Evidence map›Paper›PMID 40924739›Full record

ArticlePloS one2025

Navigating Hepatitis C care: Knowledge gaps and access barriers among young women who inject drugs in rural Appalachia.

Cheyenne R Wagi, Renee McDowell, Anyssa Wright, Kathleen L Egan, Christina S Meade, April M Young, Madison N Enderle, Angela T Estadt, Kathryn E Lancaster

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Cheyenne R WagiWake Forest University School of Medicine, Department of Implementation Science, Winston-Salem, North Carolina, United States of America.ORCID 0000-0003-2046-1157
Renee McDowellOhio State University, Columbus, Ohio, United States of America.
Anyssa WrightOhio State University, Columbus, Ohio, United States of America.
Kathleen L EganWake Forest University School of Medicine, Department of Implementation Science, Winston-Salem, North Carolina, United States of America.
Christina S MeadeWake Forest University School of Medicine, Department of Translational Neuroscience, Winston-Salem, North Carolina, United States of America.
April M YoungUniversity of Kentucky, Department of Epidemiology and Environmental Health, Lexington, Kentucky, United States of America.
Madison N EnderleWake Forest University School of Medicine, Department of Implementation Science, Winston-Salem, North Carolina, United States of America.
Angela T EstadtOhio State University, College of Public Health, Division of Epidemiology, Columbus, Ohio, United States of America.ORCID 0000-0002-2951-051X
Kathryn E LancasterWake Forest University School of Medicine, Department of Implementation Science, Winston-Salem, North Carolina, United States of America.

Funding

The role of injection partnerships and preferences for reducing HCV risk: Giving a voice to young women in rural Appalachia.K01DA048174 · NIDA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI LANCASTER, KATHRYN ELIZABETH · 2019 to 2023
$841k
NIDA NIH HHS K01 DA048174
6 · The paper itself

Abstract

backgroundHepatitis C virus (HCV) and injection drug use among young women are dramatically rising in the rural United States. From 2004 to 2017, heroin use among non-pregnant women increased 22.4% biennially, mirroring increases in HCV cases, especially among younger populations. Young women who inject drugs (YWID, ages 18-35) face elevated HCV risk due to biological, behavioral, and socio-cultural factors. Barriers to HCV testing and treatment services further delay diagnoses, fuel transmission, and limit access to harm reduction services. This study applies the Theoretical Domains Framework (TDF) to identify factors influencing HCV testing and treatment among YWID in rural Appalachia Ohio.

methodsWe conducted in-depth interviews with YWID (n = 30) in 2023 to understand their HCV testing and treatment experiences in rural Appalachia Ohio. Interviews were transcribed, inductively coded, and analyzed using grounded theory. Identified themes were mapped onto the TDF domains.

resultsKey TDF domains influencing HCV care included knowledge, beliefs about consequences, and intentions. While YWID knew where to get tested, they expressed uncertainty about treatment value and access while actively using drugs. Social influences, stigma, and mistreatment by healthcare providers created barriers to treatment. Environmental context and resources, such as transportation, also influenced access to care.

conclusionsYWID in rural Appalachia face barriers to HCV care, such as gaps in knowledge about HCV treatment, which is compounded by gendered stigma, and logistical challenges. Rapidly changing treatment restrictions led to misinformation about treatment access. These gaps highlight the need for interventions specifically designed to address YWID lived experiences.

Indexed as

Health Knowledge, Attitudes, PracticeHealth Services AccessibilityHepatitis CSubstance Abuse, IntravenousAdolescentAdultAppalachian RegionFemaleHumansOhioRural PopulationYoung Adult

Identifiers

PMID40924739
PMCPMC12419586

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.