TY - JOUR
T1 - Using database linkages to monitor the continuum of care for hepatitis C virus among syringe exchange clients
T2 - Experience from a pilot intervention
AU - Hochstatter, Karli R.
AU - Hull, Shawnika J.
AU - Stockman, Lauren J.
AU - Stephens, Laura K.
AU - Olson-Streed, Heidi K.
AU - Ehlenbach, William J.
AU - Repplinger, Michael D.
AU - Jacobs, Elizabeth A.
AU - Westergaard, Ryan P.
N1 - Publisher Copyright: © 2016 Elsevier B.V.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background Because many people who inject drugs (PWID) are at high risk of hepatitis C virus (HCV) and have poor access to medical care, many HCV-infected PWID remain undiagnosed and unaccounted for in surveillance systems. Syringe exchange programs (SEPs) are an under-utilized resource for collecting information missing from surveillance systems. Partnerships with public health agencies represent a potentially innovative approach to studying the HCV epidemic for PWID. The goal of this study was to characterize the HCV care continuum for a cohort of PWID using database linkages. Methods Data needed to describe the HCV care continuum for 235 PWID were collected from surveillance data provided by the Wisconsin Division of Public Health, a computerized survey administered by SEP staff, and a follow-up interview delivered by academic research staff. When possible, we attempted to confirm each individual's position in the HCV care continuum with at least 2 of the 3 data sources. Results Participants ranged in age from 18–63 years, 60% self-identified as non-Hispanic white, and 77% were male. Overall, we determined that 208 (89%) of the 235 participants had ever been tested for HCV and 72 (31%) had ever tested positive. Of those 72, 46 (64%) had been linked to care, 14 (19%) received pre-treatment evaluation, and 4 (6%) reported initiating treatment. Confirmation by at least 2 data sources ranged from 14–57% of cases for each stage of HCV care. Conclusion Available data sources show a large degree of variability when used to characterize the HCV care continuum. New strategies to enhance the quality and completeness of these data sources could substantially improve ongoing efforts to monitor the HCV care continuum among PWID.
AB - Background Because many people who inject drugs (PWID) are at high risk of hepatitis C virus (HCV) and have poor access to medical care, many HCV-infected PWID remain undiagnosed and unaccounted for in surveillance systems. Syringe exchange programs (SEPs) are an under-utilized resource for collecting information missing from surveillance systems. Partnerships with public health agencies represent a potentially innovative approach to studying the HCV epidemic for PWID. The goal of this study was to characterize the HCV care continuum for a cohort of PWID using database linkages. Methods Data needed to describe the HCV care continuum for 235 PWID were collected from surveillance data provided by the Wisconsin Division of Public Health, a computerized survey administered by SEP staff, and a follow-up interview delivered by academic research staff. When possible, we attempted to confirm each individual's position in the HCV care continuum with at least 2 of the 3 data sources. Results Participants ranged in age from 18–63 years, 60% self-identified as non-Hispanic white, and 77% were male. Overall, we determined that 208 (89%) of the 235 participants had ever been tested for HCV and 72 (31%) had ever tested positive. Of those 72, 46 (64%) had been linked to care, 14 (19%) received pre-treatment evaluation, and 4 (6%) reported initiating treatment. Confirmation by at least 2 data sources ranged from 14–57% of cases for each stage of HCV care. Conclusion Available data sources show a large degree of variability when used to characterize the HCV care continuum. New strategies to enhance the quality and completeness of these data sources could substantially improve ongoing efforts to monitor the HCV care continuum among PWID.
KW - Hepatitis C virus
KW - Surveillance
KW - Syringe exchange program
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U2 - 10.1016/j.drugpo.2016.12.006
DO - 10.1016/j.drugpo.2016.12.006
M3 - Article
C2 - 28126684
SN - 0955-3959
VL - 42
SP - 22
EP - 25
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
ER -