Jewett A, Al-Tayyib A A, Ginnett L, Smith B D
Oak Ridge Institute for Science and Education, 1600 Clifton Road, MS C-01, Atlanta, GA 30333, USA.
Denver Public Health, Denver, CO 80204, USA ; Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA.
AIDS Res Treat. 2013;2013:528904. doi: 10.1155/2013/528904. Epub 2013 Dec 22.
Background. The Centers for Disease Control and Prevention (CDC) recommends testing and linkage to care for persons most likely infected with hepatitis C virus (HCV), including persons with human immunodeficiency virus. We explored facilitators and barriers to integrating HCV point-of-care (POC) testing into standard operations at an urban STD clinic. Methods. The OraQuick HCV rapid antibody test was integrated at the Denver Metro Health Clinic (DMHC). All clients with at least one risk factor were offered the POC test. Research staff conducted interviews with clients (three HCV positive and nine HCV negative). Focus groups were conducted with triage staff, providers, and linkage-to-care counselors. Results. Clients were pleased with the ease of use and rapid return of results from the HCV POC test. Integrating the test into this setting required more time but was not overly burdensome. While counseling messages were clear to staff, clients retained little knowledge of hepatitis C infection or factors related to risk. Barriers to integrating the HCV POC test into clinic operations were loss to follow-up and access to care. Conclusion. DMHC successfully integrated HCV POC testing and piloted a HCV linkage-to-care program. Providing testing opportunities at STD clinics could increase identification of persons with HCV infection.
背景。美国疾病控制与预防中心（CDC）建议对最有可能感染丙型肝炎病毒（HCV）的人群进行检测并提供治疗衔接服务，包括感染人类免疫缺陷病毒的人群。我们探讨了在一家城市性传播疾病诊所将HCV即时检测（POC）纳入标准操作流程的促进因素和障碍。方法。在丹佛地铁健康诊所（DMHC）采用了奥然快检HCV快速抗体检测。为所有至少有一项风险因素的客户提供POC检测。研究人员对客户（3名HCV阳性和9名HCV阴性）进行了访谈。对分诊人员、医护人员和治疗衔接顾问进行了焦点小组访谈。结果。客户对HCV POC检测的易用性和快速出结果感到满意。将该检测纳入此环境需要更多时间，但负担并不过重。虽然咨询信息对工作人员来说很明确，但客户对丙型肝炎感染或相关风险因素了解甚少。将HCV POC检测纳入诊所操作流程的障碍是失访和获得治疗的机会。结论。DMHC成功地将HCV POC检测纳入其中，并试点了一项HCV治疗衔接计划。在性传播疾病诊所提供检测机会可以增加HCV感染者的识别率。
