Tackling misconceptions: Hepatitis C treatment for people who use drugs
With the advent of treatments called direct-acting antivirals (DAAs), a huge number of people across Canada have been successfully cured of hepatitis C. However, efforts to cure some of the most affected communities continue to be hindered by incorrect or outdated information. For example, many successes in curing hepatitis C have been achieved through the determination of people who use drugs, and yet they still encounter access barriers due to discrimination and problematic misconceptions around treatment eligibility.
These gaps in knowledge can be addressed by raising awareness about hepatitis C treatment and organizations across Canada have been working to clarify myths about DAAs that still exist among communities affected by hepatitis C and their service providers. To support these efforts, CATIE developed a pop quiz with some common questions about hepatitis C and we put Canadian hepatitis C experts to the test. Some of the answers might surprise you!
Does a person need to quit using drugs or alcohol before starting hepatitis C treatment?
For each of the hepatitis C experts, the answer to this question was a firm “no”. Canadian guidelines recommend that all people with hepatitis C should be offered treatment – that includes people who use drugs, regardless of whether they plan to continue, reduce or stop using substances.
True or false: A person who gets hepatitis C a second time can be treated again?
True, a person can be treated again for hepatitis C. The most common route of hepatitis C transmission in Canada is sharing equipment used to inject, smoke and/or snort drugs. Because there is no vaccine to prevent hepatitis C infection, and no one is immune to hepatitis C, people sometimes get reinfected with the virus. The good news is that treatment protocols are the same whether a person is receiving treatment for the first time or for a reinfection. Like the experts assert, people who use drugs should always have access to treatment regardless if the person has previously been treated for hepatitis C or not. Accessing treatment is also a great opportunity to provide counselling on how to prevent reinfection.
How much would a person pay out-of-pocket for hepatitis C treatment?
The answer is zero dollars. In Canada, hepatitis C treatment is now widely available and publicly funded, so most people will not have to pay for it themselves. There is strong evidence to suggest that offering treatment to the most affected groups is the most effective and cost-efficient approach to eliminating hepatitis C.
What is the most significant barrier to accessing hepatitis C treatment in Canada?
Unfortunately, stigma and discrimination faced by people who use drugs are the most significant barriers. This includes structural stigma caused by healthcare system policies and practices, social stigma resulting from stereotypes of people who use drugs, as well as self-stigma that occurs when a person internalizes structural or social stigma. Everyone in healthcare can address stigma and discrimination by ensuring that people who use drugs receive welcoming and respectful services, including when being treated for hepatitis C.
Watch the full pop quiz video here.
Being cured of hepatitis C provides significant health benefits and can be a positive and stabilizing factor in a person’s life. Treating hepatitis C could also be an opportunity to combine additional care and supports to address other underlying health and social issues that align with the person’s personal goals.
So, CATIE and the experts have spoken, but we’ll repeat it again for anyone who may not have heard: people who use drugs should be offered hepatitis C treatment as they are just as likely to cure their hepatitis C as anyone else!
For more information on how service providers can support uptake of hepatitis C treatment, read the CATIE statement on hepatitis C treatment efficacy among people who use drugs.
Romane Close is CATIE’s specialist in resource development and knowledge mobilization.