Theme: Epidemiology & Public Health Research Year: 2024
Background: Understanding patient preferences for hepatitis C (HCV) testing is critical to improve uptake. Despite novel testing modalities, little research exists on patient preferences. This study compared the uptake of HCV testing modalities when participants were given a choice.
Methods: People at risk of HCV were recruited from selected community sites in the National Hepatitis C Point-of-Care Testing Program. Enrolled participants received a visual aid outlining test features including time to result and mode of collection. Participants reporting prior HCV infection were offered staff-assisted HCV RNA tests [Xpert HCV Viral Load Fingerstick (result in 60 minutes) or dried blood spot (DBS) (result in 1-2 weeks)]. Participants reporting no prior HCV infection were offered self-administered INSTI HCV antibody (result in 1 minute), staff-assisted INSTI HCV antibody (result in 1 minute), staff-assisted Bioline HCV antibody (result in 5-15 minutes), or HCV RNA tests. Participants received their selected test, completed a survey, and received $20 reimbursement.
Results: Overall, 184 people were enrolled (26% female, 71% ever injecting drugs). Among those without a history of HCV (n=134), 77% (n=103) selected staff-assisted INSTI antibody testing (Figure 1). Only 5% (n=7) chose self-administered INSTI antibody testing and 3% (n=4) chose staff-assisted Bioline testing. Main reasons for selecting staff-assisted INSTI were the short time to result (75%), short time at the clinic (12%), and wanting someone else to do the test (4%). Of those with a history of HCV (n=50), 82% (n=41) selected point-of-care RNA testing and 10% (n=5) selected DBS testing. Reasons for selecting point-of-care RNA were the short time to result (41%) and having used the test before (15%).
Conclusion: Participants preferred the quickest perceived testing modality and, when given the option, few preferred self-testing over staff-assisted testing. Identifying patient preferences for HCV testing can improve uptake to achieve elimination in Australia.