%0 Journal Article
%T Successful Integration of Hepatitis C Virus Point-of-Care Tests into the Denver Metro Health Clinic
%A A. Jewett
%A A. A. Al-Tayyib
%A L. Ginnett
%A B. D. Smith
%J AIDS Research and Treatment
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/528904
%X Background. The Centers for Disease Control and Prevention (CDC) recommends testing and linkage to care for persons most likely infected with hepatitis C virus (HCV), including persons with human immunodeficiency virus. We explored facilitators and barriers to integrating HCV point-of-care (POC) testing into standard operations at an urban STD clinic. Methods. The OraQuick HCV rapid antibody test was integrated at the Denver Metro Health Clinic (DMHC). All clients with at least one risk factor were offered the POC test. Research staff conducted interviews with clients (three HCV positive and nine HCV negative). Focus groups were conducted with triage staff, providers, and linkage-to-care counselors. Results. Clients were pleased with the ease of use and rapid return of results from the HCV POC test. Integrating the test into this setting required more time but was not overly burdensome. While counseling messages were clear to staff, clients retained little knowledge of hepatitis C infection or factors related to risk. Barriers to integrating the HCV POC test into clinic operations were loss to follow-up and access to care. Conclusion. DMHC successfully integrated HCV POC testing and piloted a HCV linkage-to-care program. Providing testing opportunities at STD clinics could increase identification of persons with HCV infection. 1. Background Chronic hepatitis C virus (HCV) infection affects 3.2 million persons in the US [1] and approximately 45%¨C85% of infected persons are unaware of their infection [2]. The Centers for Disease Control and Prevention (CDC) recommends HCV testing for those persons born during 1945¨C1965 [2] and those most likely to be infected with HCV [3], including persons with human immunodeficiency virus (HIV) [4, 5]. Persons with HIV are disproportionately affected, with 25%¨C30% of HIV-infected persons being coinfected with HCV [6]. The CDC further recommends linkage to care (LTC) and treatment as appropriate for individuals with confirmed infection. Sexually transmitted disease (STD) clinics are examples of integrated healthcare facilities that provide a broad range of healthcare services (i.e., screening and testing, linkage to care) to clients in need of insurance assistance, charitable care, and/or anonymity. CDC¡¯s 2010 STD treatment guidelines recommend routine HCV testing of HIV-infected persons [7]. This recommendation suggests that clinics that reach persons at high risk for HIV infection may also reach HCV-infected persons. Prior to the CDC recommendation, one study from the mid-2000s showed only 54% of HIV-infected clients
%U http://www.hindawi.com/journals/art/2013/528904/