Monday, June 22, 2015

Qualitative analysis: Perceptions of HCV and decisions to initiate HCV treatment

The common sense model applied to hepatitis C: a qualitative analysis of the impact of disease comparison and witnessed death on hepatitis C illness perception

Stella A. Safo1*, Abigail Batchelder12, Deena Peyser13 and Alain Litwin1

* Corresponding author: Stella A Safo

1 Department of General Internal Medicine, Albert Einstein College of Medicine, 111 East 210 St., Bronx 10467, NY, USA

2 University of California, San Francisco, CA, USA
3 Rutgers University, Newark, NJ, USA

Harm Reduction Journal 2015, 12:20 doi:10.1186/s12954-015-0054-1 Published: 20 June 2015
Abstract (provisional)

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Hepatitis C virus (HCV) accounts for 15,000 deaths in the United States yearly because people living with HCV are not identified in time to seek treatment, are ineligible for or refuse treatment, or face structural impediments to obtaining treatment such as lack of access to health care or lack of insurance. People who inject drugs (PWID) comprise a large proportion—estimates of up to 60–70 %—of current and new HCV infected individuals and face many barriers to completing HCV treatment. 

We conducted 30 qualitative semi-structured interviews of current and former PWID seeking HCV treatment at an opioid-agonist treatment facility in New York City. We used thematic analysis, informed by grounded theory, to examine perceptions of HCV and decisions to initiate HCV treatment. We analyzed the themes that emerged via the common sense model (CSM) of illness perception theoretical framework. 

Using thematic analyses, two major themes emerged related to engagement in HCV treatment. First, participants independently compared HCV to HIV, and in so doing, emphasized the potential fatality of HCV and the need for treatment. Second, participants described witnessing others suffer or die from untreated HCV and expressed how these recollections impacted their desire to undergo treatment themselves. Together, these themes contributed to the way participants perceived HCV and informed their decisions to initiate treatment. Both themes reflect the CSM’s “self-regulation” process, which posits that understanding the causes and consequences of an illness impacts one’s ability to seek treatment to overcome this illness state. 

This paper offers insight into how clinicians can better understand and utilize HCV illness perceptions to evaluate willingness to engage in HCV treatment among PWID considering antiviral treatment modalities.

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