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Bui H, Zablotska-Manos I, Hammoud M, Jin F, Lea T, Bourne A, Iversen J, Bath N, Grierson J, Degenhardt L, Prestage G, Maher L. Prevalence and correlates of recent injecting drug use among gay and bisexual men in Australia: Results from the FLUX study. International Journal of Drug Policy 2018; 55:222-230. [DOI: 10.1016/j.drugpo.2018.01.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/12/2018] [Accepted: 01/26/2018] [Indexed: 10/18/2022]
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Alavi M, Micallef M, Fortier E, Dunlop AJ, Balcomb AC, Day CA, Treloar C, Bath N, Haber PS, Dore GJ, Grebely J. Effect of treatment willingness on specialist assessment and treatment uptake for hepatitis C virus infection among people who use drugs: the ETHOS study. J Viral Hepat 2015; 22:914-25. [PMID: 25996567 DOI: 10.1111/jvh.12415] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/01/2015] [Indexed: 12/13/2022]
Abstract
Among people who inject drugs (PWID) with chronic HCV, the association between HCV treatment willingness and intent, and HCV specialist assessment and treatment were evaluated. The Enhancing Treatment for Hepatitis C in Opioid Substitution Settings (ETHOS) is a prospective observational cohort. Recruitment was through six opioid substitution treatment clinics, two community health centres and one Aboriginal community controlled health organisation in Australia. Analyses were performed using logistic regression. Among 415 participants (mean age 41 years, 71% male), 67% were 'definitely willing' to receive HCV treatment and 70% reported plans to initiate therapy 12 months postenrolment. Those definitely willing to receive HCV treatment were more likely to undergo specialist assessment (64% vs 32%, P < 0.001) and initiate therapy (36% vs 9%, P < 0.001), compared to those with lower treatment willingness. Those with early HCV treatment plans were more likely to undergo specialist assessment (65% vs 27%, P < 0.001) and initiate therapy (36% vs 5%, P < 0.001), compared to those without early plans. In adjusted analyses, HCV treatment willingness independently predicted specialist assessment (aOR 3.06, 95% CI 1.90, 4.94) and treatment uptake (aOR 4.33, 95% CI 2.14, 8.76). In adjusted analysis, having early HCV treatment plans independently predicted specialist assessment (aOR 4.38, 95% CI 2.63, 7.29) and treatment uptake (aOR 9.79, 95% CI 3.70, 25.93). HCV treatment willingness was high and predicted specialist assessment and treatment. Strategies for enhanced HCV care should be developed with an initial focus on people willing to receive treatment and to increase treatment willingness among those less willing.
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Affiliation(s)
- M Alavi
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - M Micallef
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - E Fortier
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,Université de Montréal, Montréal, QC, Canada
| | - A J Dunlop
- University of Newcastle, Newcastle, NSW, Australia.,Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - A C Balcomb
- Clinic 96, Kite St Community Health Centre, Orange, NSW, Australia
| | - C A Day
- Drug Health Service, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - C Treloar
- Centre for Social Research in Health, The University of New South Wales, Sydney, NSW, Australia
| | - N Bath
- NSW Users & AIDS Association, Inc., Sydney, NSW, Australia
| | - P S Haber
- Drug Health Service, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - G J Dore
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - J Grebely
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Marshall AD, Micallef M, Erratt A, Telenta J, Treloar C, Everingham H, Jones SC, Bath N, How-Chow D, Byrne J, Harvey P, Dunlop A, Jauncey M, Read P, Collie T, Dore GJ, Grebely J. Liver disease knowledge and acceptability of non-invasive liver fibrosis assessment among people who inject drugs in the drug and alcohol setting: The LiveRLife Study. Int J Drug Policy 2015; 26:984-91. [PMID: 26256938 DOI: 10.1016/j.drugpo.2015.07.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/19/2015] [Accepted: 07/07/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this study was to assess factors associated with baseline knowledge of HCV and liver disease, acceptability of transient elastography (TE) assessment (FibroScan(®)), and willingness and intent to receive HCV treatment among persons with a history of injection drug use participating in a liver health promotion campaign. METHODS The LiveRLife campaign involved three phases: (1) campaign resource development; (2) campaign resource testing; and (3) campaign implementation. Participants were enrolled in an observational cohort study with recruitment at four clinics - one primary health care facility, two OST clinics, and one medically supervised injecting centre - in Australia between May and October 2014. Participants received educational material, nurse clinical assessment, TE assessment, dried blood spot testing, and completed a knowledge survey. RESULTS Of 253 participants (mean age 43 years), 68% were male, 71% had injected in the past month, and 75% self-reported as HCV positive. Median knowledge score was 16/23. In adjusted analysis, less than daily injection (AOR 5.01; 95% CI, 2.64-9.51) and no daily injection in the past month (AOR 3.54; 95% CI, 1.80-6.94) were associated with high knowledge (≥16). TE was the most preferred method both pre- (66%) and post-TE (89%) compared to liver biopsy and blood sample. Eighty-eight percent were 'definitely willing' or 'somewhat willing' to receive HCV treatment, and 56% intended to start treatment in the next 12 months. Approximately 68% had no/mild fibrosis (F0/F1, ≥2.5 to ≤7.4kPa), 13% moderate fibrosis (F2, ≥7.5 to ≤9.4kPa), 10% severe fibrosis (F3, ≥9.5 to ≤12.4kPa), and 9% had cirrhosis (F4, ≥12.5kPa). CONCLUSION Liver disease and HCV knowledge was moderate. High acceptability of TE by PWID provides strong evidence for the inclusion of TE in HCV-related care, and could help to prioritise HCV treatment for those at greatest risk of liver disease progression.
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Affiliation(s)
- A D Marshall
- The Kirby Institute, UNSW Australia, NSW, Australia.
| | - M Micallef
- The Kirby Institute, UNSW Australia, NSW, Australia
| | - A Erratt
- The Kirby Institute, UNSW Australia, NSW, Australia
| | - J Telenta
- Centre for Health and Social Research, Australian Catholic University, VIC, Australia
| | - C Treloar
- Centre for Social Research in Health, UNSW Australia, NSW, Australia
| | - H Everingham
- NSW Users and AIDS Association, Inc., NSW, Australia
| | - S C Jones
- Centre for Health and Social Research, Australian Catholic University, VIC, Australia
| | - N Bath
- NSW Users and AIDS Association, Inc., NSW, Australia
| | - D How-Chow
- St Vincent's Hospital Sydney, NSW, Australia
| | - J Byrne
- Australian Injecting and Illicit Drug Users League, ACT, Australia
| | | | - A Dunlop
- University of Newcastle, Newcastle, NSW, Australia; Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - M Jauncey
- Australian Injecting and Illicit Drug Users League, ACT, Australia
| | - P Read
- The Kirby Institute, UNSW Australia, NSW, Australia; Kirketon Road Centre, NSW, Australia
| | - T Collie
- Coffs Harbour Drug and Alcohol Service, NSW, Australia
| | - G J Dore
- The Kirby Institute, UNSW Australia, NSW, Australia
| | - J Grebely
- The Kirby Institute, UNSW Australia, NSW, Australia
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