Hepatitis C infection, related services, and barriers to HCV treatment among drug users in methadone maintenance treatment (MMT) clinics in Shanghai, China

Harm Reduct J. 2017 Nov 2;14(1):71. doi: 10.1186/s12954-017-0197-3.

Abstract

Background: The purpose of this study was to document the prevalence of hepatitis C among MMT patients, hepatitis C virus (HCV) knowledge of patients and MMT staff members, and the barriers preventing them from receiving or delivering HCV-related services in MMT clinics of China.

Methods: Data were collected from 240 MMT patients and 58 staff members in Shanghai MMT clinics. Structured questionnaires (HCV Knowledge Scale and Alcohol Use Disorders Identification Test) and several self-developed questionnaires were used to assess (1) patient and staff HCV knowledge, (2) attitudes toward HCV-related services in MMT clinics, and (3) what type of HCV-related services the staff members have provided in their routine work. The HCV test results were based on the patients' medical records.

Results: The HCV seropositive rate was high (70%), and both patients and staff had limited HCV knowledge. The mean score of patient HCV knowledge was 6.8 out of 20 (SD = 3.7), whereas the mean score of staff HCV knowledge was 10.9 out of 20 (SD = 3.1). For HCV-positive patients, only 13.7% had accessed HCV medical treatment. Barriers included the cost of medical treatment, lack of HCV knowledge, lack of professional training for patients to receive HCV-related services from individuals or MMT clinics, and lack of an adequate policy-making system.

Conclusions: HCV infection remains an important problem among MMT patients in China. Barriers to HCV-related services are attributable to individual, clinical, and policy-related factors. This study may provide evidence-based information for future work to optimize the resources of MMT clinics.

Trial registration: ClinicalTrials.gov NCT01647191 . Registered 17 April 2012.

Keywords: China; Hepatitis C; Heroin dependent; Methadone maintenance treatment.

MeSH terms

  • Adult
  • Alcoholism / complications
  • Analgesics, Opioid / therapeutic use*
  • China / epidemiology
  • Drug Users*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Hepatitis C / complications*
  • Hepatitis C / epidemiology
  • Hepatitis C / therapy*
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Middle Aged
  • Narcotics*
  • Opiate Substitution Treatment / statistics & numerical data*
  • Prevalence
  • Risk-Taking
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Analgesics, Opioid
  • Narcotics
  • Methadone

Associated data

  • ClinicalTrials.gov/NCT01647191