A New York City Health Department Collaboration to Improve Hepatitis C Screening and Navigation Services to Underserved Populations

Author: Jackilyn Rivera Liz Tang Angelica Boccour Tarek Mikati Yanting Kelly Huang Adeeba Khan Farma Pene Alexis Brenes Anna Huang Pei-Chi Chung Anna

Theme: Models of Care Year: 2022

Approximately 91,000 people are infected with hepatitis C virus (HCV) in New York City (NYC), with
40% undiagnosed. If untreated, HCV can cause liver failure or cancer. In 2021, HCV screening was
incorporated into all patient encounters at NYC Health Department Sexual Health Clinics (SHC).
Because SHC do not currently provide HCV treatment, NYC Health Department’s Viral Hepatitis
Program (VHP) and SHC collaborated to create referrals to culturally competent, multilingual
telephone navigation services, following screening.
Description of model of care/intervention:
People who tested HCV-positive at SHC and agreed to receive VHP navigation services were referred
for linkage to care and supportive services, including harm reduction, medication-assisted
treatment, and overdose prevention education. Those who did not agree were referred to the SHC
social work team or lost to follow-up. VHP referrals were provided by telephone and ≥3 outreach
attempts were made. Test history and linkage to care outcomes were entered into the NYC Health
Department HCV surveillance system.
During the first implementation quarter (March 2021–June 2021), 5,926 people were screened for
HCV. A higher proportion were Black (50%), Latino (30%) and older (median age was 40 years
compared with 29 years). From March 2021–February 2022, 20 people were referred to VHP: 5
(25%) were men who have sex with men; 4 (20%) were co-infected with HIV; 5 (25%) had history of
injection drug use; 19 (95%) spoke English; 1 (5%) spoke Spanish; 9 (45%) had public insurance and 6
(30%) were uninsured. Overall, 11 (55%) received navigation services, 8 were linked to care, and 6
had a subsequent negative RNA result after navigation services were received.
Conclusion and next steps:
This collaboration allowed for potentially underserved populations to receive culturally and
linguistically competent navigation services in a setting without on-site care and treatment.
Disclosure of Interest Statement:
The authors have no conflicts of interest.

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