Canadian Journal of Gastroenterology and Hepatology
Volume 29, Issue 8, 2015, Pages 411-416

Gaps in the hepatitis C continuum of care among sex workers in Vancouver, British Columbia: Implications for voluntary hepatitis C virus testing, treatment and care (Article) (Open Access)

Socías M.E. , Shannon K.* , Montaner J.S. , Guillemi S. , Dobrer S. , Nguyen P. , Goldenberg S. , Deering K.
  • a British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada, Interdisciplinary Studies Graduate Program, Canada
  • b British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada, Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada, School of Population and Public Health, University of British Columbia, Vancouver, Canada
  • c British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada, Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
  • d British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada, Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
  • e British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada
  • f British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada
  • g British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BA, Canada
  • h British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Canada, Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada

Abstract

BACKGROUND: Hepatitis C virus (HCV) eradication leads to reduced morbidity, mortality and transmission. Despite the disproportionate burden of HCV among sex workers, data regarding the HCV care continuum in this population remain negligible. METHODS: Using baseline data from an ongoing cohort of women sex workers in Vancouver (An Evaluation of Sex Workers' Health Access, January 2010 to August 2013), the authors assessed HCV prevalence and engagement in the HCV care continuum within the past year. Multivariable logistic regression analyses were used to evaluate associations with recent (ie, in the past year) HCV testing. RESULTS: Among 705 sex workers, 302 (42.8%) were HCV seropositive. Of these, 22.5% were previously unaware of their HCV status, 41.7% had accessed HCV-related care, 13.9% were offered treatment and only 1.0% received treatment. Among 552 HCV-seronegative sex workers, only one-half (52.9%) reported a recent HCV test. In multivariable analysis, women who self-identified as a sexual/gender minority (adjusted OR [aOR] 1.89 [95% CI 1.11 to 3.24]), resided in the inner city drug use epicentre (aOR 3.19 [95%CI 1.78 to 5.73]) and used injection (aOR 2.00 [95% CI 1.19 to 3.34]) or noninjection drugs (aOR 1.95 [95% CI 1.00 to 3.78]) had increased odds of undergoing a recent HCV test, while immigrant participants (aOR 0.24 [95% CI 0.12 to 0.48]) had decreased odds. CONCLUSIONS: Despite a high burden of HCV among sex workers, large gaps in the HCV care continuum remain. Particularly concerning are the low access to HCV testing, with one-fifth of women living with HCV being previously unaware of their status, and the exceptionally low prevalence of HCV treatment. There is a critical need for further research to better understand and address barriers to engage in the HCV continuum for sex workers. © 2015 Pulsus Group Inc. All rights reserved.

Author Keywords

Women People who use drugs HCV testing HCV treatment Hepatitis C Sex workers

Index Keywords

hepatitis C virus testing patient care Transgender Persons lesbianism Indians, North American Communication Barriers immigrant drinking behavior mass screening demography Homosexuality, Female indigenous people minority group human communication disorder Antiviral Agents Cohort Studies statistics and numerical data priority journal Substance-Related Disorders Hepatitis C virus Hepatitis C, Chronic substance abuse Logistic Models physical violence sex worker American Indian Residence Characteristics condom use Humans migrant bisexuality Minority Groups male Canada Emigrants and Immigrants female transgender risk factor Risk Factors Multivariate Analysis serodiagnosis prostitution peer group prevalence Continuity of Patient Care Article prison Prisons Substance Abuse, Intravenous major clinical study adult gender drug use cohort analysis Disease Management Sex Workers statistical model sexual violence antivirus agent British Columbia health care delivery homelessness Health Services Accessibility hepatitis C
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84957668361&doi=10.1155%2f2015%2f381870&partnerID=40&md5=4d943183a1147d29fccbbee39945093c
DOI: 10.1155/2015/381870
ISSN: 22912789
Cited by: 12
Original Language: English