Drug users (DU) are a marginalized group and at risk for viral hepatitis, who seldom access health services. A cross-sectional survey was conducted with 111 DU with chronic HBV/HCV and 15 in-depth interviews with health professionals/ policymakers in Rio de Janeiro, Brazil. Most interviewees were male, non-white, with a low educational background, unemployed and/or living on less than $245 a month (minimum wage). In the last 6 months, 61.8% of interviewees snorted cocaine, 64.7% at least once a week. Half of the interviewees had a stable partner and 38.3% of those with occasional partners never/almost never using condoms. Addiction treatment seeking was found to be associated with: being white (OR:5.5), high-school degree (OR:8.7), and employment (OR:5.7). Hepatitis treatment seeking was high (80.9%), and access to low-threshold, user-friendly health services was key for treatment seeking behaviors (OR:3.6). Missed opportunities for hepatitis treatment seem to be associated with structural (uneven political/financial support to hepatitis programs) and patient-related barriers (severe addiction and non-adherence). Those most in need were less likely to access treatment, calling for renewed strategies, in order to curb hepatitis among impoverished drug users and their sexual partners.
Malta, M., Cavalcanti, S., Gliksman, L., Adlaf, E., Hacker, M. de A. V. B., Bertoni, N., … Bastos, F. I. (2011). Behavior and major barriers faced by non-injectable drug users with HBV/HCV seeking treatment for hepatitis and drug addiction in Rio de Janeiro, Brazil. Ciencia e Saude Coletiva, 16(12), 4777–4786. https://doi.org/10.1590/s1413-81232011001300026