Implementation of Dried Blood Spot Testing For HIV and Hepatitis C: The NSW DBS Pilot Study: A Client-Centred Alternative to Traditional Health Care

Author: Nigel Carrington Anna Conway Carolyn Murray Anna McNulty Philip Cunningham Heng Lu Mitchell Starr Beth Catlett Bianca Prain Joanne Holden Annabelle Stevens Colette McGrath Bianca Phillip Read Phillip Keen Louise Causer Rebecca Guy Cherie Power Anna Conway Jason Grebely

Theme: Epidemiology & Public Health Research Year: 2022

Dried blood spot (DBS) testing provides an alternative to phlebotomy and addresses barriers to
accessing healthcare experienced by some key populations. Large-scale evaluations of DBS
testing programs are needed to understand their feasibility. This study aims to evaluate the
implementation of a state-wide DBS HIV and HCV testing pilot.
The New South Wales (NSW) DBS Pilot is an interventional cohort study of people testing for
HIV Ab and/or HCV RNA in NSW, Australia. Participants at risk of HIV/HCV participated in
testing via: 1) self-registration online with a DBS collection kit delivered and returned by
conventional postal service; or 2) assisted DBS sample collection at 36 community health sites
(including drug treatment and harm-minimisation services) and prisons. Participants received
results by text (negative) or a healthcare provider (positive). The RE-AIM framework was used
to evaluate reach, effectiveness, and implementation.
Reach: Between November 2016 and December 2020, 7,392 individuals were tested for HIV
and/or HCV (21% self-registration, 34% assisted in community, and 45% assisted in prison).
Effectiveness: Of 6,922 people tested for HIV (19% MSM, 13% living outside major cities, 21%
born outside Australia), 51% (3,521/6922) had no HIV test in the past two years, 0.001%
(9/6,922) were newly diagnosed with HIV, and 89% (8/9) initiated HIV treatment within six
months. Of 5,960 people tested for HCV (24% women, 35% Aboriginal and/or Torres Strait
Islander, 55% recently injected drugs), 15% had detectable HCV RNA (878/5,960), and 45%
(393/878) initiated treatment within six months. Implementation: By the end of 2020, DBS
testing was available in 36 community sites and 21 prisons.
This study demonstrates the feasibility of DBS testing for HIV and HCV in key populations
including people in rural locations, people who inject drugs, and people in prison.
Disclosure of Interest Statement:
JG is a consultant/advisor and has received research grants from AbbVie, Camurus, Cepheid,
Gilead, Hologic, Indivior, and Merck outside the submitted work. PK has received a financial
award and speakers fees from Gilead.

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