From the Journals

HCV screening, care inadequate for young adults who use opioids nonmedically



Younger adults aged 18-23 years who used opioids nonmedically were less likely to receive hepatitis C virus screening than their older peers aged 24-29 years, according to results from the Rhode Island Young Adults Prescription Drug Study (RAPIDS). Overall, those young adults screening positive for HCV received what the researchers deemed was inadequate follow-up, education, and care.

The study was carried out between January 2015 and February 2016 and assessed the self-reported HCV screening, confirmatory testing, and care experience of 196 young adults (aged between 18-29 years) who used opioids nonmedically, according to Ayorinde I. Soipe, MD, Rhode Island Hospital, Providence, and his colleagues.

A test for heptatits C. Jarun011/Thinkstock
The primary outcome was a history of self-reported HCV screening. For those individuals who received a positive result, follow-up questions on confirmatory testing, education, referral, and care were asked. Participants included 32.3% women and 37.3% nonwhite individuals with a mean age of 24.5 years, according to the report published in the Journal of Adolescent Health.

Among the total of 154 participants who reported being screened, 18 (11.7%) reported a positive test result. Of those who tested positive, only 72% received a follow-up confirmatory blood test, 67% received referral for specialty HCV care, 50% received education about living with HCV, and 56% were given education about how not to transmit HCV to someone else.

A significantly higher proportion of the older participants reported being screened (90%) vs. 60% of the younger participants (P less than .001).

Multivariate analysis showed that age, history of injected drug use, and a history of ever being hospitalized for a psychiatric illness or depression were all significantly associated with HCV screening.

Self-reported barriers to screening and testing included health insurance status, discrimination experienced from the health care community, comorbid psychiatric illness, including depression, and access to drug addiction services.

“This study demonstrates the need to not only screen at-risk patients, but to also ensure adequate follow-up after referral to care. Establishing comprehensive integrated care programs that incorporate peer support, counselors, case managers, and educators is recommended to improve follow-up care,” the researchers concluded.

The authors reported that they had no disclosures. The study was sponsored by an National Institutes of Health grant.

SOURCE: Soipe AI et al. J Adolescent Health 2018;62:114-7.

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