Introduction
Hepatitis C virus testing is recommended for people at high risk for infection, including
those with substance use disorders. Little is known about the cascade of hepatitis
C virus care (including testing, diagnosis, and treatments) among patients with substance
use disorders in real-world clinical practice. This study aims to characterize the
hepatitis C virus cascade of care and identify the factors associated with hepatitis
C virus testing and diagnosis among Florida Medicaid beneficiaries with substance
use disorders.
Methods
A retrospective cohort analysis of Florida Medicaid data (2013–2018) was conducted
in 2020 for patients aged 18–64 years with newly diagnosed substance use disorders
(year 2012 was used to ascertain 1-year previous enrollment). A generalized estimating
equation identified the factors associated with hepatitis C virus testing; a multivariable
logistic model identified the factors associated with hepatitis C virus diagnosis.
Results
Of the 156,770 patients with substance use disorders, 18% were tested for hepatitis
C virus at least once. Among the tested patients, 8% had hepatitis C virus diagnoses.
Among the 2,177 patients having a hepatitis C virus diagnosis, 11% initiated hepatitis
C virus treatments, and 96% of them completed the hepatitis C virus treatments. Factors
associated with being less likely to receive hepatitis C virus testing included being
male (AOR=0.73, 95% CI=0.71, 0.75) and White (AOR=0.85, 95% CI=0.83, 0.87), whereas
individuals who were male (AOR=1.49, 95% CI=1.35, 1.66) and White (AOR=2.71, 95% CI=2.38,
3.08) were more likely to be diagnosed with hepatitis C virus. The odds of receiving
hepatitis C virus testing significantly increased annually (AOR=1.06, 95% CI=1.05,
1.07).
Conclusions
Future studies are warranted to investigate the barriers to access hepatitis C virus
testing and treatment among Florida Medicaid beneficiaries with substance use disorders,
especially for White male individuals.
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Article Info
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Published online: June 28, 2021
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
