Onsite case management- Bridging the divide between HCV diagnosis and treatment for people who inject drugs.

Author: Wicks D, Drucker J

Theme: Models of Care Year: 2019

Many unique barriers exist for people who inject drugs (PWID) in accessing hepatitis C virus (HCV) care.
Services located in office or clinical settings have proven ineffective and inaccessible for this population.
Because of these unique barriers, The Hepatitis Education Project (HEP) has created an outreach case
management program in order to bring HCV specific case management to places where PWID live and
access services.
Description of model of care:
HEP utilizes outreach case managers, equipped to assist PWID navigate the HCV continuum of care. These
case managers give HCV education and provide testing onsite. Once diagnosed, HCV+ clients can then
immediately accessinsurance and treatment navigation, follow-ups, and referralsto a wide range of other
Since 2013 HEP has partnered with Evergreen Treatment Services (ETS), a methadone clinic where 79% of
its patients report a history of injection drug use. In July 2018, HEP placed an onsite case manager at ETS.
From July 2017-June 2018, before an outreach case manager frequented this site, 159 antibody (AB) tests
were conducted (13.25/month), 55% of which were AB+. Of those, 42% got a confirmatory test and 70%
were diagnosed. Of those diagnosed, 38% were linked to care. Since July of 2018, HEP conducted 141 AB
tests(15.6/month). Of these tests, 49% were AB+ and of those, 59% had a confirmatory test. 83% of those
were diagnosed and 44% were linked to care. Within the first 8 months of having onsite casemanagement,
AB and confirmatory tests along with diagnosis and linkage to care rates have all increased.
Conclusions and next steps:
Outreach case managers help bridge the divide separating HCV+ PWID from treatment. By providing case
management services at locations heavily accessed by the PWID community, linkage to care and
ultimately cure rates will increase.
Disclose of interest: none

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