers to treatment may require addressing the stigma healthcare practitioners can hold toward patients.
“Given that there are deeply ingrained biases toward people who use drugs, biases that are especially hard to change, we need to instead re-design the way we manage such patients to reduce opportunities for stigma-inducing interactions as we cannot reliably expect every clinician to be absent of implicit bias,” said Frederick Altice, MD, MA, professor of medicine (infectious diseases), Yale School of Medicine, and of epidemiology (microbial diseases), Yale School of Public Health.
DiDomizio E, Chandra DK, Nichols L, Villanueva M, Altice FL. Challenges to Achieving HCV Micro-Elimination in People With HIV in the United States: Provider Perspectives and the Role of Implicit Bias. Health Promot Pract. 2023;24(5):998-1008. doi:10.1177/15248399231169928
Source: Yale School of Medicine