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Type of submission: Oral
Conference track: Research
Topics: Innovative Harm Reduction Programmes; Viral Hepatitis and Tuberculosis
Presenting author: Ghazaleh Kiani
Ghazaleh Kiani, Rajvir Shahi, Arshia Alimohammadi, Tyler Raycraft, Arpreet Singh, Brian Conway
BAKCGROUND: Injection drug use is the major contributing factor for incident and prevalent Hepatitis C (HCV) infections in the developed world. The prevalence of HCV infection in Vancouver’s Downtown East Side (DTES), a population with a high incidence of injection drug use, may exceed 70%. However, relatively few individuals have been treated to date. We have developed a novel model of intervention, the Community Pop-up Clinics (CPC), as a harm reduction tool to enhance access to HCV therapy in this vulnerable population.
METHODS: Participants were recruited at weekly CPCs held at community centres. OraQuick® HCV and HIV Rapid Antibody point-of-care testing was offered. Participants identified as HCV positive were provided the opportunity to engage in multidisciplinary care at our centre. A questionnaire was administered to collect demographic information including HCV disease knowledge and desire to engage in care around it. A $10 incentive was granted for participation.
RESULTS: To date, a total of 1546 participants completed the questionnaire, with 649 (42%) self-identified as People Who Inject Drugs (PWID) (mean age 44.3 years, 78% male, 26.5% First Nations), with 145 (22.3%) reported to have shared needles and 226 (34.8%) shared other injection equipment. Among this population of PWID, 371 (57.2%) were infected with HCV, with 29 (7.8%) co-infected with HIV, 158 (24.3%) were subsequently linked to care, 26 (16.5%) received treatment for HCV infection, 20 (77%) completed treatment, with 16 (80%) achieving cure of their infection. Longer term follow-up on larger numbers of patients will be presented.
CONCLUSION: The CPC approach in a neighborhood with high prevalence of injection drug use and HCV infection has successfully identified over 300 HCV-infected PWID and engaged a significant proportion of them in care. Additional efforts must be undertaken in ensuring that engagement leads to enhanced access to curative HCV therapies in all eligible patients.