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Abstract Details
Feasibility of hepatitis C virus testing and linkage in community supervision offices: Great potential but persistent challenges
Int J Drug Policy. 2022 Mar 31;103:103668. doi: 10.1016/j.drugpo.2022.103668.Online ahead of print.
1Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
2Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA.
3The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
4Rhode Island Department of Corrections, Pawtucket, Rhode Island, USA.
5Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA; The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Electronic address: cbeckwith@lifespan.org.
Abstract
Background: Persons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to eliminate HCV will require targeted interventions within the justice system effective at providing diagnosis and treatment.
Methods: We implemented a novel HCV screening and treatment intervention for persons under community supervision in Rhode Island, USA during April 2018--March 2020. Participants received rapid point-of-care HCV antibody testing onsite and referral to community laboratory and treatment services as indicated. We assessed the HCV care cascade to identify areas for improvement.
Results: Overall, 483 individuals were screened for HCV antibody; 85 (18%) were positive. A minority of participants with positive HCV antibody tests (n=25/85, 29%) presented to community laboratories for confirmatory testing. Among participants that received HCV viral load results and linked to a treatment provider (n=12), four initiated treatment, three had record of completing treatment, and two were confirmed to have achieved cure.
Conclusion: Linkage to HCV viral load testing and treatment was challenging in this community supervision population, with substantial loss to follow-up at each step of the HCV cascade. Community supervision remains an important venue for case identification but substantial barriers to accessing HCV treatment exist. Innovative HCV diagnosis and treatment strategies are needed for community supervision populations