Theme: Epidemiology & Public Health Research Year: 2024
Background: Harm reduction programs for active drug users and people experiencing homelessness are essential to achieve good clinical outcomes and public health goals. Infectious diseases (ID) represent burdensome conditions in this setting. The Mobile Outreach Program (MOP) managed by Ares do Pinhal places significant efforts on screening, diagnosis, and treatment initiation. It has identified a growing influx of migrants, namely from Asia, that add to the complexity of disease management.
Methods: All users provide written informed consent to allow access to individual medical records. Given the importance of screening for ID in the MOP strategy, users perform rapid tests and RNA testing for HCV at the MOP -for those with AbHCV reactive. In the case of positive RNA results, users are referred to the hospital for treatment initiation and management. Since blood samples were collected at the MOP, as well as testing, diagnosis, and treatment initiation are now swifter.
Results: From the overall population of users in both 2021 (n = 1762) and 2023 (n = 1777), Asian migrants have increased from 12% to 16%. In January 2024, 138 migrants were tested for IDs, of which 33% had AbHCV+ -62% with active disease-, 5% had HIV, and 2% with HBV. In 2021, 11% had AbHCV+ -40% with active disease-, 2% HBV, and 1% HIV. All migrants were naïve to ID treatment.
Discussion/Conclusions:
The influx of Migrant users added to the management complexity, underlined by the poor living standards, and language and cultural barriers. These results show the need to adapt traditional strategies to ensure proper management. The swifter diagnosis and treatment initiation decrease dropouts, improve clinical outcomes, and reduce the overall burden on the Portuguese NHS. However, as the prevalence and incidence of HCV decreased in Portuguese users, it has surged in Asian Migrants. The MOP should continue to pursue its overarching goal of increasing all relevant stakeholders involvement.
Disclosure of Interest Statement:
The authors declare no conflicts of interest.