Background:
People who use drugs (PWUD) are particularly vulnerable to sexually transmitted and blood-borne infection(s) (STBBIs) including HCV, HIV and syphilis. In British Columbia (BC), Canada, an estimated 16,000 people are living with chronic HCV, with the largest proportion of new infections occurring among PWUD. Furthermore, data shows that syphilis rates increased by 108% in BC between 2017-2021. This study aims to characterize uptake of a low-barrier STTBI (dried-blood-spot or DBS) testing strategy among a cohort of PWUD in Vancouver, Canada.
Methods:
The Health Connect (HC) study launched in January 2024 and was designed to evaluate the impact of STBBI DBS testing at a Vancouver supervised-consumption-site (SCS). Participating SCS clients (ages 19+) completed interviewer-administered surveys at baseline, 1-month and 12-months. We used baseline data to characterize STBBI knowledge, testing behaviours, and assess uptake of DBS testing among participants.
Results:
The HC study enrolled 299 participants (median age 41; 39% women), of whom, 258 (86%) elected to participate in DBS testing (HCV, HIV and syphilis). 163 (55%) participants reported regular engagement (≥50% of the time) in SCS services when using drugs and 246 (82%) reported visiting a doctor in the past 12-months. STBBI knowledge among the HC cohort was high, with a median score of 7/8 (88%) correct answers. Among the 41 participants who declined to participate in DBS testing, 56% reported having completed STBBI testing in the past 12-months. Importantly, 67 (22%) HC participants reported being unattached to primary-care at baseline; of this cohort, 58 (87%) engaged in DBS testing with 14 (24%) returning a positive HCV RNA result and 15 (26%) returning a positive syphilis antibody result.
Conclusion:
These findings show high DBS uptake among SCS clients, suggesting that offering DBS testing in the low-barrier context of an SCS could enhance testing engagement, provide earlier diagnosis and improve linkage-to-care. |