The eliminate hepatitis C (EC) experience study: baseline characteristics of a cohort of people who inject drugs in Melbourne, Australia

Objectives: Direct-acting antivirals provide an opportunity to eliminate hepatitis C virus (HCV) as a public health threat in Australia, yet barriers to care remain. In this study, we use baseline data from a longitudinal cohort of people who inject drugs to understand differences in participant characteristics and explore experiences of stigma, health service utilisation and health literacy between three care cascade groups. Design: Cross-sectional. Setting: Community and private primary healthcare services in Melbourne, Australia. Participants: Participants completed baseline surveys between 19 September 2018 and 15 December 2020. We recruited 288 participants; the median age was 42 years (IQR: 37-49 years) and 198 (69%) were male. At baseline, 103 (36%) self-reported being € not engaged in testing', 127 (44%) had HCV RNA positivity but were € not engaged in treatment' and 58 (20%) were € engaged in HCV treatment'. Outcome measures: Descriptive statistics were used to present the baseline demographics, health service utilisation and experiences of stigma data. We explored differences in these scales between participant demographics using χ 2 test or fisher's exact tests, and differences between health literacy scores using one-way analysis of variance tests. Results: A majority were in regular contact with multiple health services, and most had previously been identified as at-risk of HCV. In the 12 months preceding baseline, 70% reported any experiences of stigma related to injecting drug use. Assessment of health literacy data identified gaps for those € not engaged in testing' and € not engaged in treatment' across two relevant domains: € ability to appraise health information' and € ability to actively engage with healthcare providers'. Conclusion: In eliminate hepatitis C experience, lower HCV testing and treatment may be explained by experiences of stigmatisation or gaps in health literacy. Enhanced interventions targeting people who inject drugs to promote HCV care are needed.