Table 3 Barriers and Enablers to HCV testing
(Authors), year (Country) | Sample | Method | Barriers | Enablers |
|---|---|---|---|---|
Barocas et al., 2014 [16], United States | n = 362 | Open-ended survey questions | Fear of positive test Low perceived risk Stigma associated with HCV and/or IVDU Lab characteristic Lack of access to transportation Time contraints Lack of knowledge of testing Cost Lack of access to MD/PCP Not having to take initiative Lack of rapport with provider Confidentiality Lack of motivation | Health concerns for self or others High perceived risk Lab characteristic Access to transportation Mobile testing center/SEP Adequate time Knowledge of testing Free testing Access to MD/PCP Not having to take initiative Rapport with provider Confidentiality Motivation |
Coupland et al., 2019 [12], Australia | n = 28 at baseline, 25 at 12 months | Semi-structured interviews | Building trust and willingness to be tested for hepatitis C Making information about HCV testing and treatment salient | |
Harris et al., 2018 [11], UK | n = 48 | In-depth interviews, focus groups and observations | Perceived lack of testing availability Perception of minimal HCV risk Fear of diagnosis and HCV stigma Confusion about the testing and treatment process Aversions to having a venous sample taken Concerns of interferon treatment Desire to move away from a drug user identity Limited psycho-social ‘stability’ Testing could be destabilising if it revealed them to be HCV positive Perception of GPs lack of interest in them and HCV more generally | Intervention timeliness: capitalising on stability and new treatments Personalized and flexible care HCV visability and communication structure Streamlined testing and treatment pathways |
Harris et al., 2014 [10], UK | n = 37 | Qualitative life history research | Fear in relation to diagnosis Apathy regarding mainstream health care services Optimism in relation to risk knowledge Confusion in relation to HCV testing and its consequences | |
Latham et al., 2019 [18], Australia | n = 19 | Semi-structured interview | People and place Rapidity of result return | People and place Method of specimen collection Rapidity of result return |
Phillips et al., 2021, UK | n = 15 | Semi-structured interviews | Lack of stability Stigma Negative discourse around testing and treatment | Trusting client-provider relationship HCV as part of recovery pathways Mitigation of prevous negative experiences of secondary care Positive narratives around HCV care |
Skeer et al., 2018 [17], United States | n = 24 | Interviews | Deservingness of HCV treatment and stigma Perceived lack of referral to HCV treatment or follow up Disincentives around HCV treatment for PWID Perception of need for treatment | |
Tofighi et al., 2020 [15], United States | n = 23 | Interviews | Limited knowledge of HCV Limited access to healhtcare providers addressing HCV Competing priority of use Benign perceptions of HCV infection Limited awareness of the availability of DAAs Cost Inability to locate or receive referrals for screening Physician preferences to not initiate HCV treatment | Accessibility of testing sites |
Ward et al., 2021 [14], United States | n = 20 | Semi-structured interviews | Drug use and lack of social support Challenges to providing peer support | Perception of HCV prevalence within networks Willingness to provide support in social networks |