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1071. Social Determinants of health (SDOH) among PWID living with HCV

BACKGROUND: Though people who inject drugs (PWID) represent the overwhelming majority of those living with HCV, most have not been treated. Many HCV+ PWID represent the most marginalized persons in society, often experiencing poverty and poor access to care. We set out to determine the social determ...

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Autores principales: Corro, Luis Gonzalez, Gutierrez, Nataly Rios, Cunningham, Chinazo O, Litwin, Alain H, Norton, Brianna L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777302/
http://dx.doi.org/10.1093/ofid/ofaa439.1257
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author Corro, Luis Gonzalez
Gutierrez, Nataly Rios
Cunningham, Chinazo O
Litwin, Alain H
Norton, Brianna L
Norton, Brianna L
author_facet Corro, Luis Gonzalez
Gutierrez, Nataly Rios
Cunningham, Chinazo O
Litwin, Alain H
Norton, Brianna L
Norton, Brianna L
author_sort Corro, Luis Gonzalez
collection PubMed
description BACKGROUND: Though people who inject drugs (PWID) represent the overwhelming majority of those living with HCV, most have not been treated. Many HCV+ PWID represent the most marginalized persons in society, often experiencing poverty and poor access to care. We set out to determine the social determinants of health (SDOH) among a population of HCV+ PWID and determine if poor SDOH were related to reduced HCV treatment uptake. METHODS: The HCV-GET UP study was a randomized controlled trial to assess the effectiveness of an HCV group evaluation intervention vs. individual HCV treatment among PWID within a primary care clinic in the Bronx, NY. HCV treatment was provided according to national guidelines.. Here, we include all patient characteristics and baseline social determinants of health (SDOH), obtained through questionnaires using Audio Computer-Assisted Self-Interview (ACASI) technology. We performed bivariate analyses between treatment initiation and the various factors of the SDOH using chi square tests. RESULTS: The majority of the 84 participants enrolled were black (35%) or Hispanic (60%) males (77%), aged 51 (SD11). The majority are on NY State Medicaid insurance (68%), indicating that their income is less than 138% of the Federal Poverty Level. 42% of participants report running out of money for basic needs on a daily or weekly basis, 69% receive food stamps, and 23% are homeless. Nearly half (45%) of participants have less than a high school education, 57% have ever been incarcerated, 48% report not having transportation to get to a medical appointment, and 25% do not trust doctors. A total of 57% of participants initiated HCV treatment, and no factors of SDOH were associated with treatment initiation. CONCLUSION: We found that HCV+ PWID have extremely poor SDOH. Despite this, over half of participants initiated HCV treatment, indicating participants willingness to receive HCV treatment, and resilience in overcoming SDOH. Poor SDOH, such as homelessness, should not be a reason to delay HCV treatment in this population; however, we risk severely muting the health benefits of HCV cure in this population, if we do not address the underlying SDOH that will certainly lead to poor health outcomes, and early death. DISCLOSURES: Chinazo O. Cunningham, MD, MPH, General Electric Health (Other Financial or Material Support, My husband is currently employed by General Electric Health and receives stock and stock options.)Quest Diagnostics (Other Financial or Material Support, My husband was previously employed by Quest Diagnostics and received stocks and stock options.) Alain H. Litwin, MD, MPH, MS, Gilead (Advisor or Review Panel member)Merck (Advisor or Review Panel member)
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spelling pubmed-77773022021-01-07 1071. Social Determinants of health (SDOH) among PWID living with HCV Corro, Luis Gonzalez Gutierrez, Nataly Rios Cunningham, Chinazo O Litwin, Alain H Norton, Brianna L Norton, Brianna L Open Forum Infect Dis Poster Abstracts BACKGROUND: Though people who inject drugs (PWID) represent the overwhelming majority of those living with HCV, most have not been treated. Many HCV+ PWID represent the most marginalized persons in society, often experiencing poverty and poor access to care. We set out to determine the social determinants of health (SDOH) among a population of HCV+ PWID and determine if poor SDOH were related to reduced HCV treatment uptake. METHODS: The HCV-GET UP study was a randomized controlled trial to assess the effectiveness of an HCV group evaluation intervention vs. individual HCV treatment among PWID within a primary care clinic in the Bronx, NY. HCV treatment was provided according to national guidelines.. Here, we include all patient characteristics and baseline social determinants of health (SDOH), obtained through questionnaires using Audio Computer-Assisted Self-Interview (ACASI) technology. We performed bivariate analyses between treatment initiation and the various factors of the SDOH using chi square tests. RESULTS: The majority of the 84 participants enrolled were black (35%) or Hispanic (60%) males (77%), aged 51 (SD11). The majority are on NY State Medicaid insurance (68%), indicating that their income is less than 138% of the Federal Poverty Level. 42% of participants report running out of money for basic needs on a daily or weekly basis, 69% receive food stamps, and 23% are homeless. Nearly half (45%) of participants have less than a high school education, 57% have ever been incarcerated, 48% report not having transportation to get to a medical appointment, and 25% do not trust doctors. A total of 57% of participants initiated HCV treatment, and no factors of SDOH were associated with treatment initiation. CONCLUSION: We found that HCV+ PWID have extremely poor SDOH. Despite this, over half of participants initiated HCV treatment, indicating participants willingness to receive HCV treatment, and resilience in overcoming SDOH. Poor SDOH, such as homelessness, should not be a reason to delay HCV treatment in this population; however, we risk severely muting the health benefits of HCV cure in this population, if we do not address the underlying SDOH that will certainly lead to poor health outcomes, and early death. DISCLOSURES: Chinazo O. Cunningham, MD, MPH, General Electric Health (Other Financial or Material Support, My husband is currently employed by General Electric Health and receives stock and stock options.)Quest Diagnostics (Other Financial or Material Support, My husband was previously employed by Quest Diagnostics and received stocks and stock options.) Alain H. Litwin, MD, MPH, MS, Gilead (Advisor or Review Panel member)Merck (Advisor or Review Panel member) Oxford University Press 2020-12-31 /pmc/articles/PMC7777302/ http://dx.doi.org/10.1093/ofid/ofaa439.1257 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Corro, Luis Gonzalez
Gutierrez, Nataly Rios
Cunningham, Chinazo O
Litwin, Alain H
Norton, Brianna L
Norton, Brianna L
1071. Social Determinants of health (SDOH) among PWID living with HCV
title 1071. Social Determinants of health (SDOH) among PWID living with HCV
title_full 1071. Social Determinants of health (SDOH) among PWID living with HCV
title_fullStr 1071. Social Determinants of health (SDOH) among PWID living with HCV
title_full_unstemmed 1071. Social Determinants of health (SDOH) among PWID living with HCV
title_short 1071. Social Determinants of health (SDOH) among PWID living with HCV
title_sort 1071. social determinants of health (sdoh) among pwid living with hcv
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777302/
http://dx.doi.org/10.1093/ofid/ofaa439.1257
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