Theme: Epidemiology & Public Health Research Year: 2019
Background:We are currently in the throes of a syndemic of HIV, HCV and the Opioid Epidemic. As a
response GLIDE created an Integrated Harm Reduction Program Model, which includes providing:
Street Outreach; HIV & HCV Testing Navigation and Linkages; Syringe Access Services & Overdose
Prevention/Education & Narcan Distribution and Community (Peer) Navigation Program. This
workshop will demonstrate how to develop an integrated program, through expansion of services
(or collaboration) to deliver efficacious and cost-effective HIV, HCV prevention and care that is not
possible in the old model of programs that silo services. By cross-training staff GLIDE has created a
national model of Harm Reduction Integrated Programming. Our model has been very successful in
working with so called “hard to reach populations” mostly homeless PWID and PWUD, and, engaging
them successfully in our programs. The proximity of the Opioid Epidemic and its intersectionality
with HIV and HCV requires an integrated response.
Methods: This session will address the issues of how to integrate HIV, Hepatitis C and drug
user health programming to improve the outcomes for our most vulnerable populations by
demonstrating how to increase the uptake of HIV/HCV Testing and improve outcomes for
HIV viral suppression and HCV Treatment, as, as well as improving linkages to PrEP for high
risk negatives. San Francisco is heavily impacted by both HIV and Hepatitis C virus (HCV).
While San Francisco has been a national leader in HIV prevention and treatment, it has
struggled to manage HIV in our most marginalized populations. If San Francisco is truly
“Getting to Zero”, then it will require innovative program models that serve our most
vulnerable and stigmatized populations. Glide has created Programs that serve populations
that other programs do not serve as effectively. It is crucial that all HIV Programs include
HCV Programming. HCV is a significant driver of morbidity, liver cancer, and death. With the
availability of new highly effective HCV treatment, we have an excellent opportunity to cure
HCV in nearly all infected patients. Given that we now have these tools to greatly reduce
HCV-related morbidity and mortality in the community, we are at a crucial juncture in HCV
prevention and treatment. As is often the case with communicable diseases, HCV
disproportionately impacts marginalized populations, specifically people who inject drugs
(PWID), people who are homeless or marginally housed, people of color (most notably
African Americans), and people living with HIV. Opioid overdoses are killing more people in
the USA, than died at the height of AIDS. Many drug Overdoses are preventable or
reversible, and we need integrated programming to ensure that all drug users have access
to Narcan and are trained to use it. GLIDE Harm Reduction’s integrated programs ensures
that all clients who use drugs are given access to Drug Overdose Prevention Training/Narcan
Distribution. This session will describe the work of GLIDE Harm Reduction Services, a
Community Based Organization, that has cross trained staff that provide Integrated HIV/
HCV Testing, Navigation and Linkages, Syringe Access Services, Drug Overdose
Prevention/Narcan Distribution and Mobile Services.
Results: Between Jan, 1, 2016 – and April 23/2019, Glide Harm Reduction Programs has provided
4,785 HCV Tests, of those individuals 4,363 were unduplicated. 1041 were Antibody Reactiv. We
were able to get 354 RNA confirmatory tests.
416 clients were linked to HCV Treatment. 197 made their first appointment. 60 individuals had their
4-week viral load blood draw. 48 individuals reached SVR 12.
*The data is an undercount of the programs achievements as we were not always able to verify who
completed treatment.
Conclusion: The presentation will consist of a power point Presentation that extrapolates on
the success of Glide’s Integrated Program Model, to provide HIV/HCV Testing, Navigation,
and Linkages services, Syringe Access Services/Overdose Prevention/Narcan Distribution.
We will discuss the challenges of integrating programs and strategies to overcome them.
We can all agree that having multiple services co-located in the same program is highly
desirable and incredibly convenient for clients. Glide Harm Reduction Services goes one step
further and cross-trains our staff so that staff are able to deliver multiple services to greater
even greater cohesion of services. The workshop is designed to help program managers
think of ways to increase the services that they can offer clients by eliminating silos, and by
cross-training staff to provided multiple services. By focusing on Glide Harm Reduction
Services, we are able to give a real world example of innovation and program expansion that
can serve as a model for others. The workshop leans heavily on harm reduction theory and
practice and the need for culturally competency and trauma informed models of care. There
will be time at the end of the presentation for Q&A so that the audience has the
opportunity to contribute to the discussion or ask questions to support their work.
Disclosure of Interest Statement: none