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Impact of a positive Hepatitis C Diagnosis on homeless Injecting Drug Users

Tompkins, C.N.E., Wright, N.M.J. and Jones, L. (2005) Impact of a positive Hepatitis C Diagnosis on homeless Injecting Drug Users. British Journal of General Practice, 55 (513). pp. 263-268. ISSN 0960-1643

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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 diagnosis. 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.

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Social Policy and Social Work (York)
The University of Leeds > University of Leeds Research Centres and Institutes > Centre for Research in Primary Care (Leeds)
Depositing User: York RAE Import
Date Deposited: 14 Aug 2009 15:47
Last Modified: 14 Aug 2009 15:47
Published Version: http://www.ingentaconnect.com/content/rcgp/bjgp/20...
Status: Published
Publisher: Royal College of General Practitioners
URI: http://eprints.whiterose.ac.uk/id/eprint/5749

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