Theme: Clinical Research Year: 2019
Background: Hepatitis C (HCV) elimination strategies call for task shifting to expand the range and
reach of where and who delivers testing. The objective of this study was to evaluate whether pointof-care (POC) antibody testing by outreach workers with lived experience of HCV could improve
knowledge of HCV status among people at risk that are not well connected to mainstream health
care access points.
Methods: 11 current/former clients of a community-based HCV treatment program were hired,
trained and supported to act as Outreach Workers (OW), to deliver HCV education and POC antibody
testing. Participants were recruited from OWs own personal networks and in non-health care
settings. Eligibility required a history of injection drug use and no prior knowledge of HCV antibody
status. Participants were randomized 1:1 to receive immediate point-of-care antibody testing or
testing as usual (referral to health centre HCV nurses). OWs also administered brief sociodemographic questionnaires.
Results: Of 380 participants, 68% were male with an average age 42.7 years. 54% had unstable/no
housing and 65% had injected drugs in the past month. 61% had never been tested for HCV and 10%
did not know if they had been tested. Of those who had been previously tested, 37% had only been
tested in prison/jail. Of the 195 who received POC, 39% tested antibody positive. Of the 185
referred to the program for testing only 8 engaged in antibody testing through the health centre
Conclusion: Utilizing point-of-care testing by outreach workers with lived experience of HCV allowed
for engagement with highly marginalized, at risk individuals, the majority of whom had not yet been
tested. This approach improved the proportion of clients who received antibody status knowledge
compared to the traditional approach of referral for phlebotomy.
Disclosure of Interest Statement: Nothing to declare