Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Removing Injection Drug Use from HCV Discourse

Subst Use Misuse; ePub 2016 Oct 21; Jordan, Perlman

Shifting the emphasis of hepatitis C (HCV) testing, from testing based on specific routes of transmission and risk to testing based on age, removes injection drug use from HCV discourse, according to a recent study. This has the potential to either facilitate HCV care for drug users or to further stigmatize and marginalize drug use and people who use drugs. Researchers used content and critical discourse analysis, informed by eco-social theory, to examine relevant documents. 15 documents were assessed for eligibility; 6 documents comprised the final set reviewed. They found:

  • In content analysis, age-based testing was both mentioned more frequently and was supported more strongly than risk-based testing.
  • Risk-based testing was frequently mentioned in terms minimizing its use and drug use was often mentioned only euphemistically.
  • The reframed emphasis largely removed discussion of injection drug use from discussion of HCV risks.


Jordan AE, Perlman DC. The shift in emphasis from risk-based to age-based hepatitis C virus (HCV) testing in the US tends to remove injection drug use from discourse on HCV. [Published online ahead of print October 21, 2016]. Subst Use Misuse. doi:10.1080/10826084.2016.1225767.