{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:41:08Z","timestamp":1792035668762,"version":"4.4.0"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Despite high rates of hepatitis C virus (HCV) infection among people experiencing unsheltered homelessness and the availability of highly effective treatments, this population remains underserved by traditional treatment models.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To explore the perspectives of patients experiencing unsheltered homelessness who are engaged in street-based HCV treatment.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This qualitative study conducted one-time, in-person, semistructured interviews from June to August 2023 of adults (aged \u226518 years) who initiated HCV treatment through a street medicine program providing comprehensive primary care to people experiencing unsheltered homelessness in Los Angeles County, California. Data were analyzed using a modified grounded theory approach with thematic analysis from November to December 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Engagement in street-based HCV treatment as part of patient care via a street medicine program.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes were participant-reported experiences with HCV treatment. Secondary measures included treatment completion, sustained virologic response (SVR), and clinician confidence ratings, obtained through medical record review and clinician survey.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 15 participants (mean [SD] age, 48.8 [7.6] years; 12 [80%] male) were interviewed, 13 (87%) of whom were unsheltered at treatment initiation. Of the 15 participants, 12 (80%) completed treatment and 10 (67%) achieved SVR. Two participants who completed treatment were lost to follow-up before confirmatory SVR laboratory samples could be drawn. Four major themes emerged: things that changed, including participants\u2019 housing status, optimism, sense of agency, commitment to their health, and HCV-related knowledge; barriers to treatment, including challenges related to unsheltered homelessness, concerns about medication adverse effects, and prior denial of treatment; facilitators to treatment, including support networks, trusted relationships with clinicians, close follow-up, and tolerability of newer medications; and communication, reflecting participants\u2019 desire to share treatment successes and encourage peers to seek treatment. Clinician confidence in treatment completion varied and did not consistently align with patient outcomes.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this qualitative study of street-based HCV treatment among adults experiencing unsheltered homelessness, participants described care as accessible, supportive, and transformative, reporting wide-ranging psychosocial benefits achieved through engaging in care. Findings highlight street-based, patient-centered models as a promising approach to HCV treatment for unsheltered homeless populations and the importance of policy environments that enable low-barrier care delivery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.23334","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:00:26Z","timestamp":1784214026000},"page":"e2623334","source":"Crossref","is-referenced-by-count":1,"title":["Street-Based Hepatitis C Treatment and Patient Experiences Among Adults Experiencing Unsheltered Homelessness"],"prefix":"10.1001","volume":"9","author":[{"given":"Aliz\u00e9e","family":"Natsoulis","sequence":"first","affiliation":[{"name":"USC Street Medicine, Department of Family Medicine and Geriatrics, Keck School of Medicine of USC, University of Southern California, Los 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