305655
Routinizing HIV and HCV Testing Using an Innovative, Scalable Dual Testing Model
Methods/Issues: Despite shared risk factors and 30% seropositivity of HIV and HCV co-infection, testing rates are low and people are often diagnosed with either disease after downstream health effects have already developed. Therefore, we routinized HIV and HCV testing using a lab-based model with EMR modifications to prompt, track, and facilitate reimbursement at five FQHCs. Medical Assistants initiate testing and draw reflex tests. Health centers started HCV testing October 2012. Patients tested have traditional risk factors, are born between 1945 and1965 or have been homeless. Health centers integrated opt-out HIV testing into the HCV testing model in September 2013. Patients tested are 13 years or older without a previous HIV diagnosis. A patient navigator facilitates the transition to and retention in specialist care.
Results: October 1, 2012 to September 30, 2013, 2438 patients were HCV tested and had an 8.3% overall seropositivity, 91.1% received RNA tests and 63.2% had chronic infections. September 1, 2013 to December 31, 2013, 2030 HIV reflex tests were performed and identified 5 new cases of HIV including the first acute case diagnosed in a primary care setting.
Conclusions: The dual testing is sustainable and replicable. Acute HIV can be diagnosed in a primary care setting. Bundling tests increases number of tests performed and diagnoses new HCV cases without known risk factors. HCV reflex test ensures RNA testing and linkage to care.
Learning Areas:
Conduct evaluation related to programs, research, and other areas of practiceEpidemiology
Other professions or practice related to public health
Protection of the public in relation to communicable diseases including prevention or control
Public health or related nursing
Public health or related research
Learning Objectives:
Design a routine screening model for community health centers;
Evaluate the effectiveness of different HIV and HCV testing models;
Identify key components of a successful testing model;
Evaluate HCV epidemiology among and FQHC population.
Keyword(s): Community Health Centers, Hepatitis C
Qualified on the content I am responsible for because: I designed, run and coordinate the dual testing program at 5 FQHCs in Philadelphia, PA being discussed. The model was developed from federal and industry funded grants targeting HCV and HIV testing, respectively. The program will soon to be replicated in other health centers in high-risk HIV areas, which I will oversee, implement and manage. My scientific interests include infectious diseases, practice and evidence-based research, epidemiology, preventative medicine and population-based interventions.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.