However, events such as specialist referrals that were not completed may have been forgotten by some women. At the time of our study, 390 participants with HCV had already died. analysis was used to predict 2 outcomes: 1) being offered treatment; and 2) receiving treatment (which included those successfully or unsuccessfully completing it, as well those still receiving treatment). In this analysis, the 159 women who were unaware of their HCV status were assumed to be null on each of the 2 dependent variables, that is, they were assumed to have neither been offered treatment nor received it. In the model predicting referral for treatment, offered in the left hand columns of Table?3, African-American race, Hispanic/Latina ethnicity, low income, and current crack/cocaine/heroin use were negatively RPB8 associated with being offered treatment, whereas elevated ALT was significantly associated with increased likelihood of treatment referral. However, in the model predicting treatment received or completed, only elevated ALT significantly increased the likelihood of treatment, whereas all other model variables were nonsignificant. We also ran these 2 models limiting the sample to the 522 women who reported awareness of their HCV status and the same variables were significant. Table?3 Multivariate Logistic Regression: Factors Associated with Referral for and Receipt of HCV Treatment Among HIV-infected and Uninfected Women with HCV ( em N /em ?=?681) thead th rowspan=”2″ colspan=”1″ Characteristics /th th colspan=”2″ rowspan=”1″ Referred for HCV Treatment /th th colspan=”2″ rowspan=”1″ Received HCV Treatment /th th rowspan=”1″ colspan=”1″ Odds Ratio /th th rowspan=”1″ colspan=”1″ Confidence Int. /th th rowspan=”1″ colspan=”1″ Odds Ratio /th th rowspan=”1″ colspan=”1″ Confidence Int. /th /thead African American0.52(0.29C0.95)*0.70(0.28C1.73)Hispanic/Latina0.50(0.25C0.99)*1.46(0.55C3.88)Other0.50(0.13C1.96)2.93(0.60C14.45)WhiteCCCCHIV-positive0.63(0.36C1.10)0.60(0.27C1.31)Income *$12,000/yr0.52(0.33C0.80)?0.97(0.50C1.86)ALT 2X2.08(1.29C3.34)?2.31(1.23C4.34)*Same health care provider1.68(0.96C2.94)1.68(0.80C3.53)In alcohol treatment1.10(0.70C1.73)1.20(0.62C2.30)Currently using alcohol0.81(0.52C1.28)0.59(0.29C1.19)Baseline IDU1.55(0.82C2.90)1.03(0.40C2.66)Current CCH Use0.44(0.23C0.85)*0.75(0.30C1.90) Open in a separate window Analysis was controlled for site. * em p? ?00.05 /em ? em p? ?0.01 /em DISCUSSION One-third (31%) of the WIHS cohort of low-income HIV-positive and HIV-at risk-negative women were found to be co-infected with HCV. However, one quarter of these HCV Ab-positive women reported being unaware of their HCV diagnosis. This lack of awareness occurred in the context of the WIHS protocol that included informing participants of their HCV status and often communicating the result to the participants primary providers. Our findings are consistent with LY500307 previous studies that have documented unawareness, denial, or stigma related to drug use, racial discrimination, previous unfavorable experiences with the health care system, and lack of knowledge among health care providers as barriers to HCV screening and treatment among women, especially those with a history of injection drug use.5,16C18 Among WIHS women who were aware of their HCV diagnosis, 1 in 4 reported evaluation by liver biopsy and treatment for HCV (with over one third of these successfully completing treatment). This rate of diagnostic and therapeutic intervention is similar to rates of HCV evaluation and treatment reported by LY500307 others. Restrepo et al. in a review of HIV/HCV co-infected patients followed in a gastroenterology medical center, reported that only 20% experienced received a liver biopsy and 15% received treatment for HCV.19 The majority of those not receiving treatment in that report were considered ineligible because of noncompliance with clinic appointments, active substance use, psychiatric illness, and advanced liver disease and other LY500307 comorbidities. In a review of the Veterans Affairs National Patient Care Database, treatment rate for HCV was 11.8%, with increasing age, black race, incarceration, drug and alcohol abuse and dependence, and comorbid illnesses being associated with nontreatment.20,21 In 2004, People from france investigators surveyed doctors looking after HCV/HIV co-infected individuals and identified inaccurate signs, lack of obtainable liver organ biopsy, psychiatric contraindication, and doctor conviction that the individual could have poor conformity, mainly because significant reasons why just about half of any kind of treatment continues to be received from the individuals.22 Hall et al. discovered a straight lower price (4%) of treatment among homeless low-income shot medication users in SAN FRANCISCO BAY AREA, with non-white poor persons less inclined to access treatment and testing. 5 Our research demonstrates that although poverty, ongoing substance make use of, and competition/ethnicity are connected with ladies becoming known for HCV treatment adversely, most women who have been referred for liver HCV or biopsy treatment do follow their physicians recommendations. When the same multivariate model utilized to predict recommendation for.