Peer-Led Community Based Integrated Infectious Disease Testing and Linkage to Care in Inclusion Health Populations in London, UK

Author: Julian Surey John Gibbons Mark Leonard Sive O'Regan Jen Fearnley Chris Laker Mario Bello Mary Maskell Binta Sultan Indrajit Ghosh Martha Veitch Andrew Hayward Binta Alistair Story

Theme: Models of Care Year: 2022

The COVID-19 pandemic presented severe challenges to services providing care to the most
vulnerable in society such as people experiencing homelessness. We describe the second phase of a
collaborative response of an integrated infectious disease inclusion health outreach team, led by
peer support workers (PSWs), nurses and community partners.
Description of model of care/intervention:
A multi-disciplinary team of community-based partners provided outreach testing with highly
trained PSWs. They utilised point-of-care testing technology (POCT), digital mobile radiology and
video supported care (VSC) with two mobile health units (MHU) serving homeless, migrant and other
inclusion health populations.
Ongoing interventions include peer-led blood borne virus (BBV) and sexually transmitted infection
(STI) testing and linkage to care; COVID-19 PCR testing of symptomatic individuals and outbreak
response mass testing; COVID-19 vaccination service; influenza, pneumococcal and hepatitis B
vaccinations; street-based sex worker (SBSW) BBVs testing.
Between May 2020 and December 2021, 3,676 BBV tests were performed. In the homeless setting
there was a high proportion of people who inject drugs (16.9%) and problematic alcohol use (31.9%).
The prevalence of BBVs was high for chronic HCV infection (8.1%), HIV (1.6%) and syphilis (1.4%). In
migrant populations a high prevalence of HBV (3.7%) was found.
In total, 13,122 COVID-19 PCR tests were done with 830 (6.3%) testing positive as well as 6,758
COVID-19 vaccinations. In the SBSW population, of the 68 tested, 21 (30.1%) were positive for at
least one STI. All individuals were supported into care by PSWs, some with VSC and follow-up data is
currently being collected on treatment outcomes.
Conclusion and next steps:
The integration of health, social care and third sector providers is highly effective and likely
very cost effective as well as being acceptable by service users and enhancing the role of
PSWs within healthcare delivery.
Disclosure of Interest Statement:

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