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. 2025 Sep:143:104890.
doi: 10.1016/j.drugpo.2025.104890. Epub 2025 Jun 26.

Factors influencing the acceptability of hepatitis C screening among people with experience of incarceration in Quebec, Canada: A qualitative descriptive study guided by the Theoretical Domains Framework

Andrea Mambro  1 , Guillaume Fontaine  2 , David Ortiz-Paredes  1 , Sameh Mortazhejri  3 , Camille Dussault  1 , Joseph Cox  4 , Justin Presseau  5 , Nadine Kronfli  6
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Free article

Factors influencing the acceptability of hepatitis C screening among people with experience of incarceration in Quebec, Canada: A qualitative descriptive study guided by the Theoretical Domains Framework

Andrea Mambro et al. Int J Drug Policy. 2025 Sep.
Free article

Abstract

Background: For hepatitis C virus (HCV) elimination to occur in carceral settings, opt-out screening on admission, the first step in the HCV care cascade, is recommended. As screening strategies in Quebec provincial prisons vary, we aimed to identify factors influencing the acceptability of HCV screening among people with experience of incarceration (PWEI).

Methods: A theory-based qualitative descriptive study was used to conduct semi-structured interviews. Interview guides and analyses were guided by the Theoretical Domains Framework (TDF). Directed content analysis was used to identify domains within the TDF reflecting barriers and facilitators to HCV screening.

Results: Nineteen interviews were conducted from January-December 2022. Most (58 %) participants identified as cisgender men, and the median age was 48 years. Social influences was the most frequently coded domain indicating the importance of peer networks in influencing HCV screening uptake. This was followed by Environmental context and resources, underscoring the prison environment's role as both a barrier and facilitator to HCV screening, and Beliefs about consequences, pointing to perceived outcomes of a positive test, underpinned by a lack of knowledge, stigma, and fear/anxiety, on HCV screening uptake.

Conclusions: The TDF was useful in identifying factors associated with the acceptability of HCV screening among PWEI. Future interventions should seek to leverage peer networks, integrate point-of-care HCV testing, and provide whole-of-sector education and wrap-around services to better support PWEI and contribute to broader efforts to eliminate HCV among incarcerated populations.

Keywords: Hepatitis C virus; Implementation science; Screening, prison, people in prison; Theoretical domains framework.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: AM, DOP, SM, CD, and JP report no competing interests. GF has received hospitality and speaker fees from AbbVie and Gilead, outside of this work. JC has received research funding from ViiV Healthcare, Merck, and Gielead; consulting fees from ViiV Healthcare, Merck, and Gilead; and payment for lectures from Gilead, all outside this work. NK has received research funding from ViiV Healthcare, Abbvie, and Gilead and speaker fees from Abbvie, all outside this work.