1. 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

2. 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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3. 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

4. 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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5. Starting point: HCV is prevalent in
people with a history of injecting drugs
80
65 65
60
50
ES IT DE FR UK
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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%

6. 1 to 1.5M in big 5 EU countries have a
“current” history of injecting drugs
0.4
0.3 0.3
0.2
0.15
IT FR UK DE ES
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)

7. 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

8. Results: demographic data (1)
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• 38 of 40 people asked agreed to
participate
• Average age was 47 years
• 74% were male

9. 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

10. 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

11. 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

12. 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

13. “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)

14. “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)

15. “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)

16. 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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