Theme: Models of Care Year: 2024
Background: Achieving optimal public health outcomes for Hepatitis C Virus (HCV) requires expanding HCV screening and treatment in the primary care setting, with a focus on eliminating the HCV reservoir among people who use drugs. Recent data also suggest a need to focus on HCV screening among men who have sex with men (MSM).
Description of Program: We implemented an HCV screening program and reviewed HCV seroprevalence at a community-based primary care clinic focused on serving LGBTQ+ populations.
Methods and Effectiveness: We provided HCV screening and treatment services at Open Door Health (ODH) in Providence, Rhode Island, USA from March 2023 to February 2024. Open Door Health is the only LGBTQ+ clinic in the state of Rhode Island. We reviewed demographic, behavioral, laboratory and HCV care outcome data for all persons presenting for primary care visits.
A total of 959 people were screened for HCV. Among those, 38 were HCV-antibody positive and 29 received reflexive HCV RNA testing; 21 were confirmed to have chronic HCV infection. All persons with confirmed HCV infection reported a history or active substance use and were sexual and gender minorities. Among those with confirmed HCV, 11 individuals were prescribed treatment, 9 attended and HCV treatment and initiation appointment, and 4 completed the full course of treatment. Only three patients achieved sustained viral response (SVR). All patients who completed treatment and who achieved SVR received intensive patient navigation services, which started eight months after we began systematically screening for HCV.
Conclusion and Next Steps: Patients presenting for primary care services at an American LGBTQ+ clinic have high rates of HCV infection and suboptimal SVR rates. The primary barrier to achieving SVR was patients failing to present for ongoing clinical appointments. We used these findings to develop and enhance our HCV screening and patient navigation program at our LGBTQ+ clinic. Similar navigation programs are likely needed in other LGBTQ+ clinics in the USA.
Disclosure of Interest Statement: We have no conflicts and no disclosures.