Integrating HCV services for drug users: a model to improve engagement and outcomes

Although the majority of prevalent and incident cases of hepatitis C are related to injection drug use, drug users often find it difficult to access treatment services because of concerns about adherence and treatment candidacy. In response to the growing epidemic, OASIS, a nonprofit community clinic, developed a successful peer-based HCV group that allowed us to engage, educate, test, and treat hepatitis C in large numbers of drug users, the majority of whom have multiple potential barriers to intervention. Integrating services for hepatitis C, addiction, mental health, and psychosocial problems, the model involves a collaboration of medical providers and peer educators and incorporates elements of other proven behavioural models, including self-help groups, therapeutic communities, and peer interventions. Our results indicate that this peer-based model is successful at engaging, educating, and treating a diverse spectrum of chaotic drug users. We conclude that an integrated, peer-based approach to intervention can engage even the most challenging addicted patients with hepatitis C, and can facilitate their successful screening and treatment.