A national programme to scale-up decentralised hepatitis C point-of-care testing and treatment in Australia

Grebely, Jason; Markus, Corey; Causer, Louise; Silk, D. B. A.; Comben, Simon; Lloyd, Andrew R.; Martı́nez, Marı́a Elena; Cunningham, Evan B; O’Flynn, Mim; Dore, Gregory J.; Matthews, Susan

doi:10.1016/s2468-1253(22)00355-7

Cited by 14 publications

(3 citation statements)

References 6 publications

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“…Providers expressed a lack of knowledge about HCV testing, particularly regarding rapid point-of-care antibody and RNA tests, highlighting the need for thorough theoretical and practical training. This is consistent with the general practice of providing extensive training to providers for administering point-of-care antibody and RNA HCV tests [ 18 , 24 , 73 ]. Additionally, there was a notable emphasis on the importance of training in pre- and post-test counseling to ensure comprehensive care.…”

Section: Discussionsupporting

confidence: 79%

“…Employing service providers with personal experience of HCV or drug use, with different social identities, and favoring peerbased approaches could enhance the trust and comfort levels of those considering testing. The integration of services is vital, creating pathways that seamlessly incorporate HCV testing with other services offered by the organization and establishing partnerships with other healthcare providers to facilitate referrals and comprehensive care [24,73,75].…”

Section: Discussionmentioning

confidence: 99%

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Using an intersectionality lens to explore barriers and enablers to hepatitis C point-of-care testing: a qualitative study among people who inject drugs and service providers

Fontaine,

Presseau,

Bruneau

et al. 2024

Int J Equity Health

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Background Hepatitis C virus (HCV) infection is a significant global health burden, particularly among people who inject drugs. Rapid point-of-care HCV testing has emerged as a promising approach to improve HCV detection and linkage to care in harm reduction organizations such as needle and syringe programs. The objective of this study was to use an intersectionality lens to explore the barriers and enablers to point-of-care HCV testing in a needle and syringe program. Methods A qualitative study was conducted using semi-structured interviews with clients (people who inject drugs) and service providers in a large community organization focused on the prevention of sexually transmitted and blood borne infections and harm reduction in Montreal, Canada. An intersectionality lens was used alongside the Theoretical Domains Framework to guide the formulation of research questions as well as data collection, analysis, and interpretation. Results We interviewed 27 participants (15 clients, 12 providers). For clients, four themes emerged: (1) understanding and perceptions of HCV testing, (2) the role of an accessible and inclusive environment, (3) the interplay of emotions and motivations in decision-making, and (4) the impact of intersectional stigma related to HCV, behaviors, and identities. For providers, five themes emerged: (1) knowledge, skills, and confidence for HCV testing, (2) professional roles and their intersection with identity and lived experience, (3) resources and integration of services, (4) social and emotional factors, and (5) behavioral regulation and incentives for HCV testing. Intersectional stigma amplified access, emotional and informational barriers to HCV care for clients. In contrast, identity and lived experience acted as powerful enablers for providers in the provision of HCV care. Conclusion The application of an intersectionality lens provides a nuanced understanding of multilevel barriers and enablers to point-of-care HCV testing. Findings underscore the need for tailored strategies that address stigma, improve provider roles and communication, and foster an inclusive environment for equitable HCV care. Using an intersectionality lens in implementation research can offer valuable insights, guiding the design of equity-focused implementation strategies.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Using an intersectionality lens to explore barriers and enablers to hepatitis C point-of-care testing: a qualitative study among people who inject drugs and service providers

Fontaine,

Presseau,

Bruneau

et al. 2024

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…The prevalence of hepatitis C is estimated to be 10 times higher in persons who are incarcerated than in persons in the general population (10.7% vs 1%) . Accordingly, the national hepatitis C elimination plan includes the following 4 components that specifically focus on carceral settings: first, increasing the availability of more effective diagnostics such as rapid point-of-care tests; second, increasing the awareness of hepatitis C risk factors, prevention, and treatment strategies for justice-involved populations through evidence-based peer-to-peer training programs and other education sessions; third, encouraging use of telehealth and the Extension for Community Healthcare Outcomes–like models and expanding the types of health care practitioners who can treat hepatitis C, such as pharmacists and nurse practitioners, to support settings with a limited clinical workforce; and fourth, increasing the availability of case managers to coordinate care and assist in Medicaid reenrollment for individuals transitioning out of corrections, a strategy supported in a recent Centers for Medicare & Medicaid Services (CMS) guidance to CMS state Medicaid directors . Moreover, the national hepatitis C elimination plan will aim to move the hepatitis C care continuum to a streamlined test-and-treat model with rapid initiation of care and minimal monitoring in collaboration with hepatitis C treatment guidelines groups.…”

mentioning

confidence: 99%