applied strategic

Pilot study of awareness and access to new treatments for hepatitis c in persons

with a history of drug injecting

Mark Gilman, Richard Littlewood

1320hr, 27 May 2016

EUROPAD May 2016

Note

• This presentation highlights the work done by applied strategic in the area of understanding treatment engagement for people with a history of injecting drugs and HCV

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Introduction

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• This work aimed to describe the current status of knowledge and access to therapy for hepatitis C in the population with a history of intravenous drug injecting and an associated higher risk for hepatitis C infection

Opening remarks

• Hepatitis C (HCV) infection is associated with long-term liver damage and cancer.

• People with history of injecting drug use are at increased risk for HCV infection as a result of risk behaviour

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Starting point: HCV is prevalent in people with a history of injecting drugs

ES IT DE FR UK

80

65 6560

50

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HCV prevalence among people with history of injecting drugs across

big 5 European countries (%)

Additional EU countries: Portugal 80%; Sweden 80%; Finland 80%; Denmark 75%; Norway 70%; Switzerland 60%; Austria 40%

1 to 1.5M in big 5 EU countries have a “current” history of injecting drugs

IT FR UK DE ES

0.4

0.3 0.3

0.20.15

applied strategic 6*Additional EU countries: Portugal 0.03M; Sweden 0.025M; Finland 0.006M; Denmark 0.015M; Norway 0.01M; Switzerland 0.015M; Austria 0.02M

Estimated number of persons with a current (within 1 year) history of injecting drugs

across big 5 EU countries (M)

Method: 38 people with history of drug injecting were surveyed

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Study population

Data collection and analysis

• Participants at the European Conference for Narcotics Anonymous, August 2015

• N=38: Exclusion criteria included never having injected drugs during their lifetime

• Interviewees were currently long-term abstinent with history of injecting drug use

• Facilitated online survey

Results: demographic data (1)

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• 38 of 40 people asked agreed to participate

• Average age was 47 years• 74% were male

Results: demographic data (2)

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• All reported injecting drugs in the past; all persons had ceased injecting drugs.

• 71% reported a drug injecting history of >5 years.

• Majority (92%) reported sharing drug injection equipment at least once

• All persons were aware of their HCV status; 11% were HCV positive

Results: disease awareness

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• HCV disease awareness is high - 71% of people surveyed reported they felt

they had sufficient HCV disease knowledge

Results: treatment awareness

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• HCV treatment awareness is high - 89% recognised IFN as treatment for

HCV • Knowledge of new HCV therapies was

comparatively low- 14-34% recognised names of recently

approved HCV treatments

Results: access to treatment

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• Access to treatment is variable - 50% could find information on new HCV

treatments- 65% considered it difficult to gain access

to new treatments

“I understand enough about hepatitis C infection and the consequences it may cause”

1.8

Test statement

Results: level of HCV knowledge in people with a history of injecting drugs

Strongly agree

Strongly disagree

Responses (n=38)

“I think it is important for people who have a hepatitis C infection to get treatment”

1.1

Test statement

Results: value of treatment

Strongly agree

Strongly disagree

Responses (n=38)

“Currently, it is difficult for people with a history of injecting drug use to engage with services for hepatitis C treatment”

4.2

Test statement

Results: treatment access

Strongly agree

Strongly disagree

Responses (n=38)

Conclusions & Recommendations

• In this population with high HCV risk there is: - good level of HCV awareness and its long-term

implications - limited knowledge concerning new HCV treatments - restricted access to new HCV therapies

• Outcomes can be improved by increasing awareness and access to new HCV treatments within this target group

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