In February 2006, PHICAS contracted with an independent consultant, David Napp of Practical Applications of Public Health, to assess the needs of co-infected individuals and the providers who serve them. The primary purpose of this study was to better understand clients’ and providers’ perspectives on the barriers to, and facilitators of, access to services for co-infected individuals with the intent of using this information to plan continued efforts to improve access to care for this population. Qualitative methods were chosen for this study because of their unique ability to capture rich descriptive data and generate explanations without the constraints of predetermined categories of analysis.  

From September 2006 through November 2006, semi-structured interviews and focus groups were conducted with a total of 28 providers and 16 clients. Providers invited to participate in interviews and focus groups were identified by PHICAS and HIP from a list of staff at Duke and UNC hospitals, case management agencies, health departments, and other organizations who serve the co-infected population in the six-county study area.

Findings are categorized as follows: 

I. Provider Barriers to HCV Testing and Treatment

1. Providers view HCV as lower priority relative to other client needs
2. Providers focus on treatment side effects and limited treatment success
3. Providers consider HCV testing and treatment too time consuming and costly
4. Few providers are knowledgeable about HCV 

II. Provider Views on Client Barriers to HCV Testing and Treatment

1. Clients do not view HCV as a priority
2. Clients are apprehensive about treatment side effects and outcomes
3. Clients have difficulty affording treatment
4. Clients have mental health and substance use needs
5. Clients lack access to transportation 

III. Provider Opinions about Knowledge Differences by Race

1. Quality of interaction between provider and client varies
2. Sources of information may be unreliable
3. Methodological concerns may exist 

IV. Client Barriers to HCV Testing and Treatment

1. Clients do not see HCV as a priority
2. Clients lack knowledge of HCV
3. Clients are apprehensive about treatment side effects
4. Clients lack access to transportation 

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