Theme: Epidemiology and Public Health Research Year: 2021
Background: Prisons are key venues for HCV elimination. Complex clinical pathways, short periods of incarceration, and frequent prisoner movements remain barriers to efficient throughput in the HCV care cascade. Point-of-care (PoC) HCV RNA testing allows same-day testing, diagnosis, and treatment. This analysis evaluated preferences for an intervention integrating PoC HCV RNA testing, fibroscan-based liver disease assessment, nurse-led clinical assessment, and direct-acting antiviral (DAA) prescription (i.e. a ‘one-stop-shop’ intervention) versus standard of care among people recently incarcerated in Australia. Methods: The PIVOT study is a historically controlled study to compare standard of care (n=240; November 2019 – May 2020) to a ‘one-stop-shop’ intervention (n=290; June 2020 – April 2021) among males recently incarcerated at one reception prison in Australia. Participants completed an intervieweradministered survey including questions on preferences for the testing and treatment models. Results: Among the 490 participants (male, 100%; mean age, 36 years) enrolled between November 2019 and April 2021, 87% (425/490) reported previous incarceration and 49% (240/490) reported a history of injecting drug use. The majority of participants preferred a ‘one-stop-shop’ intervention (87%; 425/490) compared to standard of care. The main reasons for having a preference for a ‘onestop-shop’ intervention included having all testing done on the same day (57%; 243/425), the inclusion of PoC testing (18%; 77/425), and fast-tracked treatment commencement (19%; 80/425). Among those who participated in the ‘one-stop-shop’ intervention, 96% (278/290) considered it to be ‘definitely acceptable’. Conclusion: A ‘one-stop-shop’ intervention integrating PoC HCV RNA testing, fibroscan-based liver disease assessment, nurse-led clinical assessment, and DAA prescription was highly preferred to standard of care among new male receptions to prison. The effectiveness of the model in enhancing HCV treatment uptake is being evaluated in the PIVOT study. Disclosure of Interest Statement: See example below: The PIVOT study was supported by an investigator-initiated grant to the Kirby Institute UNSW Sydney by AbbVie Pty Ltd.
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