Implicit bias among healthcare providers inhibits hepatitis C treatment for people living with HIV, study finds

A recent study reveals important insights into the challenges that may face hepatitis C virus (HCV) microelimination efforts in people living with HIV (PWH). The prevalence of HIV and HCV coinfection is increasing due to the opioid epidemic. If left untreated, hepatitis C virus infection can lead to liver damage, cancer, and death. While HIV requires lifelong treatment, hepatitis C virus can be cured with a few months of oral medication.

To understand barriers to providing hepatitis C care, the authors conducted a mixed-methods analysis that included focus groups with 14 health care providers in 11 clinics. Practitioners interviewed in the study identified several barriers to microelimination, with housing instability, medication non-adherence issues, and the inability to motivate patients being the most significant.

Importantly, the researchers found that implicit bias existed in the majority of responses provided by providers. Therefore, the authors assert that overcoming treatment barriers may require addressing health care practitioner stigma toward patients.

Research results published in journal health promotion practice.

“Given that there are deep-rooted prejudices against people who use drugs that are particularly difficult to change, we need to redesign the way we manage such patients to reduce the chance of stigma-inducing interactions, because we cannot reliably expect every clinician to Doctors can do this. There is no implicit bias,” said Dr. Frederick Altice, professor of medicine (infectious diseases) at the Yale School of Medicine and professor of epidemiology (microbial diseases) at the Yale School of Public Health.