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Hepatitis C testing services at drug treatment programs: Challenges and recommendations from the client and staff perspectives

Corrine E. Munoz-Plaza, MPH1, Shiela M. Strauss, PhD2, Janetta Astone, PhD2, Don C. Des Jarlais, PhD3, and Holly Hagan, PhD4. (1) National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, 212.845.4537, munoz-plaza@ndri.org, (2) National Development and Research Institutes, Inc, 71 West 23rd Street, 8th Floor, New York, NY 10010, (3) Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 1st Avenue and 16th Street, New York, NY 10003, (4) NDRI, 71 West 23rd, 8th floor, New York, NY 10010

Many drug users have hepatitis C virus (HCV) infection, but often remain unaware of their infection because they have never been tested for the virus. Drug treatment programs are uniquely situated to test clients for HCV, but little is known about barriers programs face in providing and having clients utilize this much-needed service. This paper presents analyses of qualitative data from 11 drug treatment programs throughout the U.S. regarding staff and clients’ perceptions of these barriers, and their recommendations for enhancing HCV testing services. Staff are primarily concerned about the implications testing HCV positive may have for clients regarding next steps in their health care and consequences to their addiction recovery; lack of definitive or mandated standards for pre- and post-test HCV counseling services; limited financial and community resources; time constraints; and clients’ psychological issues (e.g., denial, stigma). Clients emphasize the need for more comprehensive HCV testing information; increased personal time with medical staff; and lack of confidence in counselors’ HCV knowledge. Recommendations from both clients and staff for improving HCV testing services include (1) expanding the current HIV testing counseling protocol to include HCV testing; (2) standardizing HCV post-test counseling procedures to include clear HCV prevention information for clients who test negative, and comprehensive HCV secondary prevention information and referrals for HCV positive clients; and (3) elevating staff HCV awareness and education. These findings suggest a need to better communicate standards for HCV testing and counseling procedures to treatment programs, including guidelines published by the Centers for Disease Control.

Learning Objectives:

Keywords: Hepatitis C, Substance Abuse Treatment

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Characteristics of Illicit Drug Users Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA