Theme: Models of Care Year: 2019
Background: Harm Reduction Michigan(HRMI) is a small community-based organization, created to
provide important programming in response to the addiction epidemic in rural Michigan, where drug
user health has never been conceived outside of a twelve step abstinence framework.
Description of model of care/intervention: HRMI initiated routine Viral Hepatitis and HIV screening
and linkage to care (LTC), in partnership with Gilead Science’s FOCUS program, as part of our syringe
services program (SSP) which serves X rural counties in Michigan. Given the proficiency for venapuncture, we trained four former injection drug users as phlebotomists, two of which are secondary
exchangers for the SSP. We conducted an HIV and HCV point of care test preliminarily followed by a
confirmation lab draw which included screening for HBV and was processed by the Michigan
Department of Health and Human Services.
Effectiveness: In total, 403 people were tested for HIV, HBV, and HCV. 84 (21%) of these 403 were
identified as HCV antibody positive, and 27 (1%) as HCV RNA positive. The secondary exchangers
identified 10 cases of HCV. HRMI also 2 cases of HBV, and one case of HIV identified in the first year
of screening. All persons screened received their result and LTC rates were 100% (HIV) and 74%
(HCV).
Conclusion and next steps: Harm Reduction Michigan’s screening program concludes that PWIDs
trained to administer blood borne pathogen screening, diagnosis, and linkage to care, can effectively
decrease stigma in a vena-compromised, often untrusting, and heavily stigmatized population.
Disclosure of Interest Statement: Pamela Lynch discloses an affiliation of Gilead Sciences’ Speakers
Bureau.