People Who Are Too Often Left Behind

In the data I have read over the years, looking at the people living with hep C in my part of the world, there is a large group who has never had more than a single antibody test. When a confirmatory test (RNA) is not done to determine that people have chronic hep C (CHC), we see a huge drop-off in numbers moving on to receive the care they need. Now, with RNA reflex testing in place, this will help some with the linkage to care piece, and anything that can be made to be less a barrier will help as well, and it does help.

The dangers of stigmatizing hepatitis C

The numbers have always shown much the same, and no surprise, considering the demographic in this group (cohort). No, not the Baby Boomers, who when tested generally are able to secure care and treatment. Although when we look at different target populations, we do see some overlap, and some will certainly fall into the Boomer cohort as much as any other demographic that has been identified as part of a public health approach to identifying target groups of people. Like we have said, no one demographic is more deserving, but the people who are facing barriers to care like stigma over drug use, poverty, or a list of reasons why people are able to access guilt and judgement free care for what is too often a traumatized group.

Many are demonized and refused care because of their substance use. Healthcare providers and more broadly society should not doom people to added trauma or create barriers that punish, when what people need is help.

Improving access to treatment

People who are unlikely to have reasonable access to healthcare are less likely to be started in hep C treatment or reach SVR/cured. The numbers are quite alarming to anyone not aware of just how bad it is. Many falls into the ranks of the homeless, but not all. Some are currently using substances and are dealing with a list of issues that make it all but impossible for them to access and retain care and stay in care. Again, the power of lived experience has a role; When possible, peers can assist in outreach that provides relevant information and any supports that are given in a respectful and safe way.

In my own observations, a really important part of helping people who are disengaged with care is outreach. Unfortunately, this does not exist everywhere it is needed. Proven to help in engagements and retention to help in harm reduction, it is also a proven way to help in providing much needed healthcare services. Improving access to healthcare is one piece in a larger collection of ways we can help, and perhaps you feel like there is nothing you can do as a person in need of care, but there is in most cases. There are a number or community groups who you can reach out to for help, and please don’t hesitate to ask for help. Help is something we can all use now and again, and if you need some, reach out!