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Journal of Community Health
Published in: Journal of Community Health 5/2014

01-10-2014 | Original Paper

Strategies for Hepatitis C Testing and Linkage to Care for Vulnerable Populations: Point-of-Care and Standard HCV Testing in a Mobile Medical Clinic

Authors: Jamie P. Morano, Alexei Zelenev, Andrea Lombard, Ruthanne Marcus, Britton A. Gibson, Frederick L. Altice

Published in: Journal of Community Health | Issue 5/2014

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Abstract

Despite new Hepatitis C virus (HCV) therapeutic advances, challenges remain for HCV testing and linking patients to care. A point-of-care (POC) HCV antibody testing strategy was compared to traditional serological testing to determine patient preferences for type of testing and linkage to treatment in an innovative mobile medical clinic (MMC). From 2012 to 2013, all 1,345 MMC clients in New Haven, CT underwent a routine health assessment, including for HCV. Based on patient preferences, clients could select between standard phlebotomy or POC HCV testing, with results available in approximately 1 week versus 20 min, respectively. Outcomes included: (1) accepting HCV testing; (2) preference for rapid POC HCV testing; and (3) linkage to HCV care. All clients with reactive test results were referred to a HCV specialty clinic. Among the 438 (32.6 %) clients accepting HCV testing, HCV prevalence was 6.2 % (N = 27), and 209 (47.7 %) preferred POC testing. Significant correlates of accepting HCV testing was lower for the “baby boomer” generation (AOR 0.67; 95 % CI 0.46–0.97) and white race (AOR 0.55; 95 % CI 0.36–0.78) and higher for having had a prior STI diagnosis (AOR 5.03; 95 % CI 1.76–14.26), prior injection drug use (AOR 2.21; 95 % CI 1.12–4.46), and being US-born (AOR 1.76; 95 % CI 1.25–2.46). Those diagnosed with HCV and preferring POC testing (N = 16) were significantly more likely than those choosing standard testing (N = 11) to be linked to HCV care within 30 days (93.8 vs. 18.2 %; p < 0.0001). HCV testing is feasible in MMCs. While patients equally preferred POC and standard HCV testing strategies, HCV-infected patients choosing POC testing were significantly more likely to be linked to HCV treatment. Important differences in risk and background were associated with type of HCV testing strategy selected. HCV testing strategies should be balanced based on costs, convenience, and ability to link to HCV treatment.
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Metadata
Title
Strategies for Hepatitis C Testing and Linkage to Care for Vulnerable Populations: Point-of-Care and Standard HCV Testing in a Mobile Medical Clinic
Authors
Jamie P. Morano
Alexei Zelenev
Andrea Lombard
Ruthanne Marcus
Britton A. Gibson
Frederick L. Altice
Publication date
01-10-2014
Publisher
Springer US
Published in
Journal of Community Health / Issue 5/2014
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-014-9932-9

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