About
Worldwide, HCV affects around 115 million individuals, with about 80% of people living with chronic infection, the highest burden residing in low and middle-income countries (LMICs). The introduction of direct acting antivirals (DAAs) in 2014 brought promising results for elimination of HCV.
Vietnam is one of the countries with the highest HCV prevalence, and this prevalence is particularly high in HIV-infected patients and in people who inject drugs (PWID). There is still a gap in access to diagnostic tools and treatment in some settings. With the contribution of the Global Fund, DAA access is free of charge in HIV-HCV co-infected patients, but only in some selected clinical sites. The MOVIDA Hep 2 study (funded by ANRS-MIE) is a cohort study in Northern Vietnam, evaluating access to HCV treatment in HIV-HCV co-infected patients, and making use of dried blood spots (DBS) to offer HCV viral load monitoring. The main goal of the MOVIDA Hep 2 project is to compare compliance to DAA between patients followed for HIV in clinical sites with and without access to DAA.
To make HCV treatment successful, good compliance to care and good adherence to DAA are required, as well as adoption of prevention measures to prevent HCV re-infections. Recent social science research in Vietnam has focused on costs and benefits of HCV treatments, and evaluation of integrated models of care for PWID. Little qualitative research explored HCV treatment programs being implemented in decentralized health centers that are in rural and remote areas in Vietnam.
The present study is the opportunity to add a qualitative component to the main study, to learn more about the experiences and perceptions of HCV care and treatment in those co-infected with HIV in remote health centers in Vietnam. Better understanding of the synergistic relationships between perceptions about illnesses (hepatitis C, comorbid conditions, e.g. HIV), the body, and healing (or potential “cure”) can inform treatment planning and policy for future HCV services within areas in Vietnam where access to care remains complex. The qualitative evaluation will not only focus on patients, but also on healthcare workers to understand how HCV care impacts their activities, and possibly improve practice.
The project is co-lead with Dr Jennifer Van Nuil from Oxford University Clinical Research Unit (OUCRU)
