Implementing Hepatitis C Screening and Care at a Community-Based LGBTQ+ Clinic

Description of program:
We implemented an HCV screening and treatment program at Open Door Health (ODH), an LGBTQ+ clinic in Providence, RI, USA in January 2023. In January 2024, we collocated a hepatologist at our primary and sexual health clinic one day per week. The hepatologist provides HCV treatment and care services to all persons who are confirmed HCV positive.

Effectiveness:
We reviewed HCV screening and treatment data at ODH from January 2023 through December 2024. ODH serves all persons regardless of their ability to pay, with a focus on LGBTQ+ populations. In January 2024, we began providing hepatology services at ODH.

A total of 2,088 people were screened for HCV during the two-year period. Among those, 86 (4%) were HCV-antibody positive and 38 (2%) were confirmed with chronic HCV infection. Nearly all persons (95%) with confirmed HCV infection reported a history of active substance use and were sexual and gender minorities. Among those with confirmed HCV, 47% (9) initiated treatment in 2023; while 89% (17) initiated in 2024 after we offered hepatology services. Among individuals who initiated treatment in 2024, 58% (11) completed treatment or achieved sustained viral response (SVR), compared to 26% (5) from 2023. All patients who completed treatment and who achieved SVR received intensive patient navigation services.

Conclusion and next steps:
Two percent of patients undergoing screening at an LGBTQ+ clinic were confirmed with HCV. Collocating a hepatologist one day per week at ODH improved HCV outcomes. HCV screening, treatment and cure is feasible and acceptable in American primary and sexual health settings. HCV cure rates may be enhanced by co-locating specialists in primary and sexual health care clinics.