Optimizing Community-Based Hepatitis B and C Care for Engaging Housing-Insecure Individuals

Area of Science:

• Public Health
• Infectious Diseases
• Health Equity

Background:

• Hepatitis B and C (HBV/HCV) disproportionately affect individuals with substance use histories and homelessness.
• Engaging these high-risk populations for HBV/HCV testing and treatment presents significant challenges.

Purpose of the Study:

• To describe a community-based approach (GRASSROOTS HEALTH) for HBV/HCV prevention and treatment.
• To compare the effectiveness of various engagement site types in reaching and engaging this high-need population.

Main Methods:

• A retrospective observational study analyzing data from GRASSROOTS HEALTH, launched in 2018.
• Services included on-site testing, HBV vaccination, treatment navigation, and adherence support across diverse housing and drop-in centers.
• Outcomes were tracked via REDCap and analyzed by engagement site.

Main Results:

• Nearly 2000 clients were reached through the GRASSROOTS HEALTH program.
• Drop-in centers showed the greatest need for HCV treatment, while low-income/supportive housing sites had the highest demand for HBV vaccination.
• All engagement sites demonstrated a high return on effort regarding participant needs for HBV vaccination and HCV/HBV treatment.

Conclusions:

• Community-based engagement through housing and service centers is effective in reaching high-need populations for HBV/HCV services.
• Tailoring engagement strategies to specific site types may optimize outreach for distinct needs, such as HCV treatment versus HBV vaccination.