A Testing Campaign Intervention Consisting of Peer-Facilitated Engagement, Point-of-Care HCV RNA Testing, and Linkage to Nursing Support to Enhance Hepatitis C Treatment Uptake among People Who Inject Drugs: The ETHOS Engage Study
Anna Conway,
Heather Valerio,
Maryam Alavi,
David Silk,
Carla Treloar,
Behzad Hajarizadeh,
Alison D. Marshall,
Marianne Martinello,
Andrew Milat,
Adrian Dunlop,
Carolyn Murray,
Bianca Prain,
Charles Henderson,
Janaki Amin,
Phillip Read,
Pip Marks,
Louisa Degenhardt,
Jeremy Hayllar,
David Reid,
Carla Gorton,
Thao Lam,
Michael Christmass,
Alexandra Wade,
Mark Montebello,
Gregory J. Dore,
Jason Grebely
Affiliations
Anna Conway
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Heather Valerio
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Maryam Alavi
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
David Silk
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Carla Treloar
Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia
Behzad Hajarizadeh
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Alison D. Marshall
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Marianne Martinello
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Andrew Milat
Centre for Epidemiology and Evidence, NSW Health, Sydney, NSW 2065, Australia
Adrian Dunlop
Hepatitis NSW, Surry Hills, NSW 2010, Australia
Carolyn Murray
Population Health Strategy & Performance, NSW Health, Sydney, NSW 2065, Australia
Bianca Prain
Population Health Strategy & Performance, NSW Health, Sydney, NSW 2065, Australia
Charles Henderson
NSW Users and AIDS Association, Surry Hills, NSW 2010, Australia
Janaki Amin
Department of Health Systems and Populations, Macquarie University, Sydney, NSW 2109, Australia
Phillip Read
Kirketon Road Centre, Sydney, NSW 2010, Australia
Pip Marks
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Louisa Degenhardt
National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW 2052, Australia
Jeremy Hayllar
Alcohol and Drug Service, Metro North Mental Health, Metro North Hospital and Health Service, Brisbane, QLD 4029, Australia
David Reid
Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, NSW 2500, Australia
Carla Gorton
Cairns Sexual Health Service, Cairns, QLD 4870, Australia
Thao Lam
Drug Health, Western Sydney Local Health District, Sydney, NSW 2145, Australia
Michael Christmass
Next Step Community Alcohol and Drug Service, Perth, WA 6004, Australia
Alexandra Wade
Mid North Coast Liver Clinic, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia
Mark Montebello
North Sydney Local Health District, Sydney, NSW 2077, Australia
Gregory J. Dore
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
Jason Grebely
The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
This study evaluated HCV treatment initiation among people who inject drugs (PWID) following an intervention of campaign days involving peer connection, point-of-care HCV RNA testing, and linkage to nursing support. ETHOS Engage is an observational cohort study of PWID attending 25 drug treatment clinics and needle and syringe programs in Australia (May 2018–September 2019). Point-of-care results were provided to the nurse, facilitating confirmatory testing and treatment. The study aimed to evaluate treatment uptake and factors associated with treatment at 24 months post-enrolment. There were 317 people with current HCV infection and eligible for treatment (median age 43, 65% male, 15% homeless, 69% receiving opioid agonist treatment, 70% injected in last month). Overall, 15% (47/317), 27% (85/317), 38% (120/317), and 49% (155/317) of people with current HCV infection had initiated treatment at 3-, 6-, 12-, and 24-months following testing, respectively. Homelessness (adjusted hazard ratio (aHR): 0.40; 95% confidence interval: 0.23, 0.71) and incarceration in the past 12 months (vs. never, aHR:0.46; 0.28, 0.76) were associated with decreased treatment initiation in the 24 months post-enrolment. This testing campaign intervention facilitated HCV treatment uptake among PWID. Further interventions are needed to achieve HCV elimination among people experiencing homelessness or incarceration.
