A W Batchelder1, D Peyser2, S Nahvi3, J H Arnsten4, A H Litwin5. 1. Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA; Osher Center for Integrative Medicine, University of San Francisco, San Francisco, 1545 Divisadero Street, 3rd Floor, San Francisco, CA 94115, USA. Electronic address: abigail.batchelder@ucsf.edu. 2. Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA; Center for Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, USA. Electronic address: dpeyser@gmail.com. 3. Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA. Electronic address: snahvi@montefiore.org. 4. Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA. Electronic address: jarnsten@montefiore.org. 5. Einstein-Montefiore Division of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA. Electronic address: alitwin@montefiore.org.
Abstract
BACKGROUND: Hepatitis C (HCV) is a significant public health problem that primarily affects current and former substance users. However, individuals with a history of substance use are less likely to have access to or engage in HCV care. Psychological and behavioral barriers prevent many HCV-infected individuals from initiating or engaging in HCV treatment. This study aimed to investigate the psychological and behavioral experiences of current and former substance users receiving HCV treatment within a combined methadone and primary care clinic in the United States. METHODS: We conducted 31 semi-structured qualitative interviews with opioid-dependent adults enrolled in an integrated HCV treatment program within a methadone maintenance clinic in the Bronx, NY. We used thematic analysis, informed by grounded theory, and inquired about perceptions of HCV before and after initiating HCV treatment, reasons for initiating HCV treatment, and the decision to participate in individual versus group HCV treatment. RESULTS: Participants described psychological and behavioral transformation over the course of HCV treatment. These included reductions in internalized stigma and shame related to HCV and addiction, increases in HCV disclosure and self-care, reductions in substance use, and new desire to help others who are living with HCV. CONCLUSIONS: Integrating HCV treatment with methadone maintenance has the potential to create psychological and behavioral transformations among substance using adults, including reductions in HCV- and addiction-related shame and improvements in overall self-care.
BACKGROUND:Hepatitis C (HCV) is a significant public health problem that primarily affects current and former substance users. However, individuals with a history of substance use are less likely to have access to or engage in HCV care. Psychological and behavioral barriers prevent many HCV-infected individuals from initiating or engaging in HCV treatment. This study aimed to investigate the psychological and behavioral experiences of current and former substance users receiving HCV treatment within a combined methadone and primary care clinic in the United States. METHODS: We conducted 31 semi-structured qualitative interviews with opioid-dependent adults enrolled in an integrated HCV treatment program within a methadone maintenance clinic in the Bronx, NY. We used thematic analysis, informed by grounded theory, and inquired about perceptions of HCV before and after initiating HCV treatment, reasons for initiating HCV treatment, and the decision to participate in individual versus group HCV treatment. RESULTS:Participants described psychological and behavioral transformation over the course of HCV treatment. These included reductions in internalized stigma and shame related to HCV and addiction, increases in HCV disclosure and self-care, reductions in substance use, and new desire to help others who are living with HCV. CONCLUSIONS: Integrating HCV treatment with methadone maintenance has the potential to create psychological and behavioral transformations among substance using adults, including reductions in HCV- and addiction-related shame and improvements in overall self-care.
Authors: Alain H Litwin; Kenneth A Harris; Shadi Nahvi; Philippe J Zamor; Irene J Soloway; Peter L Tenore; Daniel Kaswan; Marc N Gourevitch; Julia H Arnsten Journal: J Subst Abuse Treat Date: 2008-11-28
Authors: Thijs J W van de Laar; Richard Molenkamp; Charlotte van den Berg; Janke Schinkel; Marcel G H M Beld; Maria Prins; Roel A Coutinho; Sylvia M Bruisten Journal: J Hepatol Date: 2009-06-18 Impact factor: 25.083
Authors: Abigail W Batchelder; Judith T Moskowitz; Jennifer Jain; Michael Cohn; Maya A Earle; Adam W Carrico Journal: Cogn Behav Pract Date: 2019-04-16
Authors: Erin Mandel; Claire E Kendall; Kate Mason; Mary Guyton; Bernadette Lettner; Jennifer Broad; Jason Altenberg; Jessy Donelle; Jeff Powis Journal: Can Liver J Date: 2020-06-04
Authors: Mandy D Owens; George N Ioannou; Judith L Tsui; E Jennifer Edelman; Preston A Greene; Emily C Williams Journal: Drug Alcohol Depend Date: 2018-05-08 Impact factor: 4.492
Authors: Daniel Winetsky; Daniel Burack; Pantelis Antoniou; Bill Garcia; Peter Gordon; Matthew Scherer Journal: J Infect Dis Date: 2020-09-02 Impact factor: 5.226
Authors: Alice K Asher; Carmen J Portillo; Bruce A Cooper; Carol Dawson-Rose; David Vlahov; Kimberly A Page Journal: Subst Use Misuse Date: 2016-05-24 Impact factor: 2.164
Authors: Oluwaseun Falade-Nwulia; Kathleen M Ward; Sean McCormick; Shruti H Mehta; Stephanie R Pitts; Stephanie Katz; Geetanjali Chander; David L Thomas; Mark Sulkowski; Carl A Latkin Journal: J Viral Hepat Date: 2020-03-02 Impact factor: 3.517