Post-treatment life-trajectories among people who inject drugs who completed hepatitis C treatment with direct acting antivirals: A thematic analysis

TY - JOUR

T1 - Post-treatment life-trajectories among people who inject drugs who completed hepatitis C treatment with direct acting antivirals

T2 - A thematic analysis

AU - Vojt, Gabriele

AU - Elliott, Lawrie

AU - Family, Hannah

AU - Sharkey, Christian

AU - Stephens, Brian

AU - Hutchinson, Sharon

AU - Hickman, Matt

AU - Dillon, John F

AU - Harris, Magdalena

AU - Flowers, Paul

N1 - © 2025 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

PY - 2025/9

Y1 - 2025/9

N2 - BACKGROUND: Hepatitis C Virus is a global health burden, particularly affecting people who inject drugs. Direct-acting antiviral treatment can cure almost all people infected with hepatitis C. However, the longer-term impacts on within people's life trajectories are unknown, although some suggest it may lead to fundamental behavioural changes.DESIGN: A cross-sectional exploratory retrospective qualitative design.METHODS: We interviewed 30 people who inject(ed) drugs and who had previously been treated with direct-acting antivirals on average 18 months before the interview (range: 12-24 months). Most were male, aged 36-55 years, and had been treated in urban community-based needle and syringe programmes in Scotland. All interviews were semi-structured, conducted over the phone by either peer or academic researchers, and analysed thematically.RESULTS: We present three discernible post-treatment life-trajectories. Firstly, 'A cure that was like totally new life' involved identity transformation, often associated with controlled or zero drug use, and improved physical and mental health. Secondly, 'There isn't much afterwards' comprised poor quality of life and social isolation, often due to participants' disengagement from former drug use and support networks. Thirdly, 'I'm getting tested every year now' detailed a few life changes but normalized hepatitis C testing and treatment.CONCLUSION: Our thematic analysis reinforces the positive impacts on mental well-being, physical health and self-transformation of direct-acting antiviral treatment in the short- and long-term. However, there is an urgent need for psychosocial interventions to maintain health behaviour changes and self-management, and social support for individuals post hepatitis C treatment.

AB - BACKGROUND: Hepatitis C Virus is a global health burden, particularly affecting people who inject drugs. Direct-acting antiviral treatment can cure almost all people infected with hepatitis C. However, the longer-term impacts on within people's life trajectories are unknown, although some suggest it may lead to fundamental behavioural changes.DESIGN: A cross-sectional exploratory retrospective qualitative design.METHODS: We interviewed 30 people who inject(ed) drugs and who had previously been treated with direct-acting antivirals on average 18 months before the interview (range: 12-24 months). Most were male, aged 36-55 years, and had been treated in urban community-based needle and syringe programmes in Scotland. All interviews were semi-structured, conducted over the phone by either peer or academic researchers, and analysed thematically.RESULTS: We present three discernible post-treatment life-trajectories. Firstly, 'A cure that was like totally new life' involved identity transformation, often associated with controlled or zero drug use, and improved physical and mental health. Secondly, 'There isn't much afterwards' comprised poor quality of life and social isolation, often due to participants' disengagement from former drug use and support networks. Thirdly, 'I'm getting tested every year now' detailed a few life changes but normalized hepatitis C testing and treatment.CONCLUSION: Our thematic analysis reinforces the positive impacts on mental well-being, physical health and self-transformation of direct-acting antiviral treatment in the short- and long-term. However, there is an urgent need for psychosocial interventions to maintain health behaviour changes and self-management, and social support for individuals post hepatitis C treatment.

KW - Humans

KW - Male

KW - Adult

KW - Substance Abuse, Intravenous/psychology

KW - Middle Aged

KW - Female

KW - Antiviral Agents/therapeutic use

KW - Cross-Sectional Studies

KW - Retrospective Studies

KW - Hepatitis C/drug therapy

KW - Qualitative Research

KW - Quality of Life/psychology

KW - Scotland

KW - direct acting antiviral

KW - long term outcomes

KW - hepatitis C

KW - substance use

KW - qualitative

KW - people who inject drugs

UR - https://www.scopus.com/pages/publications/105010582474

U2 - 10.1111/bjhp.70005

DO - 10.1111/bjhp.70005

M3 - Article

C2 - 40650350

SN - 1359-107X

VL - 30

JO - British Journal of Health Psychology

JF - British Journal of Health Psychology

IS - 3

M1 - e70005

ER -