Building a Community - Academic Partnership to Enhance Hepatitis C Virus Screening

Abstract

Background An estimated 3.5 million Americans are chronically infected with hepatitis C virus (HCV). However, the majority are unaware of their HCV diagnosis and few are treated. New models are required to diagnose and link HCV infected patients to HCV care. This paper describes an innovative partnership between Sisters Together and Reaching (STAR), Inc., a community organization, and Johns Hopkins University (JHU), an academic institution, for the identification of HCV cases. Methods STAR and JHU identified a mutual interest in increasing hepatitis C screening efforts and launched an HCV screening program which was designed to enhance STAR's existing HIV efforts. STAR and JHU used the Bergen Model of Collaborative Functioning as theoretical framework for the partnership. We used descriptive statistics to characterize the study population and correlates of HCV antibody positivity were reported in univariable/multivariable logistic regression. Results From July 2014 to June 2015, 325 rapid HCV antibody tests were performed in community settings with 49 (15%) positive HCV antibody tests. 33 of the 49 HCV antibody positive individuals answered questions about their HCV testing history and 42% reported a prior positive result but were not engaged in care and 58% reported that they were unaware of their HCV status. In multivariable analysis, factors that were significantly associated with screening HCV antibody positive were increasing age (AOR: 1.06, 95% CI 1.02-1.10), male sex (AOR: 5.56, 95% CI 1.92-14.29), and history of injection drug use (AOR: 39.3, 95% CI 15.20-101.49). Conclusions The community-academic partnership was successful in identifying individuals with hepatitis C infection through a synergistic collaboration. The program data suggests that community screening may improve the hepatitis C care continuum by identifying individuals unaware of their HCV status or aware of their HCV status but not engaged in care and linking them to care.

Strategies for the Elimination of Hepatitis C Virus Infection as a Public Health Threat in the United States

“…Innovative public health-academic partnerships also may be valuable at improving HCV screening and can combine the technical and clinical expertise of an academic institution with the strong local engagement of a community organization to ensure thorough follow-up for newly identified chronic HCV-infected patients. In one such partnership, collaborators at Johns Hopkins University School of Medicine engaged with a community organization in Baltimore, MD called Sisters Together and Reaching (STAR), Inc. to screen PWID at community events, drug treatment centers, and homeless shelters [19]. This effort led to the identification of 49 (15%; n=325) HCV antibody-positive individuals.…”

“…This effort led to the identification of 49 (15%; n=325) HCV antibody-positive individuals. Case management personnel worked to confirm chronic HCV infection, obtain health insurance (if not previously acquired), facilitate referral for HCV treatment, and ensure adherence to medical visits [19].…”

An Education and Field Experience Program to Increase Detection of Human Immunodeficiency Virus and Hepatitis C Virus

“…The program aims to increase HIV and HCV testing in at-risk populations in collaboration with Johns Hopkins associated programs and community partners. (13) This paper describes the development of Generation Tomorrow along with program data from October 2013-May 2015.…”