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Impact of a positive hepatitis C diagnosis on homeless injecting drug users: A qualitative study

Lookup NU author(s): Louise Jones


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Background: Increasing numbers of injecting drug users are presenting to primary care and a growing number of general practices are specifically providing care for homeless people. Injecting drug users are at the greatest risk of hepatitis C infection and homeless drug misusers, because of their drug-taking behaviour and patterns, have been identified as being at greater risk of harm of blood-borne diseases than the general population. However, little work has been conducted with injecting drug users or homeless people who have hepatitis C and little is known about how the virus may affect them. Aim: To explore the impact of a positive hepatitis C diagnosis on homeless injecting drug users. Design of study: This study employed qualitative research. In-depth interviews allowed the exploration of the impact of a potentially life-threatening diagnosis within the context of a person's expressed hierarchy of needs. Setting: A primary care centre for homeless people in the north of England. Method: In-depth interviews about the impact of a positive hepatitis C diagnosis on their lives were conducted with 17 homeless injecting drug users who had received a positive hepatitis C dognosis. The interviews were audiotaped, transcribed, and analysed using the framework approach. Results: Receiving a positive diagnosis for hepatitis C resulted in feelings of shock, devastation, disbelief, anger, and questioning. A positive diagnosis had lasting social, emotional, psychological, behavioural, and physical effects on homeless injecting drug users, even years after the initial diagnosis. Most responders were diagnosed by a doctor in primary care or by hospital staff; however, not all had sought testing and a number were tested while inpatients and were unaware that blood had been taken for hepatitis C virus serology. Conclusions: The implications for clinical policy and primary care practice are discussed, including the issues of patient choice, confidentiality, and pre- and post-test discussions. Posttest discussions should be followed up with additional social, psychological, and medical support and counselling. © British Journal of General Practice.

Publication metadata

Author(s): Tompkins CNE, Wright NMJ, Jones L

Publication type: Article

Publication status: Published

Journal: British Journal of General Practice

Year: 2005

Volume: 55

Issue: 513

Pages: 263-268

ISSN (print): 0960-1643

ISSN (electronic): 1478-5242

Publisher: Royal College of General Practitioners

PubMed id: 15826432