The objective of this study was to determine gender differences in barriers associated with HCV treatment access, uptake and adherence. A descriptive hospital based comparative cross sectional study was conducted between May 2015 and April 2016. The target population was 240 chronic infected HCV patients who met the inclusion criteria, attending 3 hospitals in Alexandria city. Data were collected through pretested pre-coded structured interview format. Two separate multivariate logistic regression models were fit for each sex. Generalized estimating equation logistic regression was used to evaluate factors contributing to 95% confidence access, uptake and adherence to HCV therapy. There were differences between males and females regarding specific demographic, clinical, individual, psychosocial and healthcare factors facilitating treatment access and uptake. Women had lower levels of HCV knowledge, self- efficiency, and social support, had higher prevalence of psychological comorbidity, felt more social stigma and healthcare discrimination. Treatment access was low for both sexes. Fewer women had access to diagnostic tests, medication and continued care compared to men. Many patient, provider, healthcare and community barriers were significantly perceived by women that impact HCV treatment. Our findings indicated that social, behavioral, clinical, and health service characteristics associated with HCV treatment access, uptake, and adherence are potentially different among women and men. Early gender-based intervention strategies to improve treatment access should focus on these differences.
 

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