Treating People Where They Are: Lessons From Outreach HCV Treatment For Networks Of People With Recent Injecting Drug Use In Victoria, Canada

Author: Barnett T, Lundgren K, Milne R, Drost A, Selfridge M, Fraser C

Theme: Models of Care Year: 2018

Housing First creates unique opportunities to treat individuals with HCV who have established
social networks and are in stable, supportive housing. By targeting Victoria Cool Aid Society
supportive housing sites for individuals with chronic mental health challenges and problematic
substance use, we can identify and cure HCV in PWID and their key social sharing networks.
Description of model of care/intervention:
This nurse-led project started with onsite education and recruitment of residents and their key
social sharing networks. Outreach nurses built relationships by attending supportive housing
units with food incentives to conduct initial screening with OraQuick/blood work, and FibroScan.
Weekly follow-ups creating individualized treatment plans led to regular check ins with staff and
residents and their social networks to provide medication, treatment monitoring and support.
Cash incentives in exchange for the previous week’s blister pack gave an excellent opportunity
to discuss harm reduction, reinfection risk and explore current health challenges.
By providing treatment to clients in their homes, our team has removed the need for clients to
present to the clinic, allowing us to treat clients with little or no prior contact with the health care
system. From February to April 2018, we visited 7 of 13 Cool Aid housing sites, screened 99
people, 50% current IDU, 4 currently on OST. 27 are HCV RNA+, 19 have started treatment, 8
pending approval for medication coverage. Peer and housing support, on-site intensive case
management have led to excellent medication adherence and engagement in primary care.
Conclusion and next steps:
This model will dramatically decrease the local burden of HCV in PWID and can be used as a
model of care for other communities. Our goal is to continue this project in all supportive
housing sites within the city to meet and treat as many PWID living with HCV as possible.
Disclosure of Interest Statement:
CACHC is part of the Victoria Cool Aid Society, a non-profit organization. We receive support for
our health programming from AbbVie Corporation, Gilead Sciences, Merck Canada.

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