173442 Access to health care for homeless people with hepatitis C in Toronto, Canada

Tuesday, October 28, 2008: 9:30 AM

Kate S. Mason, MHSc , Street Health, Toronto, ON, Canada
Erika Khandor, MHSc , Street Health, Toronto, ON, Canada

Homeless people experience higher rates of Hepatitis C (HCV) than the general population and often experience difficulties obtaining health care, few studies have examined HCV-positive homeless people's access to care. The objective of this study was to examine health and health care access among homeless adults in Toronto, Ontario who reported having HCV.


A representative random sample of 368 homeless adults in Toronto were interviewed about their health and health care access. Study findings are based on the 83 participants (23% of all homeless people interviewed) who reported having HCV.


Homeless people with HCV reported higher levels of chronic pain (61%), life stress (47%) and low energy (72%), than other homeless people. HCV respondents report much higher rates of HIV (7%), heart disease (13%) and liver problems other than HCV (37%). Injection drug use was reported by 48% and use of crack cocaine was reported by 77%.

A key indicator of health care access, 26% of homeless people with HCV reported no usual source of health care. Within the last year, 40% reported being refused health services and 61% reported experiencing discrimination by a health care provider.


Findings indicated that homeless people with HCV have much poorer health than other homeless people and face many barriers to accessing health care. High rates of substance use and discrimination by health care providers on the basis of drug use among people with HCV in our sample indicate a need for harm reduction models of health care.

Learning Objectives:
1.Describe key barriers to accessing to health care for homeless people with Hepatitis C in Toronto, Canada 2. Asses an effective harm reduction model of health care for homeless and marginalized who are Hep C positive 3. Apply our community-based approach to survey research (which included extensive partnerships and collaboration, the involvement of peer researchers, the development of policy recommendations, and advocacy to address homelessness and health issues)to other homelessness and health research

Keywords: Homeless Health Care, Hepatitis C

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted each stage of the research study being submitted for presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.