Hepatitis C virus control among persons who inject drugs requires overcoming barriers to care

Table 1 Most common barriers to engagement of persons who inject drugs into care for hepatitis C virus infection

Domain	Specific barrier
Patient-level	Low perceived treatment need
	Fear of side effects
	Lack of knowledge of serostatus
	Fear of liver biopsy
	Needles may promote relapse
	Coexisting mental health diagnosis
	Lack of insurance, poverty, low socioeconomic status
Physician-level	Concerns about reinfection
	Biases against PWID
	Adherence concerns
	Dual diagnoses
Health system-level	Navigation can be complex
	Mistrust between PWID and medical community
	High cost of HCV treatment
	Stigmatization in health care venues

HCV: Hepatitis C virus; PWID: Persons who inject drug.