Background: Vancouver's Downtown Eastside (DTES) faces the interrelated challenges of poverty, homelessness, mental health, addiction, and medical issues such as hepatitis C virus (HCV). This study evaluates a new model of engagement with people who inject drugs (PWID) in the DTES. Methods: Our centre has developed the community pop-up clinic (CPC) to engage vulnerable populations such as PWID. Rapid HCV testing is offered using the OraQuick saliva assay. If a test is positive, immediate medical consultation and an incentivized clinic appointment are offered. At this appointment, an HCV treatment plan is developed, along with a plan for engagement in multidisciplinary care. Results: In 12 months, 1,283 OraQuick tests were performed at 44 CPCs; 21% of individuals were found to be positive for HCV (68% of whom were PWID). Of individuals positive for HCV antibodies who consulted with the on-site doctor, 50% engaged in care in our clinic-61% of whom have initiated interferon-free directly acting antiviral (DAA) HCV therapy with 100% cured of HCV (per protocol). Individuals who did not engage in care were significantly more likely to be homeless (P < .0001). Conclusion: CPCs paired with a multidisciplinary model of care address the needs of vulnerable populations such as PWID, particularly in the management of HCV with interferon-free DAA therapies.
Background: Vancouver's Downtown Eastside (DTES) faces the interrelated challenges of poverty, homelessness, mental health, addiction, and medical issues such as hepatitis C virus (HCV). This study evaluates a new model of engagement with people who inject drugs (PWID) in the DTES. Methods: Our centre has developed the community pop-up clinic (CPC) to engage vulnerable populations such as PWID. Rapid HCV testing is offered using the OraQuick saliva assay. If a test is positive, immediate medical consultation and an incentivized clinic appointment are offered. At this appointment, an HCV treatment plan is developed, along with a plan for engagement in multidisciplinary care. Results: In 12 months, 1,283 OraQuick tests were performed at 44 CPCs; 21% of individuals were found to be positive for HCV (68% of whom were PWID). Of individuals positive for HCV antibodies who consulted with the on-site doctor, 50% engaged in care in our clinic-61% of whom have initiated interferon-free directly acting antiviral (DAA) HCV therapy with 100% cured of HCV (per protocol). Individuals who did not engage in care were significantly more likely to be homeless (P < .0001). Conclusion: CPCs paired with a multidisciplinary model of care address the needs of vulnerable populations such as PWID, particularly in the management of HCV with interferon-free DAA therapies.
Authors: Alyona Mazhnaya; Anna Meteliuk; Tetiana Barnard; Alexei Zelenev; Sergii Filippovych; Frederick L Altice Journal: Int J Drug Policy Date: 2017-08-12
Authors: Thomas P Giordano; Allen L Gifford; A Clinton White; Maria E Suarez-Almazor; Linda Rabeneck; Christine Hartman; Lisa I Backus; Larry A Mole; Robert O Morgan Journal: Clin Infect Dis Date: 2007-04-23 Impact factor: 9.079
Authors: Edward R Cachay; Lucas Hill; David Wyles; Bradford Colwell; Craig Ballard; Francesca Torriani; William C Mathews Journal: PLoS One Date: 2014-07-18 Impact factor: 3.240
Authors: Louisa Degenhardt; Amy Peacock; Samantha Colledge; Janni Leung; Jason Grebely; Peter Vickerman; Jack Stone; Evan B Cunningham; Adam Trickey; Kostyantyn Dumchev; Michael Lynskey; Paul Griffiths; Richard P Mattick; Matthew Hickman; Sarah Larney Journal: Lancet Glob Health Date: 2017-10-23 Impact factor: 26.763