Table 3.
Perceived barriers to linkage to care for hepatitis C virus infection among treatment-naïve, community-based people who inject drugs in Chennai, India (n = 200).
| Reason for Not Seeking Specialist Care | HCV mono-infected (n = 141) | HIV/HCV co-infected (n = 59) | P value * |
|---|---|---|---|
| Low Perceived Need for Treatment | |||
| Does not feel sick | 92 (65.3) | 20 (33.9) | <0.001 |
| Believes severe liver outcomes are unlikely | 33 (23.4) | 10 (17.0) | 0.311 |
| Poor Perceptions of Treatment | |||
| Needs more information about treatment | 106 (75.2) | 50 (84.8) | 0.136 |
| Afraid of side effects from treatment | 91 (64.5) | 51 (86.4) | 0.002 |
| Wants to avoid interferon injections | 83 (58.9) | 47 (79.7) | 0.005 |
| Competing Interests | |||
| Worried about /busy with money problems | 9 (6.4) | 48 (81.4) | <0.001 |
| Worried about /busy with other health conditions (e.g., HIV) | 0 (0.0) | 56 (94.9) | <0.001 |
| Worried about /busy with reducing drug/alcohol use | 11 (7.8) | 5 (8.5) | 0.873 |
| Provider-level Barriers | |||
| Previously treated badly by providers due to injection drug use | 8 (5.7) | 2 (3.4) | 0.726 |
| Heard about others being treated badly when they went for HCV treatment | 71 (50.4) | 41 (69.5) | 0.013 |
| Systems-level Barriers | |||
| Wants to avoid going to a government hospital for care | 96 (68.1) | 16 (27.1) | <0.001 |
| Can’t afford to pay for care or treatment | 94 (66.7) | 48 (81.4) | 0.037 |
Data are no. (%). This analysis was limited to HCV-infected participants without a history of HCV care or treatment and complete data on perceived barriers.
*
P values were calculated by Pearson’s χ2 tests.
Abbreviations: HCV, hepatitis C virus; HIV, human immunodeficiency virus; IQR, interquartile range.