# Disparities in the Diffusion of Direct-Acting Antiviral Therapy for Hepatitis C among Baby Boomers: A Mixed-Methods Study

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2022 · $152,550

## Abstract

PROJECT SUMMARY
 Hepatitis C virus infection (HCV) is the most important cause of chronic infectious disease death in the US,
with over 2 million people infected and nearly 20,000 dying annually. The greatest burden; occurs among “baby
boomers,” born 1945-1965 (75% of those infected). HCV disproportionately affects racial/ethnic minorities (25%
of those infected are Blacks; Black mortality is 87% and Hispanic mortality 43% higher than among Whites),
persons with HIV disease and injection drug users. Direct-acting antiviral (DAA) therapy recently became
available; it can cure >95% of people with HCV, but only half have been diagnosed and a much smaller proportion
treated. CDC’s National Viral Hepatitis Action Plan (NVHAP) calls for identification and treatment of all those
infected, but access for racial/ethnic minorities is problematic, due to costly medicines, stigmatization of those
with HCV, variable access to specialists, inconsistent provider awareness of need to diagnose and treat, and
variable coverage of treatment, particularly by state Medicaid plans. We propose to use an exploratory sequential
mixed methods design to analyze HCV testing and treatment patterns among US baby boomers, tracking the
diffusion of DAA therapy nationally and across demographic groups since initial licensing in 2014, and to conduct
qualitative work and surveys of patients and physicians to explore factors contributing to disparities in care.
 The Specific Aims are: 1) To use national and state-level publicly-administered health insurance claims data
to describe variations in HCV screening and treatment among the baby boomer cohort by a) examining
differences in HCV screening rates across race/ethnicity, community socioeconomic status (cSES), and primary
care utilization; b) evaluating the time between HCV diagnosis and antiviral treatment initiation among individuals
with a new diagnosis of HCV, by race/ethnicity and cSES; and c) evaluating time between FDA approval of the
first DAA HCV treatment, and initiation of DAA treatment for the prevalent population of baby boomers with
chronic HCV, by race/ethnicity and cSES; and, informed by these findings 2) To assess the contribution of patient
and provider factors to shaping disparities in diagnosis and treatment of HCV by adapting existing measures
and/or developing novel measures, and administering these to samples of HCV patients and providers, by a)
using patient focus groups and participatory feedback to adapt measures of stigma and discrimination in health
care and other settings, knowledge and beliefs about HCV and its treatment, and barriers to care (competing
needs, depression, drug use, access, patient costs, distance to care), then administering them to diverse HCV
patients in two US regions; and b) developing measures of HCV knowledge, attitudes, experiences and practices
among physicians, then administering them to primary care, gastroenterology, hepatology, and infectious
disease physicians in two US r...

## Key facts

- **NIH application ID:** 10480357
- **Project number:** 3R01DK123205-03S1
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** MARTIN F. SHAPIRO
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $152,550
- **Award type:** 3
- **Project period:** 2020-08-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10480357

## Citation

> US National Institutes of Health, RePORTER application 10480357, Disparities in the Diffusion of Direct-Acting Antiviral Therapy for Hepatitis C among Baby Boomers: A Mixed-Methods Study (3R01DK123205-03S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10480357. Licensed CC0.

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