A Community-Based Model Of Peer-Led Anonymous Rapid Hepatitis C (HCV) Testing For People Who Inject Drugs (Pwids) In Mauritius

Author: Manbode N, Mohabeer Hart M, Bundhoo N, Vencatasamy S, Ritter N

Theme: Models of Care Year: 2018

The Mauritian 2013 Integrated Biological and Behavioural Study among PWIDs
demonstrated that 96.5% tested positive for HCV. Among PWIDS positive for HIV, 99.7%
also tested positive for HCV. At the time, HCV-screening was government-led using only
laboratory testing for people living with HIV (PLWH), pregnant women, blood donors, and
PWIDs registering to the methadone-substitution programme. This study encouraged PILS
to develop a new HCV-screening programme to reach PWIDs and other key populations
PILS is the largest Mauritian HIV-support NGO, a member of the Hepatitis Alliance, and the
first organisation in the country to offer rapid HCV-screening.
In 2016, PILS started free rapid HCV screening at its nurse-led clinic. Testing, counselling,
and referral to specialists were offered by the nurse and health-care-assistant to PWIDs,
PLWH, and other KPs. After a capacity-building programme, we started peer-led outreach
rapid screening in 2017. To expand access to PWIDs, we visited methadone-distribution and
needle-exchange sites across Mauritius to offer anonymous HCV testing.
We expanded our outreach schedules, increasing methadone sites from six to twelve, and the
visit-frequency from once to twice weekly, and plan to increase to four times weekly. From
January 2017-January 2018, we conducted 295 rapid tests for PWIDs, with a positivity rate of
73% (216).
We provided HCV counselling, risk-reduction advice, treatment information to hundreds of
PWIDs, and a leg-ulcer clinic for HIV-positive PWIDs. We can refer only those who can afford
HCV genotyping – a discriminatory barrier to treatment within an existing welfare system meant
to fund universal free healthcare.
This programme has significantly increased HCV testing in PWIDs in Mauritius and helped
provide them with the right support. Our data is aiding essential advocacy work for access
to free HCV diagnostics and an expansion of the current treatment programme.

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