A Healthier Wisconsin

Integration of Hepatitis C Diagnosis and Treatment into a Mobile Harm Reduction Unit

Developing a novel platform for hepatitis C testing and treatment services within mobile harm reduction units

Full Project Name:Integration of Hepatitis C Diagnosis and Treatment into a Mobile Harm Reduction UnitPrimary Community Organization:State of Wisconsin Department of Health Services - Division of Public HealthPrimary Academic Partner:Carol Galletly, PhD, JD, Psychiatry and Behavioral MedicineAward Amount:$164,002
Award Date
Project Duration:18 months

Project Description Narrative:

Hepatitis C virus infection is the prevailing risk factor for hepatocellular carcinoma in the United States. As the most common blood-borne infection, it far outstrips any other reportable infectious disease, excluding COVID-19, in its association with reported deaths. Despite the 2016 World Health Organization's goal to eliminate viral hepatitis as a public health threat by 2030, data from the Viral Hepatitis National Strategic Plan in the United States revealed a 71% national increase in the number of acute infections of hepatitis C from 2014 to 2018.

State public health data in Wisconsin follows this trend in lockstep, with significant increases in the number of acute and total diagnoses, notably in older adolescents and young adults. This increase in cases mirrors an increase in opioid overdose-related deaths in Wisconsin. It is no coincidence that the most prevalent risk factor in new cases of hepatitis C is injection drug use. Opioid use disorder, hepatitis C and HIV represent a syndemic shaped by shared risk factors, social determinants of health, and stigma.

The Viral Hepatitis National Strategic Plan recognizes this syndemic and has determined that people who inject drugs represent a priority population for the diagnosis and treatment of hepatitis C. In the past ten years, direct-acting antiviral therapy (DAAT) has made hepatitis C an eminently curable disease. However, people who inject drugs have difficulty navigating traditional healthcare systems and facilities.

This project will develop an implementation toolkit to support Wisconsin health departments in integrating services encompassing the hepatitis C care cascade within mobile harm reduction units. Researchers will then evaluate and refine the implementation of the first portions of the care cascade services' integration in a mobile care reduction unit.

This project will ultimately aim to impact health and health equity in Wisconsin by increasing the diagnosis and treatment of hepatitis C in people who inject drugs and creating a novel and sustainable mechanism for hepatitis C care in this population.

Community partners: Wisconsin Department of Health Services, Bureau of Communicable Disease, Department of Harm Reduction; Wisconsin Department of Health Services, Division of Public Health

Outcomes & Lessons Learned:

  • Developed a protocol for rapid point of care hepatitis C antibody testing
  • Conducted interviews with persons who inject drugs to get their feedback on protocol
  • Developed staff interview guide to collect and analyze data in order to refine the protocol

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