{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T22:55:18Z","timestamp":1776293718729,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alpha Omega Alpha Carolyn L. Kuckein Student Research"},{"name":"Infectious Diseases Society of America Grants for Emerging Researchers\/Clinician Mentorship Grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>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\u2013November 2020 and June\u2013July 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.<\/jats:p>","DOI":"10.3390\/life13041033","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T04:45:32Z","timestamp":1681706732000},"page":"1033","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Access to Hepatitis C Treatment during and after Incarceration in New Jersey, United States: A Qualitative Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0761-231X","authenticated-orcid":false,"given":"Samir","family":"Kamat","sequence":"first","affiliation":[{"name":"Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1946-7589","authenticated-orcid":false,"given":"Sankeerth","family":"Kondapalli","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, NJ 07103, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shumayl","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Danias","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ksenia","family":"Gorbenko","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Institute for Healthcare Delivery Science, Mount Sinai Health System, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Cantor","sequence":"additional","affiliation":[{"name":"Center for State Health Policy, Rutgers University, New Brunswick, NJ 08901, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0095-9209","authenticated-orcid":false,"given":"Pamela","family":"Valera","sequence":"additional","affiliation":[{"name":"Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, NJ 07102, USA"},{"name":"Community Health Justice Lab, Newark, NJ 07107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aakash K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Department of Psychiatry and Behavioral Health, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4290-3083","authenticated-orcid":false,"given":"Matthew J.","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Department of Medicine, Divisions of General Internal Medicine and Infectious Disease, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1177\/003335491412900213","article-title":"Hepatitis C seroprevalence among prison inmates since 2001: Still high but declining","volume":"129","author":"Varan","year":"2014","journal-title":"Public Health Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1377\/hlthaff.2016.0296","article-title":"New Hepatitis C Drugs Are Very Costly and Unavailable to Many State Prisoners","volume":"35","author":"Beckman","year":"2016","journal-title":"Health Aff."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100567","DOI":"10.1016\/j.eclinm.2020.100567","article-title":"The hepatitis C virus care cascade in the New York City jail system during the direct acting antiviral treatment era, 2014-2017","volume":"27","author":"Chan","year":"2020","journal-title":"EClinicalMedicine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"ofaa263","DOI":"10.1093\/ofid\/ofaa263","article-title":"Outcomes of Hepatitis C Virus Treatment in the New York City Jail Population: Successes and Challenges Facing Scale up of Care","volume":"7","author":"Chan","year":"2020","journal-title":"Open Forum. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"ofx142","DOI":"10.1093\/ofid\/ofx142","article-title":"Feasibility of Treating Hepatitis C in a Transient Jail Population","volume":"4","author":"MacDonald","year":"2017","journal-title":"Open Forum. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Akiyama, M.J. (2020). Hepatitis C in the criminal justice system: Opportunities for global action in the era of viral hepatitis elimination. BMC Med., 18.","DOI":"10.1186\/s12916-020-01680-0"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S2468-1253(20)30365-4","article-title":"Hepatitis C elimination among people incarcerated in prisons: Challenges and recommendations for action within a health systems framework","volume":"6","author":"Akiyama","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/0033354916679367","article-title":"Correlates of Hepatitis C Virus Infection in the Targeted Testing Program of the New York City Jail System","volume":"132","author":"Akiyama","year":"2017","journal-title":"Public Health Rep."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Akiyama, M.J., Ross, J., Rimawi, F., Fox, A., Jordan, A.O., Wiersema, J., Litwin, A.H., Kaba, F., and MacDonald, R. (2020). Knowledge, attitudes, and acceptability of direct-acting antiviral hepatitis C treatment among people incarcerated in jail: A qualitative study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0242623"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Wurcel, A.G., Reyes, J., Zubiago, J., Koutoujian, P.J., Burke, D., Knox, T.A., Concannon, T., Lemon, S.C., Wong, J.B., and Freund, K.M. (2021). \u201cI\u2019m not gonna be able to do anything about it, then what\u2019s the point?\u201d: A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0250901"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1111\/jvh.12987","article-title":"Understanding facilitators and barriers of direct-acting antiviral therapy for hepatitis C virus infection in prison","volume":"25","author":"Lafferty","year":"2018","journal-title":"J. Viral. Hepat."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Akiyama, M.J., Columbus, D., MacDonald, R., Jordan, A.O., Schwartz, J., Litwin, A.H., Eckhardt, B., and Carmody, E. (2019). Linkage to hepatitis C care after incarceration in jail: A prospective, single arm clinical trial. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4344-1"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/jvh.12512","article-title":"The Hepatitis C virus treatment cascade at an urban postincarceration transitions clinic","volume":"23","author":"Hawks","year":"2016","journal-title":"J. Viral Hepat."},{"key":"ref_14","unstructured":"(2021, December 20). Prison Policy Initative. Available online: https:\/\/www.prisonpolicy.org\/profiles\/NJ.html."},{"key":"ref_15","unstructured":"(2021, December 20). New Jersey Reentry Corporation. Available online: https:\/\/www.njreentry.org\/application\/files\/7316\/4089\/3981\/Annual_Report_2017_Improving_Upon_Corrections.pdf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/QAI.0b013e31821e9f41","article-title":"HIV risk after release from prison: A qualitative study of former inmates","volume":"57","author":"Adams","year":"2011","journal-title":"J. Acquir. Immune Defic."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Crowley, D., Cullen, W., Lambert, J.S., and Van Hout, M.C. (2019). Competing priorities and second chances-A qualitative exploration of prisoners\u2019 journeys through the Hepatitis C continuum of care. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222186"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1007\/s11606-008-0790-y","article-title":"Living with hepatitis C: Qualitative interviews with hepatitis C-infected veterans","volume":"23","author":"Groessl","year":"2008","journal-title":"J. Gen. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s40352-019-0101-1","article-title":"\u201cService with open arms\u201d: Enhancing community healthcare experiences for individuals with a history of incarceration","volume":"7","author":"Westergaard","year":"2019","journal-title":"Health Justice"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1177\/1049732316665344","article-title":"Code Saturation Versus Meaning Saturation: How Many Interviews Are Enough?","volume":"27","author":"Hennink","year":"2017","journal-title":"Qual. Health Res."},{"key":"ref_21","unstructured":"Boyzatis, R. (1998). Transforming Qualitative Information: Thematic Analysis and Code Development, Sage Publications."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1177\/1049732315614579","article-title":"Parallel-Serial Memoing: A Novel Approach to Analyzing Qualitative Data","volume":"26","author":"Patel","year":"2016","journal-title":"Qual. Health Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1056\/NEJMp2004438","article-title":"Hepatitis C Treatment in Prisons Incarcerated People\u2019s Uncertain Right to Direct-Acting Antiviral Therapy","volume":"383","author":"Daniels","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"474","DOI":"10.3350\/cmh.2021.0015","article-title":"The impact of unrestricted access to direct-acting antiviral among incarcerated hepatitis C virus-infected patients","volume":"27","author":"Wong","year":"2021","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/wps.20306","article-title":"Treatment engagement of individuals experiencing mental illness: Review and update","volume":"15","author":"Dixon","year":"2016","journal-title":"World Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jhep.2011.05.032","article-title":"Gaps in the achievement of effectiveness of HCV treatment in national VA practice","volume":"56","author":"Kramer","year":"2012","journal-title":"J. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"ofac350","DOI":"10.1093\/ofid\/ofac350","article-title":"Care Navigation Increases Initiation of Hepatitis C Treatment After Release from Prison in a Prospective Randomized Controlled Trial: The C-LINK Study","volume":"9","author":"Papaluca","year":"2022","journal-title":"Open Forum. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1089\/apc.2010.0142","article-title":"Barriers to and facilitators of hepatitis C testing, management, and treatment among current and former injecting drug users: A qualitative exploration","volume":"24","author":"Swan","year":"2010","journal-title":"AIDS Patient Care STDS"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Bagnall, A.M., South, J., Hulme, C., Woodall, J., Vinall-Collier, K., Raine, G., Kinsella, K., Dixey, R., Harris, L., and Wright, N.M. (2015). A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-1584-x"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1353\/hpu.2018.0111","article-title":"The New Mexico Peer Education Project: Filling a Critical Gap in HCV Prison Education","volume":"29","author":"Thornton","year":"2018","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"10732748211006055","DOI":"10.1177\/10732748211006055","article-title":"The Development and Prototype Feedback of Digital Cancer 101 Videos to Enhance Cancer Education for Marginalized Communities with Limited Health Literacy","volume":"28","author":"Valera","year":"2021","journal-title":"Cancer Control"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1093\/pubmed\/fdv023","article-title":"A pilot study of rapid hepatitis C virus testing in the Rhode Island Department of Corrections","volume":"38","author":"Beckwith","year":"2016","journal-title":"J. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1080\/10509674.2017.1339159","article-title":"It\u2019s hard to reenter when you\u2019ve been locked out\u201d: Keys to offender reintegration","volume":"56","author":"Valera","year":"2017","journal-title":"J. Offender. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1056\/NEJMp2119571","article-title":"Strengthening the Medicaid Reentry Act Supporting the Health of People Who Are Incarcerated","volume":"386","author":"Khatri","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"108438","DOI":"10.1016\/j.jsat.2021.108438","article-title":"Hepatitis C treatment outcomes among patients treated in co-located primary care and addiction treatment settings","volume":"131","author":"Ngo","year":"2021","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"103283","DOI":"10.1016\/j.drugpo.2021.103283","article-title":"Linking criminal justice-involved individuals to HIV, Hepatitis C, and opioid use disorder prevention and treatment services upon release to the community: Progress, gaps, and future directions","volume":"96","author":"Taweh","year":"2021","journal-title":"Int. J. Drug Policy"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/4\/1033\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:17:13Z","timestamp":1760123833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/4\/1033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,17]]},"references-count":36,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["life13041033"],"URL":"https:\/\/doi.org\/10.3390\/life13041033","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,17]]}}}