Client And Staff Perspectives On Point-Of-Care Hepatitis C Testing For People Attending Needle Syringe Programs

Author: Latham N, Pedrana A, Doyle J, Howell J, Williams B, Higgs P, Thompson A, Hellard M

Theme: Social Science & Policy Research Year: 2018

When treated for hepatitis C, people who inject drugs (PWID) achieve similar rates of cure to
non-PWID. However, a known barrier to treatment is the need to attend multiple appointments
for diagnosis. Point-of-care (POC) tests provide results within 20 to 108 minutes and can be
offered opportunistically at sites attended by PWID. In this nested qualitative study we explore
the perspectives of needle syringe program (NSP) attendees and staff on POC testing.
Clients that had recently undergone POC hepatitis C antibody and RNA testing at NSPs in
Melbourne, Australia were recruited for a semi-structured interview. Community health
workers, nurses, general practitioners, and managerial staff involved in POC testing were also
invited to participate in an interview. A hybrid thematic analysis of interview transcripts was
then performed.
Nineteen clients and seven staff were interviewed. Amongst clients, three core themes
emerged: people and place, method of specimen collection, and rapidity of result return.
Clients were not concerned as to the level of prior healthcare training of the staff member
performing the test (i.e. a community health worker compared to a nurse). While it was highly
acceptable to be offered testing at the NSP, no clients waited onsite to receive their POC RNA
result. Four core themes emerged from the staff interviews: challenges of the research
environment, developing practical skills, strategies for engaging clients, and logistical barriers
to service delivery. The need for formal written consent and detailed data collection were
highlighted as barriers to intervention delivery and client engagement.
Offering hepatitis C testing at NSPs is acceptable to PWID, however is limited by the speed
with which POC RNA tests produce a result. Staff, including those with no prior experience in
performing hepatitis C testing, felt confident with the technical and communication skills
required to deliver POC testing

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