Values and preferences for hepatitis C self-testing among people who inject drugs in Kyrgyzstan

BMC Infect Dis. 2021 Jun 26;21(1):609. doi: 10.1186/s12879-021-06332-z.

Abstract

Background: The prevalence of hepatitis C virus (HCV) among people who inject drugs (PWID) continues to be a major public-health burden in this highly stigmatised population. To halt transmission of HCV, rapid HCV self-testing kits represent an innovative approach that could enable PWID to know their HCV status and seek treatment. As no HCV test has yet been licenced for self-administration, it is crucial to obtain knowledge around the factors that may deter or foster delivery of HCV self-testing among PWID in resource-constrained countries.

Methods: A qualitative study to assess values and preferences relating to HCV self-testing was conducted in mid-2020 among PWID in the Bishkek and Chui regions of Kyrgyzstan. Forty-seven PWID participated in 15 individual interviews, two group interviews (n = 12) and one participatory action-research session (n = 20). Responses were analysed using a thematic analysis approach with 4 predefined themes: awareness of HCV and current HCV testing experiences, and acceptability and service delivery preferences for HCV self-testing. Informants' insights were analysed using a thematic analysis approach. This research received local ethics approval.

Results: Awareness of HCV is low and currently PWID prefer community-based HCV testing due to stigma encountered in other healthcare settings. HCV self-testing would be accepted and appreciated by PWID. Acceptability may increase if HCV self-testing: was delivered in pharmacies or by harm reduction associations; was free of charge; was oral rather than blood-based; included instructions with images and clear information on the test's accuracy; and was distributed alongside pre- and post-testing counselling with linkage to confirmatory testing support.

Conclusions: HCV self-testing could increase awareness of and more frequent testing for HCV infection among PWID in Kyrgyzstan. It is recommended that peer-driven associations are involved in the delivery of any HCV self-testing. Furthermore, efforts should be maximised to end discrimination against PWID at the healthcare institutions responsible for confirmatory HCV testing and treatment provision.

Keywords: Diagnostics; Formative research; Hepatitis C; Hepatitis C self-testing; Values and preferences.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diagnostic Self Evaluation*
  • Female
  • Harm Reduction
  • Hepacivirus / isolation & purification
  • Hepatitis C / complications
  • Hepatitis C / diagnosis*
  • Hepatitis C / epidemiology
  • Hepatitis C / psychology
  • Humans
  • Kyrgyzstan / epidemiology
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Preference* / psychology
  • Patient Preference* / statistics & numerical data
  • Prevalence
  • Self-Testing
  • Serologic Tests / methods
  • Social Values
  • Substance Abuse, Intravenous* / diagnosis
  • Substance Abuse, Intravenous* / epidemiology
  • Substance Abuse, Intravenous* / psychology
  • Substance Abuse, Intravenous* / virology
  • Surveys and Questionnaires
  • Young Adult