Harm Reduction in Peer-Assisted Telemedicine for Hepatitis C: Secondary Outcomes of a Randomized Controlled Trial

Author:

Spencer Hunter1ORCID,Gregoire Devin1,Leichtling Gillian2ORCID,Herink Megan3ORCID,Seaman Andrew14,Korthuis P. Todd1ORCID,Cook Ryan1

Affiliation:

1. Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, OR 97239, USA

2. Comagine Health, Portland, OR 97232, USA

3. College of Pharmacy, Oregon State University, Corvallis, OR 97331, USA

4. Central City Concern, Portland, OR 97209, USA

Abstract

Hepatitis C (HCV) treatment for people who use drugs (PWUD) decreases injection drug use and injection equipment sharing. We examined changes in injection drug use and injection equipment sharing following HCV treatment in a randomized trial comparing peer-assisted telemedicine for HCV treatment (TeleHCV) versus peer-assisted usual care in rural PWUD. We hypothesize that TeleHCV reduces risky behaviors and peers facilitate this change. We used mixed-effects logistic regression to describe participant-level (n = 203) associations between both injection drug use and injection equipment sharing and randomized groups, frequency of peer contact, HCV treatment initiation, HCV cure, and time. Risky behaviors were surveyed at baseline and 12 and 36 weeks after HCV treatment completion. Injection drug use declined more over time in TeleHCV participants vs. control at 12 weeks (adjusted odds ratio [aOR] = 0.42, 95% CI 0.20–0.87, p = 0.02) and 36 weeks (aOR = 0.48, 95% CI 0.21–1.08, p = 0.076). Injection drug use decreased more with a greater number of peer interactions, with reductions among participants in the 3rd quartile exceeding those in the 1st quartile of peer interactions at 12 weeks (aOR = 0.75, 95% CI 0.57–0.99, p = 0.04). Similarly, injection equipment sharing decreased over time, with reductions among participants in the 3rd quartile exceeding those in the 1st quartile of peer interactions at 36 weeks (aOR = 0.08, 95% CI 0.01–0.97, p = 0.047). Peer-assisted telemedicine for HCV treatment decreases injection drug use and injection equipment sharing; peers contribute to this effect.

Funder

National Institutes of Health

National Institute on Drug Abuse

National Center for Advancing Translational Sciences

National Institute of Drug Abuse

Publisher

MDPI AG

Reference28 articles.

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2. (2024, June 20). Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022–2030, Available online: https://iris.who.int/bitstream/handle/10665/360348/9789240053779-eng.pdf?sequence=1.

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4. Harm Reduction in Health Care Settings;Chan;Med. Clin. N. Am.,2022

5. Centers for Disease Control and Prevention (2024, February 02). Viral Hepatitis Surveillance—United States, Available online: https://www.cdc.gov/hepatitis/statistics/2021surveillance/hepatitis-c.htm.

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