"It's easier to do stuff that's hard when you've got people to back you:" Hepatitis C Peer Education & Support in an Opioid Treatment Program

Issues: Hepatitis C (HCV) is the most prevalent chronic disease among injection drug users, yet relatively few have been treated. Co-morbid psychiatric illness, fragmentation of care, low social support, and concerns about adverse effects are significant barriers to evaluation and treatment. Integrating HCV treatment into opioid treatment programs is an effective way to engage current or former drug users in care. Utilizing peer education and support may reduce barriers to treatment and facilitate engagement with medical care. Description: We established a formal HCV Peer Education & Support Program in our opioid treatment programs in the Bronx to enhance existing on-site treatment of HCV. All of our HCV peer educators (25) have been patients in our opioid treatment programs, received treatment for HCV, completed a formal educational curriculum and receive ongoing education and supervision. Peer educators provide direct patient support, escort patients to off-site liver biopsies and other procedures, co-facilitate support and treatment groups, conduct outreach, and participate in advocacy efforts. Lessons Learned: Case vignettes illustrate ways in which peer involvement increases on-site engagement with HCV care, including evaluation and treatment. Patients reported having less fear about initiating treatment, more motivation to continue treatment, and feeling supported by others. Peer involvement mitigates patient concerns about HCV and its treatment, and empowers both peer educators and patients. Recommendations: Peer education and support programs are essential elements of integrating HCV care in opioid treatment programs. This innovative peer program effectively engages patients and may be a model of care for other chronic diseases.