Testing and Linkage to Hepatitis C Care From Alternative-to-Incarceration Programs: The Right Place? The Right Time?

Hepatitis C virus (HCV) infections are a leading cause of liver disease and liver cancer in the United States. Due to the intersection of substance use disorders and incarceration, HCV prevalence is far higher among criminal legal system-involved individuals than in the general population. To avoid the harms associated with incarceration, increasing efforts have been made to divert people away from jail and prison. Yet, there are few data on the HCV care cascade among people with HCV engaged in alternative-to-incarceration (ATI) programs. Here we provide background on the history of ATI programs in the United States, highlight the importance of engaging people living with HCV in ATI programs, present case examples of programs that have incorporated HCV-specific services, and discuss potential challenges and solutions to scaling up HCV-related services in ATI programs.