#VP104: HCV Testing And Treatment At Syringe Exchange Program In New York City During COVID-19

Author: Jeffrey Weiss Abigail Hunter David Kalinoski Arash Diba Amanda Clay Kastalia Medrano Nathaniel Taylor Linda Wang Ponni Perumalswami

Theme: Models of Care Year: 2021

Background: Innovative models of integrating HCV testing and treatment into syringe exchange programs are needed to effectively treat people who inject drugs. The COVID-19 pandemic has presented challenges in these efforts due to increased social isolation and reduced services. Description of model of care/intervention: VOCAL-NY, a syringe exchange program in Brooklyn has been conducting point of care HCV testing (antibody and dry blood spot RNA) since 2012 and linking viremic persons to outside agencies for treatment. A collaboration with Mount Sinai Hospital in 2019 expanded HCV testing and established hybrid onsite-telemedicine HCV treatment at VOCAL-NY. After stopping testing in mid-March 2020 due to COVID-19, HCV testing resumed in June 2020. HCV treatment has been offered to viremic clients via telemedicine by a nurse practitioner working with a care coordination team. Effectiveness: From June 2020-March 2021, 235 clients were tested for HCV antibody (51; 21.7% were reactive). 22/51 (43%) were viremic and results were given to 16/22 persons. Of these 16, 8 attended an initial HCV treatment telemedicine visit. Of these 8, six began treatment, five completed treatment and one is still on treatment. None have yet reached the SVR12 time point. Both clients who have not yet started treatment remain engaged in the pre-treatment work-up process. Of the 8 who did not have an initial telemedicine visit, 5 are lost to follow-up and 3 remain in contact but lack motivation for HCV treatment at present due to competing priorities. Conclusion and next steps: During COVID-19, telemedicine is a feasible model of providing HCV treatment at a syringe exchange program but enhanced strategies to retain clients are needed for them to receive their HCV RNA results and successfully be linked to HCV treatment. Ongoing client engagement that recognizes clients have many competing priorities is effective at gradual engagement in HCV treatment. Disclosure of Interest Statement: See example below: The conference collaborators recognise the considerable contribution that industry partners make to professional and research activities. We also recognise the need for transparency of disclosure of potential conflicts of interest by acknowledging these relationships in publications and presentations.

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