Point-of-care rapid testing for hepatitis C antibodies at New Zealand needle exchanges

The study's principal aim was to ascertain the viability of point-of-care rapid testing for hepatitis C (HCV) antibodies by non-clinician frontline peer needle exchange staff. Secondary aims included identifying HCV-exposed clients, improving their access to treatment, assessing their knowledge of HCV and strengthening client-staff relationships.

Peer staff at three South Island needle exchange services (two urban, one mobile) were trained to administer point-of-care rapid HCV antibody tests, to clients, with finger-stick blood sampling, along with a short self-report questionnaire. Clients testing HCV antibody positive were offered on-site venepuncture by clinical staff, to confirm reactive rapid test results.

Two hundred and four people were tested across the three sites. Of these, 131 (64.2%) tested HCV antibody positive (reactive) and by the study's conclusion confirmatory venepuncture testing (n=55) had produced 14 new diagnoses and seven people had commenced treatment. Additionally, the study successfully assessed clients' previous HCV testing rates and their knowledge of test results. Through the interactions involved in testing participants, needle exchange staff reported strengthened relationships with clients.

This study demonstrated the viability of administering rapid point-of-care HCV antibody tests to needle exchange clients by non-clinician frontline peer staff. The efficacy of point-of-care testing and its appropriateness for use in this context to identify HCV-exposed needle exchange clients was demonstrated by the high proportion of participants receiving a reactive result, the identification of viremic clients and their support into treatment.