ArticleHarm reduction journal2025
Breaking the vicious cycle of delayed healthcare seeking for people who use drugs.
Article in Harm reduction journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Why do people trust (or mistrust) health organizations? A systematic review.International journal for equity in health · 2026Pooled it
- Does perceived stigma impact opioid use disorder treatment uptake? A cross-sectional secondary analysis of buprenorphine engagement among syringe service program participants.Addiction science & clinical practice · 2026Trial
- 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
- Exploring the impact of stigma on the health of inclusion health groups: a qualitative scoping review and critical analysis.BMC public health · 2025Article
- Harnessing telemedicine to deliver patient-centered opioid agonist treatment within a community-based harm reduction service: a mixed methods evaluation.Harm reduction journal · 2025Article
- Active and resolved HCV infections among people with new HIV-1 diagnoses in Germany, 2009-2019.BMC infectious diseases · 2025Article
- Long-Term Benefits Following Hepatitis C Cure Through Facilitated Telemedicine; Experiences of People With Opioid use Disorder Five Years After Achieving a Sustained Virological Response.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Facilitated Telemedicine as a Patient-Centered, Sociotechnical Intervention to Integrate Hepatitis C Treatment Into Opioid Treatment Programs and Overcome the Digital Divide Among Underserved Populations: Qualitative Study.JMIR public health and surveillance · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundPeople who use drugs (PWUD) are at increased mortality risk, yet they typically avoid healthcare settings due to stigma and shunning. Understanding the healthcare journey from the viewpoint of PWUD has been understudied, although it is essential for informing solutions to increase healthcare access to improve their healthcare outcomes. We aimed to understand the process of accessing healthcare for PWUD, including perceived barriers and facilitators, by exploring their experiences, attitudes, and beliefs.
methodsWe employed purposive sampling to recruit PWUD to participate in nine focus group discussions (FGDs) (N = 57) in Athens, Greece. Inclusion criteria required a history of injection drug use, internet access, and Greek verbal fluency. The FGDs were audio-recorded, transcribed, translated into English, and de-identified. We analyzed FGD transcripts using modified grounded theory.
resultsParticipants' mean (standard deviation) age was 47.9 (8.9) years, 89.5% (51/57) were male, 91.2% (52/57) were of Greek origin, and 61.4% (35/57) had attended at least 10 years of school. We identified three key themes from the FGD transcript analysis: (1) seeking care after an individual's rapid health decline, (2) facing barriers in accessing healthcare, and (3) building trust to improve access to healthcare for PWUD. Participants disclosed that they tended to seek healthcare after a rapid deterioration in their health. They experienced multiple barriers to healthcare access such as stigma, healthcare system mistrust, unresponsive emergency medical services and competing priorities such as homelessness, mental health challenges, and ongoing manifestations of substance use disorder (SUD). Participants' recommendations to build patient-provider trust and improve healthcare access include stigma minimization, promotion of empathy in the patient-provider relationship, and engaging community organizations that serve PWUD to build bridges with healthcare providers and institutions.
conclusionsPWUD in Athens, Greece demonstrate delayed health-seeking behaviors and report multifaceted healthcare access barriers including stigma, delays in emergency care, poor mental health, homelessness, and SUD manifestations. Key trust-building processes to expand healthcare access include minimizing stigma and promoting empathy in healthcare encounters, enhancing healthcare staff education on SUD, improving the responsiveness of emergency medical services, engaging community organizations, and exploring telehealth's role in improving healthcare access for PWUD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.