#VP138: Lessons learned in Alabama’s HCV work with the PWID population

Author: Anthony Lee

Theme: Models of Care Year: 2021

Background: The challenge of addressing Alabama’s Hepatitis C (HCV) epidemic has been compounded by the opioid epidemic assailing this southern Appalachian state. Screening and diagnosis of HCV is only a first step in addressing this challenge. Description of model of care/intervention: We implemented a community screening program, to target vulnerable populations. To meet this target, we partnered with Federally Qualified Health Centers (FQHCs) and Medication Assisted Treatment (MAT) sites. We also implemented a CME based training program to improve access by enabling primary care and MAT providers to manage and treat HCV. Effectiveness: Between 2018-2019, we screened a total of 13,021 patients and detected a seropositivity of 16% (2097/13021). The sero-positive rate in the Non-Baby Boomers (NBB) population is 21% (945/4545) vs 14% (1152/8476) for baby boomers (BB). More than 1 out of 3 (37% or 345/945) of seropositives NBB indicated injection drug use (IDU). (Of these, 72% (246/345) indicated IDU within the last 12 months at testing). Viremic patients with known IDU status in the NBB cohort had higher odds of being linked to care but lowest odds of being treated. 95% (240/252 IDU NBB) vs 75% (460/613 BB). Odds ratio 6.65 95 % CI: 3.62 to 12.22; p

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