HealthHCV Calls for Increased HCV Testing in Primary and HIV Care Settings Launches “20/20: A Clear Vision for HCV Testing” Initiative Background HealthHCV calls on primary care providers, HIV care providers, and substance use/addictions treatment providers to increase hepatitis C (HCV) testing that follows CDC and USPSTF recommendations by 20% by 2020. Increasing testing and treatment by 20% or more would reduce HCV-related morbidity and mortality by 50% by 2020. HealthHCV’s “20/20: A Clear Vision for HCV Testing” Initiative proposes a clear target to increase testing and diagnosis of HCV in settings serving at risk populations. HCV remains a worldwide epidemic with over 160 million people chronically infected, and 4.7 million infected with HCV in the United States. Baby boomers are five times more likely to have HCV and represent over 75% of Americans with HCV. Additionally, according to the CDC, 25% of people living with HIV in the U.S. are co-infected with HCV and 80% of people with HIV who inject drugs also have HCV. Program Overview The 20/20 HCV screening initiative targets populations at increased risk for HCV infection, such as underserved individuals living in areas with high prevalence of HIV and injection drug/opioid use. HealthHCV will provide onsite training and technical assistance for up to 25 sites in the pilot year, targeting approximately 100 providers, to enhance outreach and education, screening and linkage to care services at sites, such as community health centers, Ryan White HIV/AIDS clinics, and substance use/addictions treatment centers. The cohort of site teams will meet virtually, a minimum of four times, to discuss strategies for identifying at risk individuals, considerations for incorporating screening into daily practice, and practical strategies for linking individuals diagnosed with HCV (including those previously diagnosed or treated) back into the treatment pathway. Patient screening data as well as data on linkage to care will be collected and reported quarterly. Technical assistance activities will address the following readiness issues related to integrating HCV screening and linkage into practices: • Workforce Shortages. The healthcare workforce is facing a wave of retirements and burnout, the impact of which is much greater among health centers and HCV screening, care, and treatment providers given the increase in HCV diagnoses. High proportions of patients living with HCV also have associated comorbidities, such as substance use disorders and HIV, further complicating their care needs. • Skills. Health centers and substance use/addictions treatment centers report that staff have limited skills in HCV screening and linkage in terms of disciplines (e.g. few hepatologists, gastroenterologists, and infectious disease clinicians) and protocols (e.g. awareness of screening guidelines). • Competing Priorities. Health centers are focused on general primary medical care and health issues that are predominant among their service populations (e.g. hypertension, diabetes) as well as pursuing patient-centered medical home recognition and responding to health system changes related to healthcare reform. • Potential to Disrupt Service Flow. Many health centers and substance use/addictions
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treatment centers lack specialty services. These organizations are concerned that care issues such as HCV, HIV, and behavioral health are beyond their organizational capacity to tackle. Stigma: Discomfort Addressing HCV and Substance Use With Patients. Concerns include providers’ lack of comfort with culturally diverse populations, substance use and harm reduction practices, and discussing sexual behavior and sexual orientation.
HealthHCV is partnering with national and international organizations to support viral hepatitis awareness efforts, recognizing the need for many voices to reach communities living with, or at risk for, chronic HCV infection. About HealthHCV As an initiative of HealthHIV, a national non-profit based in Washington, DC, HealthHCV seeks to advance the case for awareness, reform, and education on HCV across all sectors of healthcare. HealthHCV’s purpose is to: advocate for the implementation of sound public health policy responsive to the shifting landscape of viral hepatitis; design and implement medical and consumer education and training programs to address the needs of people living with viral hepatitis; and, conduct health services research that identifies trends across viral hepatitis and the broader health care landscapes. From health systems to primary care providers, consumers, and other related health agencies, HealthHCV continually strives to impact the HCV epidemic through tailored initiatives and programs with national and local impact. For More Information For more information about HealthHCV’s efforts or to obtain the State of HCV CareTM national survey report, please contact Marissa Tonelli, Director of HealthHCV, at marissa@healthhcv.org, 202-507-4726, or visit www.HealthHCV.org.