Associations of HCV Knowledge and Medical Mistrust with Being Screened for HCV and Offered HCV Treatment among People with HIV
JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED(2021)
Abstract
An estimated one-fourth of people with HIV in the U.S. are coinfected with hepatitis C virus (HCV). We examined patient-related correlates of HCV screening , treatment in a convenience sample of 1,853 HIV-positive adults in Connecticut, Louisiana, New York, North Carolina, Pennsylvania , Texas. Overall, 85.1% reported being screened for HCV, and 30.8% reported ever being offered treatment. In multivariate logistic regres-sions, greater HCV knowledge, lower HCV-related medical mistrust, older age, and prior substance use treatment were associated with higher screening and treatment likelihoods. For screening, Ryan White HIV/ AIDS Program eligibility, having a high school education or less, and identifying as "other" race/ ethnicity were additionally significant. Mistrust, which has arisen as a response to centuries of systemic racism, mediated the association between combined Black/ Latino race/ ethnicity and lower screening likelihood. We recommend patient -level (e.g., peer navigation) and provider interventions to integrate HCV screening and treatment into HIV care.
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Key words
HIV, HCV coinfection, HCV screening, HCV treatment, racial, ethnic disparities
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