Project 455923

Over the last five years, hepatitis C virus treatment has led to the possibility of elimination in Canada. With highly effective, all-oral therapies of 8-12 weeks that are widely available, the major barrier to elimination is engaging those who have acquired hepatitis C. Typically men have higher rates of hepatitis C as compared to women, however Canadian studies have demonstrated that women of childbearing age now have higher rates than men and are less likely to be treated. These increased rates are related to the power imbalance in injecting practices, and survival sex, and put women at higher risk. Prenatal care is a time where women are often engaged with the healthcare system, and thus may also be an opportune time to link women to hepatitis C care. At present it is not known whether women receive hepatitis C care postpartum prior to their next pregnancy. We propose a formal analysis using Ontario data to better understand at which point women can be better supported to receive treatment. At present, there are two treatments that work against hepatitis C; and it will be important that both are considered in the treatment of pregnant women. As small safety studies have been completed, with larger studies underway, better understanding women's desires regarding both screening and treatment is imperative. We propose to complete a survey of women's desires to be treated in pregnancy, as well as to better understand the stigma they may have faced in healthcare settings by enrolling 100 women who are pregnant with hepatitis C from practices in Ontario, Saskatchewan, and British Columbia. The finding of the Ontario data, paired with the prenatal desires of women from the survey, will provide better understanding of how women with hepatitis C can be better supported to be tested and treated for hepatitis C in pregnancy or postpartum.