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Type of submission: Oral
Conference track: Practice
Topics: Harm Reduction Services and Service Provision; Peer-Driven Treatment, Care and Harm Reduction
Presenting author: Konstantine Labartkava
Konstantine Labartkava, Tamar Bortsvadze, Julie Bouscaillou, Maia Butshavili, Ina Inaridze, Tamar Kikvidze, Guram Shafatava, Mikheil Tavadze, Natia Labartkava, Dimitri Tsiklauri, Paata Porchkidze, Aleko Khinchigashvili, Temur Khatiashvili, Ana Gamezardashvili, Elisabeth Avril
Issue: PWIDs represent the primary community affected by HCV infection in Georgia . In 2015, the government of Georgia started the HCV elimination program, which aims to reduce HCV-related morbidity, mortality and prevalence in the country.
However, barriers, such as criminalization and stigmatization of drug use and other structural barriers are hindrances to improve access to HCV treatment and Harm reduction services for PWIDs. A collaborative project between the grass-roots organization New Vector, Medecins du Monde France and ‘Neolab’ has been developed to enhance HCV assessment and treatment in this group.
Settings: This peer-supported model of HCV care has been implemented in Tbilisi, the capital of Georgia. The majority of participants in the project were male (99%), with a median age of 46 who had advanced liver diseases (stage ≥ F3). 65% were unemployed.
Project: In this model, peer-support intervention was a central mean to improve HCV treatment outcomes for PWIDs. The role of peer-supporters included educational interventions on hepatitis C, transmission, testing and monitoring; providing support to beneficiaries as they navigated the National HCV elimination program treatment pathways; acting as a go-between the clinical services and beneficiaries; and advocating for them where necessary. Overall, six peer-supporters followed 244 beneficiaries through the 12 to 48 weeks’ long treatment period.
Outcome: The model demonstrated that the peer-based model of care including HR services can be an effective strategy for increasing HCV treatment uptake and completion. As of September 2016, all patients completed the treatment and 208 received SVR12 results. Of those, 89% of patients who reached the SVR12. Of those started a treatment, five had to stop prematurely due to serious medical events. Among those who completed the treatment, 81.3% never missed any dose, and 90.4% never delayed nor missed one of the bi-monthly medical appointments.