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Background and aims: Mathematical modelling has demonstrated the theoretical feasibility of HCV treatment‐as‐prevention strategies in custodial settings, yet limited empirical data exists. The Australian 'Surveillance and Treatment of Prisoners with Hepatitis C' study is the world's first trial of hepatitis C virus (HCV) treatment‐as‐prevention in prison. This study aimed to analyse how expert stakeholders involved in the Australian HCV response assessed the acceptability of HCV treatment‐as‐prevention in prison using interview data from the SToP‐C qualitative substudy. Design and setting: Qualitative analysis using semi‐structured interviews in Australia. Participants: Nineteen key HCV experts. Measurements Drawing upon Sekhon's theoretical framework of acceptability, data were organized thematically under four component constructs of acceptability: affective attitude; ethicality; opportunity costs; and perceived effectiveness. Findings Most differences in participant assessments of acceptability were a matter of relative emphasis and prioritization rather than absolute polarity. Nonetheless, a small minority of participants was overtly critical of the approach. Arguing against the focus on treatment, they instead advocated for prevention‐as‐prevention, including the improvement and expansion of existing harm reduction measures. Conclusions: Qualitative analysis of expert stakeholder assessments of the acceptability of hepatitis C virus treatment‐as‐prevention in Australian prisons found no opposition to the universal rollout of direct‐acting anti‐virals, but most voiced concern regarding the lack of effective primary prevention in Australian prisons. [ABSTRACT FROM AUTHOR]

Background and Aims: Hepatitis C (HCV) is a global public health concern, particularly in the prison setting where prevalence is substantially higher than in the general population. Direct‐acting antivirals have changed the treatment landscape, allowing for treatment scale‐up efforts potentially sufficient to achieve prevention of onward transmission (treatment‐as‐prevention). The Surveillance and Treatment of Prisoners with hepatitis C (SToP‐C) study was the first trial to examine the efficacy of HCV treatment‐as‐prevention in the prison setting. Social capital is a social resource which has been found to influence health outcomes. This qualitative study sought to understand the role of social capital within an HCV treatment‐as‐prevention trial in the prison setting. Design Semi‐structured in‐depth interviews were undertaken with participants recruited from the SToP‐C study following HCV treatment completion (with cure). Setting: Three male correctional centres in New South Wales, Australia (including two maximum‐security and one minimum‐security). Participants: Twenty‐three men in prison participated in semi‐structured interviews. Measurements Thematic analysis of transcripts was completed using a social capital framework, which enabled exploration of the ways in which bonding, bridging and linking social capital promoted or inhibited HCV treatment uptake within a treatment‐as‐prevention trial. Findings Social capital fostered HCV treatment uptake within an HCV treatment‐as‐prevention trial in the prison setting. Bonding social capital encouraged treatment uptake and alleviated concerns of side effects, bridging social capital supported prison‐wide treatment uptake, and linking social capital fostered trust in study personnel (including nurses and correctional officers), thereby enhancing treatment engagement. Conclusions: Social capital, including bonding, bridging and linking, can play an important role in hepatitis C treatment‐as‐prevention efforts within the male prison setting. [ABSTRACT FROM AUTHOR]