Theme: Models of Care Year: 2018
Hepatitis C (HCV) is the most common infectious disease among people who inject
drugs (PWID). Engaging PWID in harm reduction services, such as needle exchange
programs, is pertinent to reduce HCV and HIV transmission. Additionally, testing for HIV
and HCV among PWID is important to improve identification and linkage to care rates.
This project looks at the implementation of HIV and HCV testing at the IDEA Exchange
in Miami, FL; Florida’s first and only needle exchange program.
Description of model of care/intervention:
The IDEA Exchange implemented dual routine, anonymous, opt-out, universal HIV/HCV
antibody screening of all participants at initial enrollment. Reactive HIV Ab patients were
given a second rapid test of a different brand; if reactive again, that participant is seen
as HIV positive and linked to appropriate care. Reactive HCV Ab patients receive
subsequent blood draw. The anonymous blood specimen is then sent to a partnering
lab where samples are frozen and analyzed for HCV RNA. Viral loads are reported back
to the IDEA Exchange, and patients are referred to the onsite linkage to care
coordinator in order to be actively linked to HCV care. Both HIV and HCV Ab negative
participants receive subsequent testing every 3 months after enrollment to capture
Implementation of the new screening protocol occurred March 1st, 2018. HIV and HCV
testing numbers were compared 4-weeks pre and 4-weeks post implementation. Overall
testing numbers increased by 283% and 203% for HIV and HCV, respectively. Biggest
increases were seen in testing at 3-month participant follow up, with testing increasing
by 700% and 1650% for HIV and HCV, respectively.
Conclusion and next steps:
Implementation of this model showed higher rates of HIV and HCV testing at initial
enrollment and 3 month follow-up. Universal screening and routine testing among PWID
through needle exchange can increase identification of new HIV and HCV infections.
Disclosure of Interest Statement: See example below:
This program is supported by the Gilead FOCUS program