1Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
2Rutgers New Jersey Medical School, Newark, NJ 07103, USA.
3Institute for Healthcare Delivery Science, Mount Sinai Health System, New York, NY 10016, USA.
4Center for State Health Policy, Rutgers University, New Brunswick, NJ 08901, USA.
5Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, NJ 07102, USA.
6Community Health Justice Lab, Newark, NJ 07107, USA.
7Department of Emergency Medicine, Department of Psychiatry and Behavioral Health, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA.
8Department of Medicine, Divisions of General Internal Medicine and Infectious Disease, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Despite effective antiviral therapy for hepatitis C virus (HCV), people who are incarcerated and those returning to the community face challenges in obtaining HCV treatment. We aimed to explore facilitators and barriers to HCV treatment during and after incarceration. From July-November 2020 and June-July 2021, we conducted 27 semi-structured interviews with residents who were formerly incarcerated in jail or prison. The interviews were audio-recorded and professionally transcribed. We used descriptive statistics to characterize the study sample and analyzed qualitative data thematically using an iterative process. Participants included five women and 22 men who self-identified as White (n = 14), Latinx (n = 8), and Black (n = 5). During incarceration, a key facilitator was having sufficient time to complete HCV treatment, and the corresponding barrier was delaying treatment initiation. After incarceration, a key facilitator was connecting with reentry programs (e.g., halfway house or rehabilitation program) that coordinated the treatment logistics and provided support with culturally sensitive staff. Barriers included a lack of insurance coverage and higher-ranking priorities (e.g., managing more immediate reentry challenges such as other comorbidities, employment, housing, and legal issues), low perceived risk of harm related to HCV, and active substance use. Incarceration and reentry pose distinct facilitators and challenges to accessing HCV treatment. These findings signal the need for interventions to improve engagement in HCV care both during and after incarceration to assist in closing the gap of untreated people living with HCV.