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Barriers and facilitators to Hepatitis C (HCV) Screening and Treatment – A Prisoners’ Perspective

Crowley, C, Van Hout, MC, Lambert, J, Cullen, W, Kelly, E and Murphy, C (2018) Barriers and facilitators to Hepatitis C (HCV) Screening and Treatment – A Prisoners’ Perspective. Harm Reduction Journal. ISSN 1477-7517

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Open Access URL: https://dx.doi.org/10.1186/s12954-018-0269-z (Published version)


Background: Hepatitis C Virus (HCV) infection is a global epidemic with an estimated 71 million people infected worldwide. People who inject drugs (PWID) are over represented in prison populations globally and have higher levels of HCV infection than the general population. Despite increased access to primary health care while in prison, many HCV infected prisoners do not engage with screening or treatment. With recent advances in treatment regimes, HCV in now a curable and preventable disease and prisons provide an ideal opportunity to engage this hard to reach population.
Aim: To identify barriers and enablers to HCV screening and treatment in prisons
Methods: A qualitative study of four prisoner focus groups (n=46) conducted at two prison settings in Dublin, Ireland.
Results: The following barriers to HCV screening and treatment were identified, lack of knowledge, concerns regarding confidentiality and stigma experienced and inconsistent and delayed access to prison health services. Enablers identified included; access to health care, opt-out screening at committal, peer support, and stability of prison life which removed many of the competing priorities associated with life on the outside. Unique blocks and enablers to HCV treatment reported were, fear of treatment and having a liver biopsy, the requirement to go to hospital and in-reach hepatology services and fibroscaning.
Conclusion; The many barriers and enablers to HCV screening and treatment reported by Irish prisoners will inform both national and international public health HCV elimination strategies. Incarceration provides a unique opportunity to upscale HCV treatment and linkage to the community would support effectiveness.

Item Type: Article
Uncontrolled Keywords: 1117 Public Health And Health Services
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine
Divisions: Public Health Institute
Publisher: BMC Biomed Central
Date Deposited: 20 Nov 2018 09:40
Last Modified: 20 Feb 2023 15:57
DOI or ID number: 10.1186/s12954-018-0269-z
URI: https://researchonline.ljmu.ac.uk/id/eprint/9672
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