ArticleMedical care2025
Medicaid Policy and Hepatitis C Treatment Among Rural People Who Use Drugs.
Article in Medical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Hepatitis B and C Prevention, Screening, and Diagnostic Services at HIV Treatment Sites: International Epidemiology Databases to Evaluate AIDS.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Drug Use and Social Connectivity Related to Hepatitis C Infection Among Rural People Who Use Drugs.Journal of viral hepatitis · 2026Article
- Hepatitis C care cascade using direct-acting antivirals in rural new York State from 2013 to 2023: a retrospective observational study.BMC infectious diseases · 2026Observational
- Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics?Tropical medicine and infectious disease · 2025Article
- The impact of smartphone addiction on creativity among college students: a moderated mediation model of negative emotion and perceived social support.Frontiers in psychiatry · 2025Article
- Implementation Evaluation of a Multicomponent Intervention to Address the Infectious Disease and Overdose Syndemic Among People Who Use Drugs in Rural Settings.Journal of public health management and practice : JPHMPArticle
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
backgroundRestrictive Medicaid policies regarding hepatitis C virus (HCV) treatment may exacerbate rural health care disparities for people who use drugs (PWUD). We assessed associations between Medicaid restrictions and HCV treatment among rural PWUD.
methodsWe compiled state-specific Medicaid treatment policies across 8 US rural sites in 10 states and merged these with participant survey data. We hypothesized that local restrictions regarding prescriber type, sobriety, and fibrosis estimates were associated with HCV treatment outcomes. We conducted a cross-sectional, ecological analysis of treatment restrictions and HCV treatment outcomes using bivariate analyses to characterize differences between PWUD who initiated HCV treatment and unadjusted logistic regressions to assess associations between restrictions and treatment.
resultsAmong 944 participants, 111 (12%) reported receiving HCV treatment. Participants receiving treatment were older [median age (interquartile range): 42 (34-53) vs. 35 (29-42), P<0.001], more likely to receive disability support (32% vs. 20%, P=0.002), and less likely to be Medicaid-insured (57% vs. 71%, P < 0.001). More PWUD in states without any restrictions reported receiving treatment (17% vs. 11%, P=0.08) and achieving HCV cure/clearance (42% vs. 30%, P=0.01) than in states with restrictions. Restrictions were associated with lower odds of receiving HCV treatment (odds ratio=0.61, 95% CI: 0.35-1.06, P=0.08). Sensitivity analyses showed a similar association with HCV cure/clearance (odds ratio=0.60, 95% CI: 0.40-0.91, P=0.02).
conclusionsWe identified significant unadjusted associations between Medicaid restrictions and receipt of HCV treatment and cure, which has substantial implications for health outcomes among rural PWUD. Lifting remaining Medicaid restrictions will be critical to achieving HCV elimination.
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