HCV Bilgi Eksiklikleri, Indiana'daki Madde Kullananlarda Enfeksiyon Oranlarıyla İlişkili

Özet (abstract)

Hepatitis C virus (HCV) elimination requires both treatment scale-up and prevention, yet knowledge deficits among people who use drugs (PWUD) may undermine both. Situated within the Information-Motivation-Behavioral Skills (IMB) framework, this study examines whether HCV-specific knowledge is independently associated with HCV-positive status among a multiply marginalized population of PWUD in Indiana, a state with documented HCV vulnerability stemming from the 2015 Scott County outbreak and ongoing injection drug use epidemic. Cross-sectional online survey data were collected from 167 PWUD (Indiana residents, > = 18 years) in 2022. After excluding four respondents without HCV test results, 163 were included in serostatus analyses; the primary complete-case regression included 161 participants after excluding two participants with missing housing status. An 11-item HCV knowledge scale was administered and evaluated for internal consistency using Cronbach's alpha and corrected item-total correlations. One item demonstrated a negative item-total correlation (r = − 0.137) and no discriminative value by HCV status; following standard psychometric practice, it was excluded, yielding a refined 10-item scale (alpha = 0.766) used in all primary analyses. The 11-item scale (alpha = 0.696) was retained for sensitivity analysis. Multivariable logistic regression examined the association between knowledge score and HCV-positive status, adjusting for LGB identity, housing instability, sex, race, and age. 43.6% of participants with known serostatus tested HCV-positive. In the full sample, 22.4% of participants with available housing data reported observed unstable housing, 75.4% reported injection drug use, and 17.4% identified as LGB. HCV-positive participants scored significantly lower on the 10-item knowledge scale (M = 7.37 vs. 8.87 out of 10; Mann-Whitney U = 1,822, p < .001, r = .44). In adjusted complete-case models ( N = 161), each one-point increase in knowledge score was associated with 30% lower odds of HCV-positive status (aOR = 0.70, 95% CI 0.58–0.86, p < .001). Findings were essentially identical in the 11-item sensitivity analysis (aOR = 0.69, 95% CI 0.57–0.85, p < .001). LGB identity was independently associated with higher odds of HCV-positive status (aOR = 3.79, 95% CI 1.43–10.04, p = .007). Among HCV-positive participants, 50.7% were currently in treatment, 19.7% remained diagnosed but untreated, and 14.7% had achieved a cure. The most pronounced knowledge gaps concerned HCV chronicity (53.5% vs. 91.3% correct) and non-transmission via kissing (49.3% vs. 85.9%). Lower HCV knowledge is strongly and independently associated with HCV-positive status in this marginalized sample, a finding that is robust across both the 10- and 11-item versions of the knowledge scale. Targeted education correcting specific misconceptions about chronicity and non-transmission routes, embedded in harm reduction infrastructure alongside LGB-affirming care and expanded DAA financing, may meaningfully advance Indiana’s micro-elimination goals. Future administrations should use the refined 10-item scale prospectively.

Yazarların özeti; kaynağından alınmıştır. Harm Reduction Journal, 2026 · DOI ↗