Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study
Abstract Background Global commitment to achieving hepatitis C virus (HCV) elimination has enhanced efforts in improving access to direct-acting antiviral (DAA) treatments for people who inject drugs (PWID). Scale-up of efforts to engage hard-to-reach groups of PWID in HCV testing and treatment is c...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-05-01
|
| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-022-00640-6 |
| _version_ | 1817989699514400768 |
|---|---|
| author | Heidi Coupland Charles Henderson Janice Pritchard-Jones Shih-Chi Kao Sinead Sheils Regina Nagy Martin O’Donnell Paul S. Haber Carolyn A. Day |
| author_facet | Heidi Coupland Charles Henderson Janice Pritchard-Jones Shih-Chi Kao Sinead Sheils Regina Nagy Martin O’Donnell Paul S. Haber Carolyn A. Day |
| author_sort | Heidi Coupland |
| collection | DOAJ |
| description | Abstract Background Global commitment to achieving hepatitis C virus (HCV) elimination has enhanced efforts in improving access to direct-acting antiviral (DAA) treatments for people who inject drugs (PWID). Scale-up of efforts to engage hard-to-reach groups of PWID in HCV testing and treatment is crucial to success. Automatic needle/syringe dispensing machines (ADMs) have been used internationally to distribute sterile injecting equipment. ADMs are a unique harm reduction service, affording maximum anonymity to service users. This paper explores the feasibility and acceptability of extending the HCV cascade of care to sites where ADMs are located. Methods The ADM users into Treatment (ADMiT) study was undertaken in a metropolitan region in Sydney, Australia. This mixed methods study involved analysis of closed-circuit television footage, ethnographic methods (fieldwork observation and in-depth interviews) and structured surveys. Researchers and peers conducted fieldwork and data collection over 10 weeks at one ADM site, including offering access to HCV testing and treatment. Results Findings from 10 weeks of fieldwork observations, 70 survey participants and 15 interviews highlighted that there is scope for engaging with this population at the time they use the ADM, and enhanced linkage to HCV testing and treatment may be warranted. Most survey participants reported prior HCV testing, 61% in the last 12 months and 38% had received HCV treatment. However, fieldwork revealed that most people observed using the ADM were not willing to engage with the researchers. Field work data and interviews suggested that extending the HCV cascade of care to ADMs may encroach on what is a private space for many PWID, utilized specifically to avoid engagement. Discussion Enhanced linkage to HCV testing and treatment for people who use ADMs may be warranted. However, data suggested that extending the HCV cascade of care to ADMs may encroach on what is a private space for many PWID, utilized specifically to avoid engagement. The current study raises important public health questions about the need to ensure interventions reflect the needs of affected communities, including their right to remain anonymous. |
| first_indexed | 2024-04-14T00:49:56Z |
| format | Article |
| id | doaj.art-a36932e3a49c4afcb0e13f3f897a7a3d |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-14T00:49:56Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-a36932e3a49c4afcb0e13f3f897a7a3d2022-12-22T02:21:50ZengBMCHarm Reduction Journal1477-75172022-05-0119111110.1186/s12954-022-00640-6Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods studyHeidi Coupland0Charles Henderson1Janice Pritchard-Jones2Shih-Chi Kao3Sinead Sheils4Regina Nagy5Martin O’Donnell6Paul S. Haber7Carolyn A. Day8Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health DistrictNew South Wales Users and AIDS Association, Surry HillsAW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney Local Health DistrictHIV and Related Programs (HARP) Unit, Population Health, Sydney Local Health DistrictAW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney Local Health DistrictDrug Health Services, Royal Prince Alfred Hospital, Sydney Local Health DistrictDrug Health Services, Royal Prince Alfred Hospital, Sydney Local Health DistrictEdith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health DistrictEdith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health DistrictAbstract Background Global commitment to achieving hepatitis C virus (HCV) elimination has enhanced efforts in improving access to direct-acting antiviral (DAA) treatments for people who inject drugs (PWID). Scale-up of efforts to engage hard-to-reach groups of PWID in HCV testing and treatment is crucial to success. Automatic needle/syringe dispensing machines (ADMs) have been used internationally to distribute sterile injecting equipment. ADMs are a unique harm reduction service, affording maximum anonymity to service users. This paper explores the feasibility and acceptability of extending the HCV cascade of care to sites where ADMs are located. Methods The ADM users into Treatment (ADMiT) study was undertaken in a metropolitan region in Sydney, Australia. This mixed methods study involved analysis of closed-circuit television footage, ethnographic methods (fieldwork observation and in-depth interviews) and structured surveys. Researchers and peers conducted fieldwork and data collection over 10 weeks at one ADM site, including offering access to HCV testing and treatment. Results Findings from 10 weeks of fieldwork observations, 70 survey participants and 15 interviews highlighted that there is scope for engaging with this population at the time they use the ADM, and enhanced linkage to HCV testing and treatment may be warranted. Most survey participants reported prior HCV testing, 61% in the last 12 months and 38% had received HCV treatment. However, fieldwork revealed that most people observed using the ADM were not willing to engage with the researchers. Field work data and interviews suggested that extending the HCV cascade of care to ADMs may encroach on what is a private space for many PWID, utilized specifically to avoid engagement. Discussion Enhanced linkage to HCV testing and treatment for people who use ADMs may be warranted. However, data suggested that extending the HCV cascade of care to ADMs may encroach on what is a private space for many PWID, utilized specifically to avoid engagement. The current study raises important public health questions about the need to ensure interventions reflect the needs of affected communities, including their right to remain anonymous.https://doi.org/10.1186/s12954-022-00640-6Automatic syringe dispensing machinesPeople who inject drugsHepatitis CEngagement |
| spellingShingle | Heidi Coupland Charles Henderson Janice Pritchard-Jones Shih-Chi Kao Sinead Sheils Regina Nagy Martin O’Donnell Paul S. Haber Carolyn A. Day Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study Harm Reduction Journal Automatic syringe dispensing machines People who inject drugs Hepatitis C Engagement |
| title | Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study |
| title_full | Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study |
| title_fullStr | Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study |
| title_full_unstemmed | Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study |
| title_short | Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study |
| title_sort | setting foot in private spaces extending the hepatitis c cascade of care to automatic needle syringe dispensing machines a mixed methods study |
| topic | Automatic syringe dispensing machines People who inject drugs Hepatitis C Engagement |
| url | https://doi.org/10.1186/s12954-022-00640-6 |
| work_keys_str_mv | AT heidicoupland settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT charleshenderson settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT janicepritchardjones settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT shihchikao settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT sineadsheils settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT reginanagy settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT martinodonnell settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT paulshaber settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy AT carolynaday settingfootinprivatespacesextendingthehepatitisccascadeofcaretoautomaticneedlesyringedispensingmachinesamixedmethodsstudy |