Theme: Models of Care Year: 2019
Background: Micro-elimination ‘seek and treat’ approaches create unique opportunities to treat
individuals with high risk of transmitting HCV. By targeting Victoria Cool Aid Society supportive housing
sites for individuals with chronic mental health challenges and problematic substance use, we were able
to identify and cure HCV in People with Injecting Drug Use (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, and sustained
virological response (SVR) bloodwork gave an excellent opportunity to discuss harm reduction,
reinfection risk and explore current health challenges.
Effectiveness: By providing treatment to clients in their homes and with their friends, our team 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 2018 to March 2019, we visited 11 of 13 Cool Aid housing sites,
screening 180 people. 72 were HCVab+ and 51 had a positive HCV RNA. 43 patients started treatment
(24 current IDU, 18 on OST) and 32 have SVR results (1 LTF, 1 death, 6 still on treatment, 1 pending).
Peer and housing support, on-site intensive case management has led to excellent medication
adherence and engagement in primary care.
Conclusion: This micro-elimination model of care has dramatically decreased the local burden of HCV in
PWID and can be used as a model of care for other nurses and communities.
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.