Challenges and Opportunities of Co-Producing Community-Based Healthcare for Hepatitis C and HIV for People who Use Drugs (Preprint)

UNSTRUCTURED People who inject drugs are at increased risk of Hepatitis C (HCV) and human immunodeficiency virus (HIV); unfortunately, traditional healthcare approaches have failed to adequately reach and support this population. Rates of accessing HCV and HIV treatment among individuals who inject drugs are low for a variety of reasons, including negative experiences with healthcare, suggesting a need for novel approaches to testing and healthcare delivery. In this short report we discuss challenges - as well as strategies to navigate these challenges - encountered by a multidisciplinary team of healthcare professionals, community representatives, researchers, and people with lived experience using drugs, in our efforts to co-produce a novel, community-based, peer-led, HIV/HCV testing program with options for immediate linkages to medical providers. We encountered challenges and tensions between team members with varied background in multiple aspects of the project: scoping the project, setting the pace and urgency of the work, navigating payment, defining success, and situating the project for sustainability. Strategies to navigate these challenges included: dedicated effort to building personal and meaningful connections, fostering mutual respect, identifying common ground to make shared decisions, and celebrating small successes. While co-created care presents unique challenges, we believe the resulting program is strengthened by challenging assumptions and carefully considering various perspectives to think creatively and productively about solutions.