Theme: Models of Care Year: 2024
Background: The COVID-19 pandemic disrupted healthcare services in British Columbia, leading to a decline in hepatitis C virus (HCV) testing. HCV prevalence is high among marginalized populations including people living with HIV, people who use drugs (PWUD), and Indigenous communities, are disproportionately affected, contributing to increased liver-related morbidity and mortality.
Description of model of care/intervention/program: The Dr. Peter Centre (DPC) launched a program aiming to eliminate HCV among clients, emphasizing education, capacity-building, and adherence support. Barriers to treatment are addressed through peer and nurse-led education, peer trainings, low-barrier testing, and clinician capacity-building. The DPC’s model emphasizes collaboration and holistic approaches to health care services, including Indigenous ways of knowing. Integrating HCV education and support within DPC’s existing range of health services will assist clients to optimize the benefits of testing and treatment, improve health outcomes, prevent transmission, and fulfill the goals of the program.
Effectiveness: Identifying education gaps, emphasizing trauma-informed care, peer leadership, aftercare support, and ongoing engagement proved essential for success (300+ clients reached, 30+ DBS and POCT completed, and 10+ staff trained). Project challenges exacerbated by intersecting public health crises were addressed through emergent strategies, including dried bloodspot testing, residence stabilization care for HCV treatment, and peer advisory committees to guide client engagement. Providing culturally relevant support at all levels of care is key, requiring the involvement of Peers, Nurses, Nurse Practitioners, Indigenous facilitators, and their physicians to ensure continuum of care.
Conclusion and next steps: Community-based and HIV-integrated HCV testing for PWUD holds promise for key populations. The next steps involve a HCV Resource Nurse, dietitian involvement, and extended admissions for stabilization and treatment. The program’s responsiveness, ongoing community engagement, and peer involvement remain crucial for effective HCV micro-elimination. The program continues to optimize strategies for PWUD, advancing HCV elimination, and addressing testing and treatment barriers.
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