How the Rural Risk Environment Underpins Hepatitis C Risk: Qualitative Findings From Rural Southern Illinois, United States

Authors

Suzan M Walters, New York University School of Global Public Health
David Frank, New York University School of Global Public Health
Marisa Felsher, Thomas Jefferson UniversityFollow
Jessica Jaiswal, University of Alabama
Scott Fletcher, New York University School of Global Public Health
Alex S Bennett, New York University School of Global Public Health
Samuel R Friedman, New York University School of Global Public Health
Lawrence J Ouellet, University of Illinois Chicago
Danielle C Ompad, New York University School of Global Public Health
Wiley Jenkins, SIU School of Medicine
Mai T Pho, University of Chicago

Document Type

Article

Publication Date

1-13-2023

Comments

This article is the author’s final published version in International Journal of Drug Policy, Volume 11, January 2023, Article number 103930.

The published version is available at https://doi.org/10.1016/j.drugpo.2022.103930. Copyright © Walters et al.

Abstract

Background: Hepatitis C virus (HCV) infection has increased among persons who inject drugs (PWID) in the United States with disproportionate burden in rural areas. We use the Risk Environment framework to explore potential economic, physical, social, and political determinants of hepatitis C in rural southern Illinois.

Methods: Nineteen in-depth semi-structured interviews were conducted with PWID from August 2019 through February 2020 (i.e., pre-COVID-19 pandemic) and four with key informants who professionally worked with PWID. Interviews were recorded, professionally transcribed, and coded using qualitative software. We followed a grounded theory approach for coding and analyses.

Results: We identify economic, physical, policy, and social factors that may influence HCV transmission risk and serve as barriers to HCV care. Economic instability and lack of economic opportunities, a lack of physically available HCV prevention and treatment services, structural stigma such as policies that criminalize drug use, and social stigma emerged in interviews as potential risks for transmission and barriers to care.

Conclusion: The rural risk environment framework acknowledges the importance of community and structural factors that influence HCV infection and other disease transmission and care. We find that larger structural factors produce vulnerabilities and reduce access to resources, which negatively impact hepatitis C disease outcomes.

Recommended Citation

Walters, Suzan M; Frank, David; Felsher, Marisa; Jaiswal, Jessica; Fletcher, Scott; Bennett, Alex S; Friedman, Samuel R; Ouellet, Lawrence J; Ompad, Danielle C; Jenkins, Wiley; and Pho, Mai T, "How the Rural Risk Environment Underpins Hepatitis C Risk: Qualitative Findings From Rural Southern Illinois, United States" (2023). College of Population Health Faculty Papers. Paper 166.
https://jdc.jefferson.edu/healthpolicyfaculty/166

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English