Willingness to Receive Treatment for Hepatitis C among Injecting Drug ‎Users on Methadone Program: Implications for Education and Treatment

Document Type : Original Article(s)


1 Program of International Research and Training, National Drug and Alcohol Research Centre, School of Public Health and Community ‎Medicine, University of New South Wales, Sydney, Australia

2 Department of Psychology, School of Psychology and Educational Sciences, Alzahra University, Tehran, Iran

3 Statistician, School of Health, University of Technology Sydney, Sydney, Australia

4 Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

5 Department of Psychology, School of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran


Background: Hepatitis C virus (HCV) is common among people who inject drugs (PWID) on methadone program in Iran (Persia). However, a few PWID on methadone program report willingness to receive HCV treatment. This study aimed to assess the factors which were associated with willingness to receive HCV treatment in a group of PWID on methadone program in Iran.Methods: We surveyed 187 PWID at seven drops in centers in Tehran, Iran. Details of demographic characteristics, drug use, injection, HCV, and drug treatment history were collected a using 25-item questionnaire. Participants were serologically tested for the current status of HCV.Findings: The study found that 28.3% of the participants were HCV seropositive. In total, 49.1% of the participants reported unwillingness to receive HCV treatment. Awareness of current HCV status [odds ratio (OR) = 3.43; 95% confidence interval (CI): 1.33-7.26; P < 0.050]; adequate knowledge of HCV treatment centers in the community (OR = 3.9; 95% CI: 1.24-5.38; P < 0.050); participation in an educational program on HCV (OR = 2.9; 95% CI: 2.33-8.56; P < 0.001) and recent participation in the meetings of self-help groups (OR = 4.6; 95% CI: 3.43-9.33; P < 0.001) were significantly associated with current willingness to receive HCV treatment. Conclusion:The study results indicate that awareness of HCV status and the provision of adequate HCV education via different information centers can be associated with an increased willingness for HCV treatment among PWID on methadone program. Conducting more research is suggested to assess the efficacy of educational programs and self-help groups in facilitating HCV treatment among PWID on methadone program. 


  1. Alam-Mehrjerdi Z, Abdollahi M, Higgs P, Dolan K. Drug use treatment and harm reduction programs in Iran: A unique model of health in the most populated Persian Gulf country. Asian J Psychiatr 2015; 16: 78-83.
  2. Razzaghi EM, Rahimi Movaghar A, Green TC, Khoshnood K. Profiles of risk: a qualitative study of injecting drug users in Tehran, Iran. Harm Reduct J 2006; 3: 12.
  3. Ministry of Health and Medical Education. Control of AIDS in the Islamic Republic of Iran's progress report [Online]. [cited 2013]; Available from: URL: http://www.unaids.org/sites/default/files/en/dataanalys is/knowyourresponse/countryprogressreport/2014cou ntries/IRN_narrative_report_2014_fa.pdf [In Persian].
  4. Mohtasham AZ, Rezvani M, Jafari SR, Jafari SA. Prevalence of hepatitis C virus infection and risk factors of drug using prisoners in Guilan province. East Mediterr Health J 2007; 13(2): 250-6.
  5. Mohammad Alizadeh AH, Alavian SM, Jafari K, Yazdi N. Prevalence of hepatitis C virus infection and its related risk factors in drug abuser prisoners in Hamedan- Iran. World J Gastroenterol 2005; 11(26): 4085-9.
  6. Alavi SM, Etemadi A. HIV/HBV, HIV/HCV and HIV/HTLV-1 co infection among injecting drug user patients hospitalized at the infectious disease ward of a training hospital in Iran. Pak J Med Sci 2007; 23(4): 510-3.
  7. Alavian SM, Mirahmadizadeh A, Javanbakht M, Keshtkaran A, Heidari A, Mashayekhi A, et al. Effectiveness of methadone maintenance treatment in prevention of hepatitis C virus transmission among injecting drug users. Hepat Mon 2013; 13(8): e12411.
  8. Zobeiri M, Adibi P, Alavian SM. Intravenous drug use and hepatitis C virus in Iran. Hepat Mon 2012; 12(1): 9-10.
  9. Rahimi-Movaghar A, Razaghi EM, Sahimi-Izadian E, Amin-Esmaeili M. HIV, hepatitis C virus, and hepatitis B virus co-infections among injecting drug users in Tehran, Iran. Int J Infect Dis 2010; 14(1): e28-e33.
  10. Chen EY, North CS, Fatunde O, Bernstein I, Salari S, Day B, et al. Knowledge and attitudes about hepatitis C virus (HCV) infection and its treatment in HCV mono-infected and HCV/HIV co-infected adults. J Viral Hepat 2013; 20(10): 708-14.
  11. Zamani S, Ichikawa S, Nassirimanesh B, Vazirian M, Ichikawa K, Gouya MM, et al. Prevalence and correlates of hepatitis C virus infection among injecting drug users in Tehran. Int J Drug Policy 2007; 18(5): 359-63.
  12. Alipour A, Haghdoost AA, Sajadi L, Zolala F. HIV prevalence and related risk behaviours among female partners of male injecting drugs users in Iran: results of a bio-behavioural survey, 2010. Sex Transm Infect 2013; 89(Suppl 3): iii41-iii44.
  13. Amin-Esmaeili M, Rahimi-Movaghar A, Razaghi EM, Baghestani AR, Jafari S. Factors correlated with hepatitis c and b virus infections among injecting drug users in Tehran, IR Iran. Hepat Mon 2012; 12(1): 23-31.
  14. Bini EJ, Kritz S, Brown LS, Robinson J, Calsyn D, Alderson D, et al. Hepatitis B virus and hepatitis C virus services offered by substance abuse treatment programs in the United States. J Subst Abuse Treat 2012; 42(4): 438-45.
  15. Grebely J, Thomas DL, Dore GJ. HCV reinfection studies and the door to vaccine development. J Hepatol 2009; 51(4): 628-31.
  16. Reed C, Bliss C, Stuver SO, Heeren T, Tumilty S, Horsburgh CR Jr, et al. Predictors of active injection drug use in a cohort of patients infected with hepatitis C virus. Am J Public Health 2013; 103(1): 105-11.
  17. Zeremski M, Dimova RB, Zavala R, Kritz S, Lin M, Smith BD, et al. Hepatitis C virus-related knowledge and willingness to receive treatment among patients on methadone maintenance. J Addict Med 2014; 8(4): 249-57.
  18. Orwat J, Samet JH, Tompkins CP, Cheng DM, Dentato MP, Saitz R. Factors associated with attendance in 12-step groups (Alcoholics Anonymous/Narcotics Anonymous) among adults with alcohol problems living with HIV/AIDS. Drug Alcohol Depend 2011; 113(2-3): 165-71.
  19. Shah HA, Abu-Amara M. Education provides significant benefits to patients with hepatitis B virus or hepatitis C virus infection: a systematic review. Clin Gastroenterol Hepatol 2013; 11(8): 922-33.