Theme: Social Science & Policy Research Year: 2024
Background: Several harm reduction programs have started to address hepatitis C (HCV) infection and transmission among people who inject drugs (PWID) in South Africa. These programs importantly provide the empirical evidence essential for policymaking, implementation, review, and evaluation.
Approach: With twelve senior program managers involved in the harm reduction program, we defined the policy question to be addressed as what are the key policy considerations for HCV prevention, treatment and care in South Africa? We conducted a harm reduction program and research data review using a logical framework. Existing HCV program and research data from 1 January 2022 to 31 December 2023 were assessed using the following themes: access/coverage, achievements, gaps, challenges, best practices, and sustainability. We used the synthesis approach to summarize the results of the review and present the outcomes relating to HCV prevention because of the suboptimal review results.
Analysis: Our key program and research data on prevention were drawn from 1478 PWID. The data shows that about 70% of PWID are HCV positive, 55% had shared needles and syringes in the past six months, 51% had been arrested in the past six months, 2% were aware of the causes of HCV, 45% knew that HCV is curable, 26% knew where to access treatment and no one was aware of HCV self-test before the HCV self-test study implementation. These results show high HCV positivity rates, high-risk needles sharing behavior, negative law enforcement agents involvement, low HCV awareness and knowledge and no information about HCV-self testing which must be addressed in the prevention policy.
Conclusion: The key policy considerations for HCV prevention are increased screening and access to self-testing, targeted communication and messaging, focused behavior change communication, law enforcement agents sensitization, enhanced distribution of needles and syringes, awareness raising among PWID and communities and training service providers.
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