Theme: Epidemiology & Public Health Research Year: 2017
It has been shown that people who use drugs (PWUD) are disproportionately disengaged from healthcare, and constitute the majority of prevalent and incident HCV infection in Canada. To achieve the World Health Organization’s goal to eliminate HCV as a public health concern by 2030, there is a need to design innovative approaches to link PWUD to care.
Participants were recruited at CPCs held at several community centres in the Downtown East Side (DTES) of Vancouver from 03/13-03/17. The prevalence of HCV infection in this community exceeds 65%. At the CPC event, OraQuick® HCV Rapid Antibody point-of-care testing was offered. Participants identified as HCV positive were provided immediate interaction with a physician or nurse and further engaged in care in a multidisciplinary setting to address their physical, psychological, social and addiction-related needs within the following 5 days. Participation was incentivized with a $10 gift card.
To date, we have recruited 3053 participants and 728 were active PWUD by history. Of the PWUD population 58% were found to be infected with HCV (n = 423). Among HCV infected individuals, the mean age was 47.5 years, 22.7% were Indigenous, 56.7% were male, 20% were homeless. All were offered initial medical appointments and 58.6% (n = 248) were reliably engaged in medical care. To date, 60 patients have received all-oral regimens and achieved sufficient follow-up to ascertain SVR, with 55/60 (92%) being cured.
In our community, the CPC model appears to be a useful tool for the diagnosis of HCV infection among PWUD, their engagement in multidisciplinary care and subsequent provision of successful HCV treatment. This portable and targeted intervention can be readily adapted to local needs. Ongoing research will help design optimal strategies to further improve the cascade of care in this key group of “core transmitters.”
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