Summary: In a message to the substance use treatment and public health communities, CDC and SAMHSA leaders highlight the need for and opportunities to increase the provision of HIV and viral hepatitis testing as a part of substance use disorder treatment services.
In a new joint letter, the leaders of the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) encourage the public health and substance use disorder (SUD) treatment communities to increase the number of people with SUD who are tested and treated for HIV and viral hepatitis.

In their message, “Advancing HIV and Viral Hepatitis Testing with Point-of-Care Diagnostics for People with Substance Use Disorder,” Miriam Delphin-Rittmon, PhD, Assistant Secretary for Mental Health and Substance Use, and Mandy Cohen, MD, MPH, Director, Centers for Disease Control and Prevention, discuss the connection between injection drug use and acquisition of hepatitis C, hepatitis B, and HIV, the prevalence of these diseases among people who inject drugs, and CDC’s recommendations for HIV, HCV, and HBV testing for people who inject drugs. While millions of Americans receive SUD treatment services each year, they observe, only a third of the nation’s 15,000 SUD treatment facilities offer HIV, HCV, or HBV testing. They encourage those facilities to integrate HIV and viral hepatitis testing into the services they offer clients and highlight recent advances in point-of-care diagnostics that support such integration, including FDA-approved POC tests for HIV and the recently FDA-cleared fingerstick POC HCV RNA test that enables same-day diagnosis.

​Providing these tests in SUD treatment settings can reduce barriers to accessing them and facilitate initiation of treatment.

https://www.hiv.gov/blog/cdc-and-samhsa-leaders-encourage-hiv-and-viral-hepatitis-testing-in-substance-use-disorder-treatment

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12 December 2024
By Sorcha Daly, Rebecca Bulmer, Vincent Condron, Gary Hind and Matthew Smith

Hepatitis C (HCV) is a blood-borne virus that is most commonly acquired by people who inject drugs. If left untreated, HCV can cause cirrhosis of the liver, liver failure and liver cancer. Unfortunately, due to its most common transmission routes (the sharing of unsterile injecting equipment), hepatitis C is also a stigmatised disease. As such, people who use drugs with a HCV diagnosis face multi-layered stigma, often seen as instruments of contagion, rather than those deserving of care.
It is unsurprising, then, that receiving a positive diagnosis of hepatitis C can have a negative effect on mental health. Diagnosis is associated with lower self-esteem, social isolation, and fears around disclosure and confidentiality breaches. There are also much higher levels of existing mental health difficulties in people diagnosed with HCV. As Dame Carol Black notes in her independent review of drugs in the UK, “trauma (physical, sexual or psychological) and mental ill-health are the drivers and accompaniment” of drug dependency.   
Despite the obvious need for mental and other health services for people with a HCV diagnosis, stigma related to HCV and its transmission routes affect how people interact with health services and can stop people from seeking health care. This not only excludes people from the testing and treatment that could quickly and simply cure HCV, but from accessing mental health and recovery services needed to support the cessation of practices that elevate the risk of acquiring HCV and other blood-borne viruses.

At the Hepatitis C Trust, a group of Peer Researchers have been discussing the use of stigmatising language in policy and research documents and service delivery. We reviewed words and phrases (too many to fit into this blog) used in service delivery, policy and academic papers. Phrases such as ‘drug of choice’ (‘it was never a choice, just a necessity’) and ‘substance use disorder’ (I didn’t use because I was disordered, I just couldn’t deal with the trauma’) were highlighted. As the quotes from our meeting demonstrate, language often misrepresents the reality, perspectives and experiences of people who take and/or are dependent on drugs, leading to policy and practice that fails to meet their needs.

TO CONTINUE READING:​https://www.centreformentalhealth.org.uk/hepatitis-c-and-mental-health-using-peer-support-to-fight-stigma/