#VP41: Acceptability Of Community-Based Hepatitis C Testing And Treatment Among People Who Inject Drugs In Yangon, Myanmar

Author: Win Lei Yee Bridget Draper Daniel O'Keefe Anna Bowring Alisa Pedrana Hla Htay Sonjelle Shilton Nwe Nwe Khin Pyone Kyi Khin Sanda Aung Win Naing Margaret Hellard

Theme: Epidemiology and Public Health Research Year: 2021

Background In Myanmar, people who inject drugs (PWID) experience high burden of hepatitis C virus (HCV) infection. Hospital-based HCV care has several challenges regarding limited clinical workforce, costs and long waiting lists. The advent of direct-acting antivirals (DAA) and rapid point-of-care (POC) diagnostics provides opportunities to shift to community-based HCV care, expanding access for PWID. Methods We assessed the acceptability of community-based HCV testing and treatment among PWID as part of an 18-month feasibility study in Yangon, Myanmar. Since January 2019, a team comprising a medical doctor, nurse and laboratory technician provided HCV care at two clinics. One clinic focusing on PWID has a peer worker on the team. On-site HCV diagnosis was performed using Xpert® HCV viral load test. Patients who tested HCV RNA positive were given DAAs, within seven days in most cases. Acceptability of community-based testing and treatment was assessed by five-point Likert scale surveys and indepth interviews following 12-week post-treatment (SVR12) testing. We report on data from 254 baseline surveys, 139 SVR12 surveys and ten in-depth interviews among PWID. Results Ninety-three percent (235/253) of baseline survey participants injected drugs in the past six months and 63%(161/254) were on methadone maintenance therapy. Seventy-two percent (181/253) and 77%(184/238) of participants reported POC antibody and RNA testing very acceptable respectively. Most participants reported blood taking from the vein, and blood testing at the clinic (rather than at a laboratory) very acceptable. Seventy percent (97/139) of SVR12 survey respondents were very satisfied with the overall HCV care. Similarly, qualitative interview participants (n=10) reported high acceptability of testing and treatment at the clinic and cordial services of the clinic staff. Conclusion To achieve international HCV elimination targets, improved access for key populations is required. Community-based HCV testing and treatment was highly acceptable to the majority of our PWID participants in Yangon. Disclosure of Interest Statement This study is part of a FIND programme known as Hepatitis C Elimination through Access to Diagnostics (HEAD-Start), funded by Unitaid.

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