Meet Alyssa

Alyssa is a 29-year-old, single mother with a three-year-old daughter. She lives in urban Atlanta and currently works in a low-income job as a grocery store clerk.

A Closer Look

Alyssa copes with her stress through alcohol and intravenous substance abuse. Although using, she is punctual and sober for her work shifts. She has the support of her aunt, who often takes care of her daughter for days at a time. This gives Alyssa the opportunity to cut loose a bit, sometimes sharing needles with friends while out at the clubs on weekends. She knows that this carries a risk of disease transmission, but she is not getting tested because she doesn’t feel ill. Unfortunately, Alyssa actually is positive for HCV, she just doesn’t know it.

A Look Ahead

Alyssa truly wants a better life for herself and her daughter, but she often feels trapped in the cycle of using drugs and isn’t sure how she could ever stop.

Healthcare Outlook

Alyssa’s history with healthcare workers has not been positive. She has felt dismissed by doctors based on her race when expressing concerns during her prenatal visits and visits to the ER. Alyssa also had a traumatic birth with her daughter and has not returned to the doctor since.

The Bigger Picture

People who inject drugs account for about 70% of new HCV infections. ~60% of people with HCV may be unaware of their status. 42% of people who use drugs reported peer-to-peer injection practices within the last 30 days. The first few years of injection drug use constitutes as a high-risk period; rate of HCV infection can exceed 40%

People who inject drugs account for about 70% of new HCV infections
~60% of people with HCV may be unaware of their status
42% of people who use drugs reported peer-to-peer injection practices within the last 30 days
The first few years of injection drug use constitutes as a high-risk period; rate of HCV infection can exceed 40%

Healthcare providers in substance use disorder treatment programs and needle/syringe exchange programs should offer routine, opt-out HCV-antibody testing with reflexive or immediate confirmatory HCV-RNA testing and linkage to care for those who are infected¹

To reduce barriers for people who inject drugs (PWID), healthcare providers should offer linkage to harm reduction services including intranasal naloxone, needle/syringe service programs, medications for opioid use disorder, and other substance use disorder treatment programs¹

Additional Third-Party Resources

Identification and Management of HCV in People Who Inject Drugs

CDC Recommendations for Hepatitis C Screening Among Adults

Hepatitis C Questions and Answers for Health Professionals

Determination of Need for Syringe Services Programs

1. AASLD-IDSA. https://www.hcvguidelines.org/unique-populations/pwid. Last updated September 29, 2021. Accessed October 13, 2021.

2. Blach S, et al. HCV cascade of care and next steps for HCV elimination in the United States following the COVID-19 pandemic. Poster present at: AASLD. The Liver Meeting; November 12-15, 2021; Digital experience.

3. Lamb S. Int J Drug Policy. 2018;61:44-51.

4. CDC. https://www.cdc.gov/ssp/syringe-services-programs-summary.html. Accessed February 14, 2022.