Harm Reduction Strategies To Combat Hepatitis And The Opioid Epidemic

Author: Loris A Mattox, Braunz Courtney

Theme: Social Science & Policy Research Year: 2017

HIV Education and Prevention Project of Alameda County (HEPPAC) is based in Oakland, California; HEPPACs mission is to curb HIV and hepatitis infection among active substance users. HEPPACs primary population are active opioid users who are marginally housed and chronically homeless.
HEPPAC launched a mobile HCV screening model focused on IDUs in Oakland, where there was no formal screening activities. The goal of Seek, Test and Link was to increase IDUs hepatitis awareness and link to primary care.

HEPPAC utilized a renovated recreational vehicle to canvass known areas of intravenous drug use in the city of Oakland. Community Outreach Workers completed Phlebotomy certification to perform screening services in a non-clinical setting. Syringe exchange services served as point of entry services to engage IDUs to services and introduce HCV screening services. Reflex testing technology was used and an incentive based follow up strategy was utilized to move testing participants along the HCV cascade with the goal of assessment for treatment for confirmed positives and primary care for negatives.

HEPPACs Seek, Test, Link program, Oakland IDUs utilizing harm reduction services received HCV screening services in a non-clinical setting. 20% of the total tested were confirmed positive and a limited number of confirmed positives linked to primary care and/or began HCV treatment. External barriers; lack of mobile clinical services, lack of provider capacity to provide services to active IDUs, chronically homeless communities and mental illness.

HEPPACs integrated ham reduction model is successful in increasing protective behaviors of populations who are at increased risk for hepatitis infection. Extensive linkage to care strategies is needed to retain HCV infected IDUs to achieve sustained virologic response (SVR) to HCV treatment.

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