Theme: Models of Care Year: 2018
Background: HCV prevalence among drugs users (DUs) remains high. Screening and treatment can be difficult for the most vulnerable and precarious DUs, especially migrants and refugees, with bad life conditions and little or no knowledge of the French health system. Our goal was to provide a comprehensive harm reduction approach to promote facilitated access to HCV diagnosis and treatment among hard to reach DUs. Description of model of care/intervention: A team of nurses and social workers was organized as a mobile and fix unit to reach out to vulnerable drug users to provide harm reduction services. The goal was to set a comprehensive approach that covers rapid testing, full blood test (if positive), Fibroscan measure, hepatologist consultation in the addiction clinic, AAD treatment initiation and follow up in an outreach setting. Considering the difficulties for DUs to enter treatment, each step is closely monitored by the mobile unit in collaboration with addiction and infectious disease clinics, office-based general practitioners and nurses, social services. Effectiveness: Between January 2012 and April 2018, 550 HCV rapid tests were done both in the addiction clinic and in the mobile units. 30 tested HCV and 1 HCV+/HIV+). Among these 28 HCV positive rapid tests, 15 already knew their serology and 13 did not. The poster presentation will focus on the treated patients. Conclusion and next steps: This integrated outreach approach for screening and treating HCV seems to be a good way to initiate and/or avoid care interruptions that could lead to reinfections. Reinfection prevention is a major issue among the most vulnerable DUs. Disclosure of interest statement: The conference collaborators recognize the considerable contribution that industry partners make to professional and research activities. We also recognize the need for transparency of disclosure of potential conflicts of interest by acknowledging these relationships in publications and presentations.
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