Barreras pragmáticas para acceso a la prueba del VHC. Perspectivas de las personas que usan drogas inyectables y que viven con VIH / Pragmatic barriers for delay in access to HCV testing services: Perspective of People With Injecting Drugs and living with HIV

Varada Jayant Madge, Ruchi Sogarwal Sogarwal, Sunil Mehram

Resumen


Antecedentes: La Hepatitis C (VHC) está surgiendo como un gran problema de salud pública y su co-infección con el VIH está en aumento especialmente en las Personas Con Drogas Inyectables (PWID-People With Injecting Drugs). Las barreras para el retraso en el acceso a los servicios de atención del VHC pueden llevar a una progresión de la enfermedad e impactar en la sociedad a través de la pérdida de fuerza de trabajo productiva.
Objetivo: Esta investigación cualitativa se llevó a cabo para explorar las barreras en el retraso en la toma de pruebas para el VHC entre las PWIDs.
Material y método: Este estudio se realizó en dos distritos de la India, a saber, Imphal (Estado de Manipur) y Amritsar (Estado de Punjab). Participaron un total de 32 PWIDs a través de entrevistas a profundidad (In-Depth Interviews-IDI) y Discusiones de Grupo Focal (Focus Group Discussions (FGD).
Resultados: En su mayoría, las barreras reportadas para el retraso en las pruebas para VHC estuvieron relacionadas con el contexto socioeconómico en el que viven las PWIDs; las inhibiciones para tomar la prueba debido al miedo a un resultado positivo, la falta de disponibilidad de servicios de VHC sobre todo en áreas rurales y remotas, los costos y los largos periodos de espera. El uso de drogas entre las mujeres influyó en el comportamiento de búsqueda de atención.
Conclusión: Las PWIDs enfrentan riesgos significativos de VHC para la salud. Las barreras relacionadas con los sistemas socioeconómicos y de la salud generan una brecha en el cuidado continuo de las PWIDs. Por lo tanto, el papel de apoyo de los proveedores de atención a la salud, la concientización de la hepatitis viral, el cuidado y el apoyo de la familia, son fundamentales para que las PWIDs vivan una vida sana.

Abstract
Background: Hepatitis C Virus (HCV) is emerging as a major public health problem and its co-infection with HIV is on the rise especially in People Who Inject Drugs (PWID). Barriers for delay in accessing services for HCV care may lead to disease progression and impact the society in the form of loss of productive workforce.
Aim: This qualitative research was undertaken to explore the barriers for delay in testing for HCV amongst PWIDs.
Methods and Material: The study was conducted in two districts of India i.e. Imphal (Manipur state) and Amritsar (Punjab state). A total of 32 PWIDs participated through In-Depth Interviews (IDI) and Focus Group Discussions (FGD).
Results: Mostly, the barriers reported for delay in HCV testing were related to socio economic context in which the PWIDs live; inhibitions to get tested due to fear of a positive result, unavailability of HCV services particularly in rural and remote areas, financial costs and long waiting period. Drug use amongst females influenced care seeking behavior.
Conclusion: PWIDs face significant health risks of HCV. The socio economic and health systems related barriers create gap for continuum of care* for PWIDs. Supportive role of the health care providers, awareness on viral hepatitis, care and support from family is thus fundamental to PWIDs living a healthy life.
* The study conceptualized continuum of care as broad array of health care services comprising of health education, awareness on harm reduction practices, access to health care services and home based care.

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