A Perfect Storm and A Perfect Opportunity: The Story of an Innovative HCV Screening and LTC Program for Substance Users in Georgia


Author: Sutton M

Theme: Models of Care Year: 2019

Background:
Imagine Hope has managed HIV testing on behalf of Georgia’s Department of Behavioral
Heath/Office of Addictive Disease since 1996; testing nearly 200,000 individuals for HIV over the past
two decades. In response to long-standing client requests and in partnership with Gilead Sciences’
FOCUS project Imagine Hope began offering HCV testing and linkage in tandem with HIV testing in
March 2015.
Description of model of care/intervention:
HCV screening and linkage was integrated with an existing robust HIV testing program. Starting with
5 partner clinics in 2015, HCV screening is now conducted in 31 substance use and Medication
Assisted Treatment (MAT) facilities. Individuals testing HCV antibody positive (Ab+) receive RNA
confirmatory testing, with an emphasis on linking newly identified HCV+ individuals to education,
care, and treatment though dedicated linkage coordinators. Additionally, Imagine Hope’s capacity
building efforts enabled 2 MAT programs to integrate HCV treatment into their opioid use treatment
services.
Effectiveness:
HIV sero-prevelance rates have remained well under 1% annually. However, from April 2015-
December 2108 of the 27,401 individuals that were tested for HCV in 31 clinics across Georgia,
10.5% (2,882) tested HCV Ab+, and 70.6% (1972) were confirmed to be HCV RNA positive. Of those
HCV RNA+, 67.8% (1338) were linked to care. Of note 78.9% (1364) of HCV RNA+ clients were
outside of the baby boomer cohort.
Conclusion and next steps:
Implementation of HCV testing and linkage to care in tandem with an HIV testing embedded in
substance use and MAT programs provides an example of how the consequences of growing opioid
epidemic can best be addressed in individuals with substance use diagnoses. Plans are underway to
expand HCV screening and linkage services 10 additional clinics.
Disclosure of Interest Statement:
Imagine Hope receives funding from the Georgia Department of Behavioral Health and
Developmental Disabilities and Gilead Sciences FOCUS project.

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