Meeting People Where They Are At: Preliminary Results From the Evaluation of HEP@HOME, a Mobile Outreach Program Targeting People Who Inject Drugs and Who Have Reduced Access to Mainstream Hepatitis C (HCV) Health Services

Author: Rosie Gilliver Caroline James Edmund Silins Anna Doab Nicholas Rich Phillip Read

Theme: Epidemiology & Public Health Research Year: 2022

Looking at new ways to provide HCV testing and treatment for people with reduced access to
mainstream health services, in particular people who inject drugs (PWID), is essential to achieve the
goal of elimination of HCV. Few models of care treat people with HCV in the community without
requiring a visit to a healthcare service.
The Hep@Home program provides assertive testing and treatment close to where people live. The
model utilises the connections between Kirketon Road Centre (KRC) outreach and local community
peers who use drugs. HCV Dried Blood Spot tests are completed and positive results assertively
followed-up by a Clinical Nurse Consultant. Clients meet staff in locations including in parks, the
outreach van or at the doorstep of their home. Medication is delivered free to peoples’ door by a
local peer and non-clinical staff. The evaluation comprises analysis of clinical data and surveys of
participants about linkage to care and barriers to HCV testing and treatment: (1) when returning for
a negative result, (2) being assessed for HCV treatment, and, (3) at SVR12.
To February 2022, 37 people have been tested and 20 enrolled in the evaluation. Six people have
commenced treatment, four people have completed treatment and thus far two people achieved
SVR12. Two people found to have advanced liver disease were referred to treatment they otherwise
may not have received. Common barriers to not initiating treatment previously were not feeling sick
(75%), not knowing HCV status (50%) and having other priorities (50%). Recruitment into the
program and evaluation is ongoing.
This innovative and flexible model of care shows promise, offering new opportunities for people who
inject drugs to receive specialist HCV care close to their home or a location of their choosing,
improving access, autonomy, and a new strategy for achieving elimination.
Disclosure of Interest Statement
PR has received research funding from Gilead Sciences, as well as institutional and individual
honoraria from Gilead Sciences, Abbvie and MSD.

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