Identifying the experiences of people who inject drugs (PWID) with Direct-Acting Antiviral (DAA) HCV treatment to inform policies and programs

The advent of new interferon-free hepatitis C virus (HCV) Direct-Acting Antiviral (DAA) therapies has the potential to transform the health outcomes of HCV-infected individuals. These new treatments can be completed in as little as 8-12 weeks, with few side effects, and very high cure rates (e.g., >95%). Since March 2015, British Columbia (BC) has increased the availability and provision of DAA HCV treatment, and is among the first Canadian settings to do so. Nonetheless, little is known about how the increased availability of DAA treatment will impact the uptake of treatment, experiences of treatment, and the social, health and behavioural trajectories of patients post-treatment. To achieve the equitable scale-up of DAA interventions at the population level, reductions in HCV incidence and prevalence must be achieved under challenging "real-world" conditions among key populations - and, concerted efforts to avoid reinfection must be sustained over the long term. These challenges are particularly relevant for people who inject drugs (PWID) - a population who also encounters a variety of social and structural barriers to accessing health care. The proposed study will inform the development of DAA HCV treatment policies and service delivery practices (including clinical and provincial guidelines), to optimize treatment outcomes and prevent reinfection over the long term. We will undertake a 3-year qualitative study using annual, in-depth semi-structured interviews with 60 PWID and 20 key stakeholders (including care providers, policy makers, and community organization representatives) in Vancouver. Through engagement with our knowledge partners (BC Ministry of Health, BC Centre for Disease Control, Vancouver Coastal Health, YouthCO HIV/Hep C Society) and our annual Stakeholder Workshops, our study includes integrated knowledge translation strategies to inform evolving DAA policy and care.