Theme: Models of Care Year: 2019
Background: Georgia embarked on an elimination programme in 2015. Though anti-HCV screening
for people who inject drugs (PWID) has been implemented at point-of-service, access to
confirmatory viremia testing remains a major barrier. We evaluated two novel approaches to
improve access to viremia testing among PWID attending for care at harm reduction sites (HRS).
Description of model of care/intervention: This is an ongoing non-randomized interventional study
where HRS are assigned to one of three arms i) at four HRS, decentralized testing (Arm 1) where
blood draw, viremia testing and results provision is done on-site on the same day, ii) at two HRS a
centralized viremia testing approach is implemented (Arm 2) with blood draw on site and testing at a
centralized lab. Test results are made available at HRS at a follow up visit, iii) at two HRS testing is
done as per standard of care (Arm 3) where patients are referred to a treatment centre for testing
and results provided at the treatment centre.
Effectiveness: Between 21 May and 1 Feb 2019, 1292 participants were enrolled. Participants were
predominantly male (95%), median age 44 years and 76% were currently injecting drugs.
To date, 1038 participants who had a confirmatory viremia test done, 606 in Arm 1, 232 in Arm 2 and
200 Arm 3. On average participants received their results the same day (on average within 3 hours) in
Arm 1, 20.7 days in Arm 2 and 19 days in Arm 3 from the time they had blood drawn for testing.
Conclusion and next steps: Providing blood draw for HCV confirmatory viremia testing at HRS where
PWIDs attend for care/needle provision improves access to HCV confirmatory viremia testing. The
“HRS based approaches” resulted in a larger proportion of participants receiving their confirmatory
test results and the turnaround time was shortest where blood draw at HRS was combined with onsite testing.
Disclosure of Interest Statement: This project is funded by Unitaid