Theme: Epidemiology & Public Health Research Year: 2024
Background: The prevalence of Hepatitis C Virus (HCV) infection among key populations (KPs) in Johannesburg, South Africa, presents a significant public health challenge. People who inject drugs (PWID) and people who use drugs (PWUD) are particularly vulnerable to HCV transmission, yet access to screening, testing, and treatment services tailored to their needs remains limited. In this prospective observational study, we aimed to assess the effectiveness of Hepatitis C Virus Self-Testing (HCVST) in diagnosing HCV among KPs, including PWID, PWUD, men who have sex with men (MSM), and sex workers (SW).
Methods: Assisted implementation of HCV self-testing was conducted in Johannesburg, integrating HCVST with existing HIV services offered to KPs from May 2023 to February 2024. Participants presenting at HIV service sites were offered HCV self-tests (oral-based or blood-based). Those testing positive were offered confirmatory PCR testing.
Results: Out of 1355 PWIDs and PWUDs screened, 97% had never tested for Hepatitis C before, with 998 (73.7%) testing positive on Antibody self-tests, and 853 (63%) subsequently confirmed as positive through PCR testing. Of these, 28 (3.4%) individuals have been initiated on treatment to date, with 12 completing their treatment regimen. Observations reveal reluctance among participants to initiate treatment at clinics, preferring services to be brought to their locations.
Conclusion: Our findings underscore the urgent need for PWID and PWUD-friendly screening, testing, and treatment services tailored to the needs of KPs in Johannesburg. Innovative strategies to deliver healthcare services directly to these populations are essential to enhance access and uptake of essential interventions. Addressing this evolving problem requires collaborative efforts and ongoing adaptation of healthcare approaches to ensure inclusivity and effectiveness in combating the HCV epidemic among vulnerable populations.