Optimizing Community-Based Hepatitis B and C Care for Engaging Housing-Insecure Individuals.

Abstract

IntroductionHepatitis B and C (HBV/HCV) are bloodborne infections, with individuals who have histories of substance use and homelessness bearing a disproportionate risk. Long-standing difficulties in engaging these populations have made testing and treatment challenging. This retrospective observational study describes a community-based approach to HBV/HCV prevention and treatment, comparing the effectiveness of different engagement site types in reaching and engaging this high-need population.MethodsGRASSROOTS HEALTH was launched in 2018 to improve HBV/HCV care by providing on-site testing, HBV vaccination, treatment navigation, and adherence support across various housing and drop-in centers. Outcomes were tracked through REDCap and analyzed by engagement site.ResultsGRASSROOTS HEALTH reached nearly 2000 clients, with the greatest needs for HCV treatment in drop-in centers and HBV vaccination in low-income/permanent supportive housing. All sites demonstrated a relatively high return on effort, as evidenced by the percentage of participants needing HBV vaccination or HCV/HBV treatment.ConclusionEngaging individuals through housing and service centers effectively reached a high-need community, with findings suggesting that different engagement points may enhance outreach based on the primary focus (HCV treatment vs HBV vaccination).