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Ho N, Vandyk A, Horvath C, Magboo Cahill T, O'Byrne P. The experiences of people who use injection drugs with accessing hepatitis c testing and diagnosis in western countries: A scoping review. Public Health Nurs 2024; 41:37-56. [PMID: 37712447 DOI: 10.1111/phn.13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The purpose of this scoping review was to summarize the literature that reported on the experiences of people who use injection drugs' access to hepatitis C testing and diagnosis in Western countries. METHODS The initial search was conducted in 2020 and an updated review was completed in 2022. Seven electronic databases were searched using a peer-reviewed search strategy and included: full-text, peer-reviewed studies with people who inject(ed) drugs, hepatitis C testing or diagnosis, conducted in Western countries. Excluded were studies published prior to 2014 and intervention studies. Two-step screening was conducted in duplicate. Conventional content analysis was used. RESULTS Six studies were found from the search. The studies were published between 2014 and 2021 in Australia, United Kingdom, and United States. A total of 19 participant characteristics were extracted to contextualize their experiences, demonstrating a lack of demographic data. Four themes were found: Awareness and Knowledge, Stigma, Healthcare Service, and Psychological Responses. There were 58 occurrences of client quotes where participants described their experiences, 29 occurrences of quotes describing client-identified barriers, and 14 occurrences of quotes describing client-identified facilitators. CONCLUSION A scoping review was conducted to present the experiences, barriers, and facilitators of people who use injection drugs to hepatitis C testing. The lack of demographic data and connection to client quotes further exacerbates the inequities among the population by overlooking their intragroup identities. Understanding their experiences of accessing hepatitis C testing and collecting demographic data will help advance health policies and interventions targeting people who use injection drugs.
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Affiliation(s)
- Nikki Ho
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Amanda Vandyk
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Cynthia Horvath
- Ottawa Public Health, Health Protection Service, Ottawa, Ontario, Canada
| | - Taliesin Magboo Cahill
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Patrick O'Byrne
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Public Health, Health Protection Service, Ottawa, Ontario, Canada
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Living with Hepatitis C Virus: A Systematic Review and Narrative Synthesis of Qualitative Literature. Can J Gastroenterol Hepatol 2017; 2017:3268650. [PMID: 28529936 PMCID: PMC5424189 DOI: 10.1155/2017/3268650] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/20/2017] [Indexed: 02/07/2023] Open
Abstract
Background and Aims. The lived experience of HCV has not been well documented in the literature. The aim of this systematic review was to understand the experiences of living with Hepatitis C Virus (HCV). Methods. Five databases were searched from inception until January 19, 2015. Studies were included if they focused on adults diagnosed with HCV; reported experience living with HCV; and described original research. Results. 46 studies were included. Studies found that participants had reduced quality of life due to physical symptoms. Due to physical symptoms and discrimination, many participants switched to part-time work or quit their jobs. Many individuals reported negative experiences with the healthcare system; themes of feeling unsupported, not having adequate information, and not feeling involved in decisions were reported. Stigma significantly impacted those living with HCV. Conclusions. Published literature indicates that those with HCV often feel stigmatized and unsupported in their care, relationships, and work environments, while simultaneously coping with physical and psychological symptoms. This synthesis points to areas where greater education, compassion, and patient-centered healthcare could improve the experience of people living with HCV.
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Health-Related Quality of Life for individuals with hepatitis C: A narrative review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:936-49. [DOI: 10.1016/j.drugpo.2015.04.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/10/2015] [Accepted: 04/24/2015] [Indexed: 02/06/2023]
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Jones L, Atkinson A, Bates G, McCoy E, Porcellato L, Beynon C, McVeigh J, Bellis MA. Views and experiences of hepatitis C testing and diagnosis among people who inject drugs: systematic review of qualitative research. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 25:204-11. [PMID: 24332457 DOI: 10.1016/j.drugpo.2013.11.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 10/30/2013] [Accepted: 11/11/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many 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. METHODS Based 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. RESULTS 28 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. CONCLUSION This 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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Affiliation(s)
- L Jones
- Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
| | - A Atkinson
- Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - G Bates
- Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - E McCoy
- Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - L Porcellato
- Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - C Beynon
- Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - J McVeigh
- Centre for Public Health, Faculty of Education, Health and Community, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - M A Bellis
- Public Health Wales, Haydn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK
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Olsen A, Banwell C, Dance P. Reinforced biographies among women living with hepatitis C. QUALITATIVE HEALTH RESEARCH 2013; 23:531-540. [PMID: 23258115 DOI: 10.1177/1049732312469730] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In a growing body of social research it is suggested that hepatitis C virus (HCV) infection is a low priority for people who inject drugs. We expand on the evidence to explore the link between identity and health using biographical adaptation theories. We examined experiences of HCV infection and illness among women who inject drugs, women who are no longer injecting drugs, and women who have never injected drugs. We investigated the relationship between identity and illness experience and found that illness does not simply dislocate one's biographical trajectory. For women who used drugs the shared symbolism of HCV infection was understood and accepted via a self-identity linked to poverty and experience of injecting drugs. Rather than disrupting their expected life trajectory, the narratives of most women incorporated the disease experience within their life story, confirming their identity as a person who injected drugs and as someone with constant and serious life stressors.
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Affiliation(s)
- Anna Olsen
- University of New South Wales, Sydney, Australia.
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Copeland L, Robertson J, McKenzie J, Kimber J, Macleod J, Hickman M, de Angelis D. Premature mortality in Scottish injecting drug users: a life-history approach. Scott Med J 2012; 57:38-42. [PMID: 22408214 DOI: 10.1258/smj.2011.011289] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Scotland, deaths in drug users are known to be higher than in the rest of the UK and most of Europe. Reducing drug-related deaths is currently a national priority for the Scottish Government. This study aimed to present a description of the life histories of a group of injecting drug users who have recently died, with a view to highlighting areas for further research. The Edinburgh Addiction Cohort study recently carried out 432 follow-up interviews between the years 2005 and 2007. Thirty-three cases who completed this extensive interview detailing early life, education, employment, drug use, opiate substitution treatment, criminal history, mental health problems and overdose have subsequently died, leaving this source of rich information about their lives. The design of the interview used the life grid approach. Information was also compiled from full primary care records and General Register Office death certificates. Early life adversity was apparent for many cases, with a steady progression into early criminal behaviour and drug misuse. Poor adult life outcomes illustrated the lifelong damaging effects of drug injecting. Death occurred significantly earlier than in the general population or those living in deprived communities who did not use drugs. In conclusion, a clearer understanding of the life histories of problem drug users would be advantageous for health-care professionals and policy-makers. More qualitative research studies are needed to highlight areas which might require early intervention and also complement the existing secondary data studies.
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Affiliation(s)
- L Copeland
- Muirhouse Medical Group, 1 Muirhouse Avenue, Edinburgh EH4 4PL, Scotland, UK.
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Jost JJ, Goldsamt LA, Harocopos A, Kobrak P, Clatts MC. Hepatitis C knowledge among new injection drug users. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687630902858948] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Treloar C, Rhodes T. The lived experience of hepatitis C and its treatment among injecting drug users: qualitative synthesis. QUALITATIVE HEALTH RESEARCH 2009; 19:1321-1334. [PMID: 19690211 DOI: 10.1177/1049732309341656] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Hepatitis C virus infection is a stigmatized condition because of its close association with injecting drug use. There is a need to explore how people who inject drugs (IDUs) perceive hepatitis C, including in relation to treatment experience. We undertook a review, using a qualitative synthesis approach, of English-language qualitative research focusing on the lived experience of hepatitis C among IDUs. The review included 25 published articles representing 20 unique studies. A synthesis of this literature generated three interplaying themes: social stigma, biographical adaptation, and medical and treatment encounters. Interactions with health systems can reproduce stigma linked to drug injecting and hepatitis C, as well as trivialize the lived experience of diagnosis and illness. Hepatitis C can be biographically reinforcing of socially accommodated risk and spoiled identity, as well as disruptive to everyday life. We hypothesize hepatitis C as a liminal illness experience, oscillating between trivial and serious, normalized and stigmatized, public and personal. We conclude by emphasizing the disconnects between the lived experience of hepatitis C among IDUs and Western health care system responses.
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Affiliation(s)
- Carla Treloar
- The University of New South Wales, New South Wales, Australia
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Rhodes T, Treloar C. The social production of hepatitis C risk among injecting drug users: a qualitative synthesis. Addiction 2008; 103:1593-603. [PMID: 18821870 DOI: 10.1111/j.1360-0443.2008.02306.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Intervention impact on reductions in hepatitis C virus (HCV) incidence among injecting drug users (IDUs) are modest. There is a need to explore how drug injectors' interpret HCV risk. AIMS To review English-language qualitative empirical studies of HCV risk among IDUs. METHODS Qualitative synthesis using a meta-ethnographic approach. Searching of eight electronic databases and reference lists identified manually papers in peer-reviewed journals since 2000. Only studies investigating IDU perspectives on HCV risk were included. Themes across studies were identified systematically and compared, leading to a synthesis of second- and third-order constructs. FINDINGS We included 31 papers, representing 24 studies among over 1000 IDUs. Seven themes were generated: risk ubiquity; relative viral risk; knowledge uncertainty; hygiene and the body; trust and intimacy; risk environment; and the individualization of risk responsibility. Evidence supports a perception of HCV as a risk accepted rather than avoided. HCV was perceived largely as socially accommodated and expected, and in relative terms to human immunodeficiency virus (HIV) as the 'master status' of viral dangers. Symbolic knowledge systems, rather than biomedical risk calculus, and especially narratives of hygiene and trust, played a primary role in shaping interpretations of HCV risk. Critical factors in the risk environment included policing, homelessness and gendered risk. CONCLUSIONS Appealing to risk calculus alone is insufficient. Interventions should build upon the salience of hygiene and trust narratives in HCV risk rationality, and foster community changes towards the perceived preventability of HCV. Structural interventions in harm reduction should target policing, homelessness and gendered risk.
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Affiliation(s)
- Tim Rhodes
- Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine, University of London, London, UK.
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Roy É, Nonn É, Haley N, Cox J. Hepatitis C meanings and preventive strategies among street-involved young injection drug users in Montréal. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2007; 18:397-405. [DOI: 10.1016/j.drugpo.2007.02.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Revised: 02/02/2007] [Accepted: 02/12/2007] [Indexed: 12/11/2022]
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Tilden B, Charman D, Sharples J, Fosbury J. Identity and adherence in a diabetes patient: transformations in psychotherapy. QUALITATIVE HEALTH RESEARCH 2005; 15:312-324. [PMID: 15761102 DOI: 10.1177/1049732304272965] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The authors present the case study of a 26-year-old woman who developed diabetes in early adolescence and who attended seven CAT sessions. They used phenomenology to analyze therapy transcripts, case notes, and a reflexive journal and extract the major themes. The client's identity had been overshadowed by the development of a "diabetic identity" that the client rejected. Poor adherence was linked to the rejection. Motivation to manage her diabetes changed during the CAT sessions once her identity was confirmed as being separate from her diabetes. The client was then able to integrate diabetes into her life. Psychological and psychosocial factors are linked in complex ways, in both the personal development of adolescents with diabetes and their transition to adulthood. Understanding the impact of diabetes on identity can enhance the effectiveness of therapeutic interventions with nonadhering clients.
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