Developing an Integrated Hepatitis C Care and Treatment Model in a Community Based Clinical Setting

Treatment readiness is a crucial component in eradicating the adverse impact of Hepatitis C on the mono-infected and co-infected (HIV/AIDS) communities and beyond. Disparately affecting African Americans, often the steps to initiate treatment proves to be a tedious process; from readiness assessments to education and completing preliminary medical appointments and labs. Current HCV surveillance data shows an increase in both incidence and prevalence, occurring more rapidly and debilitating amongst those co-infected. Theories show through the use of the patient navigation (PN) model in a clinical setting, both patients and providers self-efficacy are enhanced making it more likely for them to become and remain engaged through treatment completion. Because of the complexities of needs of mono-infected and HIV/HCV co-infected clients, integrated care provides maximum benefit for this population. At Harlem United this integrated care includes linkage to care, patient navigation for primary care and support services, developed curriculum based education and peer-led support groups, in addition to personalized care and treatment plans all supported by an interdisciplinary team. Since integrating the patient navigation model within the Hepatitis C program, treatment completion rates for those who test positive and are connected to care has increased from 7% (2013) to 25% (2014). To support the proposed model, a qualitative analysis should be performed to assess the model and indicators of client’s willingness to progress in care. Such research could further give insight to clinics’ capacity to engage, retain and treat clients with HCV and inform future model modifications.