Using Peer Outreach to Identify Hepatitis C Infections Among Clients of a Syringe Service Program

Area of Science:

• Public Health
• Infectious Diseases
• Addiction Medicine

Background:

• Hepatitis C virus (HCV) infection remains a significant public health concern, particularly among people who inject drugs (PWID).
• Syringe service programs (SSPs) are vital in reaching PWID with harm reduction services, including testing for infectious diseases.
• Increasing HCV testing uptake within this population is crucial for early diagnosis and treatment.

Purpose of the Study:

• To evaluate the effectiveness of a peer-worker-led, van-based hepatitis C testing strategy within an SSP.
• To identify barriers to HCV testing acceptance among clients of syringe service programs.

Main Methods:

• A syringe service program trained peer workers to offer rapid, onsite hepatitis C antibody testing to clients at van-based clinics.
• Data were collected from August 2019–March 2020 and June 2021–March 2022.
• Client consent rates and reasons for refusal were recorded.

Main Results:

• Out of 573 approached clients, only 28 (5%) consented to hepatitis C testing.
• Primary reasons for refusal included prior testing, lack of time, and lack of perceived risk.
• Among the 28 individuals tested, 9 (32%) showed positive results for hepatitis C antibodies.

Conclusions:

• The current peer-worker testing strategy demonstrated low acceptance rates among SSP clients.
• Significant adjustments to the testing approach are necessary to improve engagement and increase hepatitis C screening in this vulnerable population.
• Further research into tailored interventions is warranted to enhance HCV testing uptake among PWID.