HIV and HCV screenings in harm reduction settings – a pilot project based on a proximity strategy

Author: Costa I, Lopes R, Merendeiro C

Theme: Models of Care Year: 2019

CRESCER has outreach teams since 2002, operating daily in the main neighborhood of consumption
in Lisbon-Portugal, following 1500 people per year. This proximity approach is focused in reach drug
users, who are in an vulnerable situation. This group is shown to be at the highest risk of HIV and
HCV infection. CRESCER proposed a pilot project which aimed at assessing people on the field.
Description of model of care/intervention:
In cases of positive results, strategies were used to enhance treatment compliance: provide
transport, establish partnerships with hospitals/associations, ensure medication intake and
psychological support. Qualitative and quantitative data were collected. The treatment cascade of
this pilot project is described.
This project has been running since October, 2018 until March, 2019. The sample comprises 62
subjects, 39 of whom were screened for both HCV and HIV infection, while 23 were only screened to
HCV. The sample analysis showed an average age of 44.23 years, mostly from male gender (79.03%)
and homeless individuals (72.58%). Also, 53.23% reported intravenous substance use, 25.81% shared
consumption material, 50% had sex without condom and 29.03% were not followed by any health
structure. As regard to screening results, 2 subjects were positive for HCV and HIV, 19 for HCV only
and 1 for HIV only. 21 subjects were referred to medical appointments. Until now, seven have
attended the appointments, three of whom have started treatment (for the remaining four, no
treatment was required).
Conclusion and next steps:
This pilot project is a novel and creative approach that overcomes barriers to HIV and HCV infection
treatment. This methodology has proved effective for reach and screen psychoactive substances
users. We believe that the next step should be the integration of HIV and HCV infection treatment in
harm reduction settings in order to link all the subjects to care.
Disclose of interest: none

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