Reported Barriers to Hepatitis C Treatment among Pregnant and Early-Parenting Mothers Undergoing Substance Use Disorder Treatment in One U.S. State
Barriers to Treatment Uptake
2. Methods and Materials
“I thought that I got it from my baby dad but then I found out that I could give it to myself from using dirty needles.” Postnatal, 31.
“I figured I probably gave it to myself because I used needles on myself.” Postnatal, 33.
3.1. Barriers to Treatment Uptake
3.1.1. Low Priority Due to Other Life Circumstances
“Well, I really don’t think about it because I got some ‘shit’ going on.” Postnatal, 31.
“I have been homeless, so I just rent a lone room in a place. I just, I have been, I’m not that settled. So, to make appointments and I work weekends and I work night shifts, So I just don’t got time, right now to.” Pregnant, 42.
“Just like transportation and work.” Postnatal, 32.
“I kinda forgot about it.” Postnatal, 30.
3.1.2. Uncertainty about Currently Available Treatments and Side Effects
“I think it’s the medicine, like being scared of the medicine and the side effects because that’s what it was with me. Like they told me I would be sick, they told me I had to eat this much and I would feel really down and low and they had me scared and now people are saying it’s not going to make you feel like that. I don’t know, I guess I’ll find out…” Postnatal, 33.
“No just knowing that it’s not that interferon. You know for a while, that was the only option. If it was still just that, I don’t know that I would do it but now that there is more than just that, I don’t have any problem with getting treatment.” Postnatal, 31.
3.1.3. Uncertainty/Misinformation about Treatment Eligibility Requirements
“… every time I’ve come back and it can’t happen for some reason like, I was dirty, I wasn’t clean long enough, I was on suboxone for too long, I was pregnant. So, hopefully this time would be a little different.” Pregnant, 25.
“I’ve always been told that you have to be clean for six months before your insurance will pay for it and I just hit six months…” Postnatal, 31.
“You have to have a certain amount of clean time- I’m not sure what it is but I know I’ve hit it.” Postnatal, 30.
“Yes, after six months of my treatment and I’ve got that now.” Postnatal, 22.
3.1.4. Active Substance Use
“… When you’re in the ‘madness’, you know, you’re not going to worry about treating something that you got from using a dirty needle when you’re still using a dirty needle… Again, in the highness, you don’t, you’re not worried about Hep C. You might talk about it before you use a needle after somebody like, ‘You don’t have Hep C, do ya?’, but that’s about it.” Postnatal, 31.
“… wrapped up in drug use, just not taking the time to take care of their bodies like they should.” Postnatal, 41.
“Know when you are active in addiction, you don’t, that’s the last thing on your mind. You’ve got to get your fix because that’s the first thing, you know that’s what heals you in the moment.” Postnatal, 36.
“They still want to use.” Postnatal, 32.
“I don’t tell anybody because people do judge but no I sought care so that I could get rid of it so that I would not have to tell the community if I got hurt.” Postnatal, 32.
“Fear that they might, people might know that they have it.“ Pregnant, 31.
“Being treated differently. People looking at them differently.“ Pregnant, 41.
“Scared of having it, what that means. Like a lot of people don’t realize that a lot of it is just cirrhosis of the liver. Alcoholics have cirrhosis of the liver and that’s what Hep C causes. I think it’s the stigma behind it.” Postnatal, 32.
3.1.6. Complexity of the Treatment Process
“You are going to have to get in a doctor, see them and they have to refer you to the liver specialist. It’s just a lot of steps to get you there and it’s worth it but if you are not, you’ve got to be committed to get it done because you can’t miss any appointments, you’ve got to go get blood drawn every two weeks. It’s a lot. And if you don’t have a car, it’s like how the hell are you going to get there?” Postnatal, 31.
“If you don’t have the medical care or access to it as well or transportation—I mean it’s a lot.” Postnatal, 32.
3.2. Facilitators of Treatment Uptake
“If someone would give me money for the day of work I miss. That would probably be it [motivation to initiate treatment].” Pregnant, 42.
“I do worry about being able to take the other one like at the same time, all the time, like that might be rough but I think doing it at the recovery house, I think that’s a good way to start because I mean, your medicine is monitored, you have to go get it from somebody else. I feel like now is probably the best time to start it, before I’m on my own.” Postnatal, 31.
Provision of Information
“I don’t know, maybe just get it out there to where people actually can hear that there is a treatment and because a lot of people are worried about insurance this, insurance that, just let them know that no, they can get it because it’s there. It surprised me that it’s there.” Postnatal, 33.
“I have only ever heard Hep C talked about in detox or centers like this. I’ve never heard a regular doctor or anyone else. Even when I went to my PCP and said I am trying to get treated, he never, he never, he wasn’t gonna touch it. Making information available if you’re not in treatment or around detox. And letting people know that the treatment is not like chemo.” Postnatal, 30.
“I didn’t know the regulations have changed. A lot of people don’t know. They still feel like you have to be in treatment two to three years before you can get it. I think there should be more information put out there that there is more access to it with less restrictions right now.” Postnatal, 32.
“Just more information like, not knowing if you have to be clean for so long or not knowing what the options are. I never see anything about the treatment like you see a lot of stuff about, do you have Hep C?” Postnatal, 31.
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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Adekunle, A.D.; Harp, K.L.; Al-Abdali, Z.G.; Critchfield, A.S.; Barnhart, S.; Winter, K.T. Reported Barriers to Hepatitis C Treatment among Pregnant and Early-Parenting Mothers Undergoing Substance Use Disorder Treatment in One U.S. State. Infect. Dis. Rep. 2022, 14, 1-11. https://doi.org/10.3390/idr14010001
Adekunle AD, Harp KL, Al-Abdali ZG, Critchfield AS, Barnhart S, Winter KT. Reported Barriers to Hepatitis C Treatment among Pregnant and Early-Parenting Mothers Undergoing Substance Use Disorder Treatment in One U.S. State. Infectious Disease Reports. 2022; 14(1):1-11. https://doi.org/10.3390/idr14010001Chicago/Turabian Style
Adekunle, Ayooluwatomiwa Deborah, Kathi L. Harp, Zaynab G. Al-Abdali, Agatha S. Critchfield, Sheila Barnhart, and Kathleen T. Winter. 2022. "Reported Barriers to Hepatitis C Treatment among Pregnant and Early-Parenting Mothers Undergoing Substance Use Disorder Treatment in One U.S. State" Infectious Disease Reports 14, no. 1: 1-11. https://doi.org/10.3390/idr14010001