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J Viral Hepat. 2015 Oct;22(10):792-9. doi: 10.1111/jvh.12393. Epub 2015 Jan 14.

Visits to primary care physicians among persons who inject drugs at high risk of hepatitis C virus infection: room for improvement.

Author information

1
Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.
2
Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada.
3
Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
4
Addiction Research and Study Program, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada.
5
Montréal Public Health Department, Agence de la santé et des services sociaux de Montréal, Montréal, QC, Canada.
6
Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.

Abstract

The role of primary care physicians (PCP) in hepatitis C virus (HCV) prevention is increasingly emphasized. Yet, little is known about the patterns of contacts with PCP among persons who inject drugs (PWID). We sought to assess the 6-month prevalence of PCP visiting among PWID at risk of HCV infection and to explore the associated factors. Baseline data were collected from HCV-seronegative PWID recruited in HEPCO, an observational Hepatitis Cohort study (2004-2011) in Montreal, Canada. An interviewer-administered questionnaire elicited information on socio-demographic factors, drug use patterns and healthcare services utilization. Blood samples were tested for HCV antibodies. Using the Gelberg-Andersen Behavioral Model, hierarchical logistic regression analyses were conducted to identify predisposing, need and enabling factors associated with PCP visiting. Of the 349 participants (mean age = 34; 80.8% male), 32.1% reported visiting a PCP. In the multivariate model, among predisposing factors, male gender [adjusted odds ratio (AOR) = 0.45 (0.25-0.83)], chronic homelessness [AOR = 0.08 (0.01-0.67)], cocaine injection [AOR = 0.46 (0.28-0.76)] and reporting greater illegal or semi-legal income [AOR = 0.48 (0.27-0.85)] were negatively associated with PCP visits. Markers of need were not associated with the outcome. Among enabling factors, contact with street nurses [AOR = 3.86 (1.49-9.90)] and food banks [AOR = 2.01 (1.20-3.37)] was positively associated with PCP visiting. Only one third of participating PWID reported a recent visit to a PCP. While a host of predisposing factors seems to hamper timely contacts with PCP among high-risk PWID, community-based support services may play an important role in initiating dialogue with primary healthcare services in this population.

KEYWORDS:

drug use; hepatitis C; injection; physician; primary care

PMID:
25586516
DOI:
10.1111/jvh.12393
[Indexed for MEDLINE]

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