Different distributions of social conditions, vulnerabilities, (e.g. drug use, mental illness) or other infections (HIV, HBV, TB), contribute to differences among populations affected by hepatitis C virus (HCV) infection. The different distribution of these comorbidities drives heterogeneity in cascades of care (diagnosis, initiation of treatment, cure and retention in care). My research project aims to improve HCV treatment and prevention by applying concepts of syndemic theory to improve the integration and delivery of health services among populations affected by HCV infection, such as people born 1945-65 ("Baby Boomers") and people who inject drugs (PWID).
The British Columbia Hepatitis Testers Cohort (BC-HTC), which includes all individuals tested for HCV, HIV, HBV, sexually transmitted infections or TB since 1990, linked with administrative and healthcare data, will be used for this study. The study will extend the HCV cascade of care to include prevention and care related to underlying syndemic factors (e.g. drug use, mental illness and other co-infections). Gaps in HCV care cascades, and syndemic factors associated with gaps, will be identified, and factors associated with these gaps will be investigated. This will facilitate identification of avenues for shared and integrated interventions to improve prevention and care for HCV, and underlying substance use.