Publications & Reports

Community-based, point-of-care hepatitis C testing: perspectives and preferences of people who inject drugs.

Latham NH, Pedrana A, Doyle JS, Howell J, Williams B, Higgs P, Thompson AJ, Hellard ME
Burnet Institute, and Monash University, 85 Commercial Rd, Melbourne, VIC, 3004, AUSTRALIA.

Abstract

A barrier to hepatitis C treatment for people who inject drugs (PWID) is needing to attend multiple appointments for diagnosis. Point-of-care hepatitis C tests provide results within 20 to 105 minutes and can be offered opportunistically in non-clinical settings such as needle syringe programs. In this nested qualitative study we explored the acceptability of point of care testing for PWID. PWID attending participating needle substitution programmes were screened using the OraQuick HCV antibody mouth swab (result in 20 minutes); those with a reactive result then underwent venepuncture for a point of care RNA test: the Xpert HCV Viral Load (result in 105 minutes). Convenience sampling was used to select participants for a semi-structured interview. A hybrid thematic analysis was performed, guided by Sekhon’s ‘Theoretical Framework of Acceptability’. Nineteen participants were interviewed. Three core themes emerged: people and place, method of specimen collection, and rapidity of result return. It was highly acceptable to be offered testing at the needle substitution programmes by nurses and programme workers, who were described as competent and non-judgmental. Most participants reported that even if a finger stick point of care RNA test were an option in the future, they would prefer venepuncture, as the sample could be used for pre-treatment workup and bundled testing. Waiting 20 minutes to receive the antibody test result was acceptable, whereas the 105 minutes required for the RNA result was unacceptable. Offering point of care hepatitis C testing at needle substituion programmes is acceptable to PWID and tests that avoid venepuncture are not necessarily the most attractive to PWID. This article is protected by copyright. All rights reserved.